Dr Alexander Street Neurologic Music Therapist

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Neurorehabilitation and neurodevelopment for adults & children

Home-based

On rehab unit

In schools

Online

Attention and other cognitive training

Attention is the foundation for learning with all age groups and essential for neurorehabilitation.

Beat and rhythmic pattern copying exercises train attention, executive function, self-monitoring and error correction, starting with focused and sustained attention and progressing to selective, divided and alternating.

Cognitive training is essential to enable planning and organising used for tasks around the home such as cooking and cleaning, and for navigating the outside world. These exercises help lay the foundations for transitioning into language acquisition and rehabilitation for aphasia and dyspraxia of speech.

Arm, hand and finger rehabilitation

There is a musical instrument or device for every movement and sequence, which can be spatially arranged to meet existing movement range and degree of dexterity and be adjusted as they improve. The equipment provide auditory, visual and tactile feedback and music is used that optimises the priming, timing and smoothness of movement.

Core strength, sit-to-stand & pre-gait exercises are facilitated using a range of instruments and prepare for gait training using rhythmic auditory stimulation. These techniques use the pulse (the beat) of simple, musical compositions to cue movement and improve balance, velocity and stride length. They can be accessed by adults with neurological injury or disease and children with a range of conditions including cerebral palsy.

Walking and mobility training

specialist Music Therapist

Alex Street (PhD, MTDip, BMus)

Specialist Music Therapist in Neurorehabilitation & Neurodevelopment

I am Dr Alex Street, a music therapist dedicated to personalized patient-centred care, with 20-years clinical and 10-years research experience in neurorehabilitation and education settings using music. Working with healthtech companies and healthcare providers is an important part of my work each week, helping to develop new services and technology to improve rehabilitation accesibility and outcomes.

Billing and Insurance Information

Have a billing or insurance query? Contact me for assistance.

Payment Methods

I accept payment via cash, credit/debit cards, and bank transfers for your convenience.

Insurance Partners

I work with case managers and insurance companies, including Irwin Mitchell, NeuroHealth Case Management, Slater and Gordon and TJB Rehabilitation.

Accreditations

PhD

2014

Doctor of philosophy awarded for Home-based neurologic music therapy for arm hemiparesis following stroke: A Feasibility Randomised Controlled Trial.

HCPC Registration AS05574

2004

Health and Care Professions Council ensures competence and professionalism.

BAMT Member

2003

British Association of Music Therapy membership for excellence in practice.

MATADOC

(Music Therapy Assessment Tool for Awareness in Disorders of Consciousness)

Explore resources

Home exercise programs

We can work together to create a weekly program of exercises, including breathing, vocal, cognitive, mobility and hand/arm exercises using tablet and touchscreen instruments

iPads adapted for finger exercises

Using apps such as Garageband and Thumbjam on iPads, it is possible to improve finger dexterity and i can help with configuring these apps. See this article for some details on exercises:

Upper limb rehabilitation in chronic stroke using neurologic music therapy: Two contrasting case studies to inform on treatment delivery and patient suitability: https://doi.org/10.1080/08098131.2019.1606848

Recovery

Tips and techniques: listening to preferred music and/or audiobooks improves mood and cognitive recovery. Some streaming services have a mood function, enabling the selection of playlists based on your previous listening that are compiled under different headings, for example 'energise' or 'relax.' Listening at set times each day, for 20-60 minutes is recommended.

See example of listening for stroke recovery:

'Measuring the effects of listening for leisure on outcome after stroke (MELLO)'

Music listening for stress and anxiety

In myocardial infarction, music listening has been found to reduce heart rate and systolic blood pressure

In Autistic Spectrum Disorder, music listening improves neural connectivity, social communication, parent-child relations

Using music with your child

Singing nursery rhythms and familiar songs is a great shared experience that can also help develop attention and speech. Try holding hands whilst singing and moving in time to the pulse; leaving a gap for your child, for example on the last word of each line; take turns singing a line each, try singing soft and louder.

Turn-taking using instruments also helps with attention and coordination of movement: try using a good quality drum using hands, fingers and mallets or sticks; invest in a half or quarter sized guitar, which is easier to hold and access, use an app to tune it, try an 'open D' tuning, take turns strumming the open strings, model different ways of playing - from soft to loud, fast to slow, pluck individual strings. You can also sing some songs like 'Row your boat' to this open tuning, without the need to change chords.

Latest news and publications

At the Society for Research in Rehabilitation hosted at the University of Essex on 15th January we presented a poster of our upper limb rehabilitation EEG study, sharing progress. Stroke survivors have received 15 sessions in their home in three-weeks, a treatment dosage for these exercises that has not been delivered previously anywhere in the world.

It takes massed practice to make the best possible recovery of arm and hand, and actively playing instruments does the job perfectly: We have been using Garageband (see video clip on this website) for about 10-years now to help brain injury survivors with upper limb hemiparesis recover and use their arm and hand more. There is plenty of research reporting robust evidence from brain imaging and standardised outcome measures that music-based interventions are an effective tool, also improving areas of cognition including verbal memory, as well as mood and reducing fatigue.

We are working to make these exercises for upper limb rehabilitation more accessible to brain injury survivors, their spouse or caregiver and the clinicians working in hospitals, rehab centres and the community.

Below is a video demonstrating how to configure Touchscreen guitar chords for thumb, alternating left then right,

pushing each one up the chord from the bottom of the screen. The sound quality is excellent when connected to an external speaker, such as the JBL Charge 4.

Participants in our study underwent pre-/post-EEG in our lab and standard outcome measures (Action Research Arm Test, 9-hole-peg-test) in their homes.

We published results from the first biomedical music therapy feasibility study in the UK in 2017, which also included these iPad exercises.

Home-based neurologic music therapy for arm hemiparesis following stroke: results from a pilot, feasibility randomized controlled trial

https://journals.sagepub.com/doi/10.1177/0269215517717060

Protocol details are here:

https://pubmed.ncbi.nlm.nih.gov/26441586/

CONFERENCES

At The Neurosciences and Music | VIII13-16 JUNE 2024, Helsinki, Finland & Online we discussed the role of machine learning to aid in delivery of music-based interventions in the community for arm rehabilitation post-stroke. This would be to address the challenges of intervention delivery - insufficient clinicians and time in community rehab - so that larger, multi-site trials can be facilitated, working towards development and implementation of app-based exercises.

The literature from previous research suggests that a reduction from fatigue might result from 1-hour listening to preferred music daily for 6-8-weeks, and that the autonomic nervous system responds to musical emotional arousal, i.e. the right music (tempo, arrangement, etc) can relax, enliven, and everything inbetween.

Discussions with leading figures in neurorehab on the active ingredients of interventions, including music-based ones, at The Sociey for Research in Rehabilitation took place on 29 April 2024

PUBLICATIONS AND BROADCASTS

August 2024: Preferred music listening for people living with dementia: Two home-based case studies discussing compilation process, autobiographical and biophysical responses. In the journal 'Geriatric Nursing.'

https://doi.org/10.1016/j.gerinurse.2024.07.022

BBC World Service: People Fixing the World featuring two participants & Dr Alex Street from the RadioMe for dementia study:

https://www.bbc.co.uk/sounds/play/p0hm9q83 (listen from about 8-minutes)

The Art and Craft of Music Therapy for Stroke Rehabilitation in a Remote North Indian Community: A Case Study

https://voices.no/index.php/voices/article/view/3724

What might an interactive music therapy service bring to the adult intensive care unit? A suggested service based on data from a scoping review

https://doi.org/10.1177/13594575241235126

service user feedback

Did music therapy help with anything else? Yes, movements, mood, coordination

Emma

Inpatient, acute ward

This is an amazing service that needs extending. As the first tool to (name of husband) finding his voice we were thrilled, we continue to sing! Thank you Alex for your support, your fun, relaxed manner helped in difficult times

Anna

Spouse of patient

It made exercises less boring and more interesting. Exercise time passed quickly

Satvik

Inpatient

consultation booking

Get in Touch

07799392838

alexstreetuk@yahoo.com

Sunday: Closed
Monday - Thursday: 09:00 - 19:00
Friday: 09:00 - 17:00
Saturday: Closed

Cambridgeshire Music Therapy