Home-based
On rehab unit
In schools
Online
Attention is the foundation for learning with all age groups.
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.
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.
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.
Have a billing or insurance query? Contact me for assistance.
I accept payment via cash, credit/debit cards, and bank transfers for your convenience.
I work with case managers and insurance companies, including Irwin Mitchell, NeuroHealth Case Management, Slater and Gordon and TJB Rehabilitation.
Doctor of philosophy awarded for Home-based neurologic music therapy for arm hemiparesis following stroke.
Read more: https://journals.sagepub.com/doi/pdf/10.1177/0269215517717060
Read more: https://www.tandfonline.com/doi/full/10.1080/08098131.2019.1606848
Health and Care Professions Council ensures competence and professionalism.
British Association of Music Therapy membership for excellence in practice.
qualified (Music Therapy Assessment Tool for Awareness in Disorders of Consciousness)
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
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
Tips and techniques: listening to preferred music and/or audiobooks improves mood and cognitive recovery. See:
'Measuring the effects of listening for leisure on outcome after stroke (MELLO)'
I have been revisiting 'Elevator Music: A Surreal History of Muzak, Easy-Listening and Other Mood Song' by Joseph Lanza, published by quartet books in 1995 - two years before I started my music degree at City University, London. This book introduced me to Brian Eno's sound installations, and compositions including 'Music for Airports' and 'Neroli.' If you are interested in the design and application of music and sound-worlds outside of the commercial world of music industry promotion that, in the west, we are all accustomed to, then it's well worth a read.
Today's developments, where music streaming services have various 'mood' functions, and companies are developing machine learning algorithms to match music to biophysiological data in order to maintain or adjust mood and arousal, are certainly more bespoke to individual needs. But Lanza reports the entire history of easy-listening, with 'Lite FM,' 'Beautiful Music,' 'Mood Music,' all being broadcast on FM radio, generating huge profits and stimulating listeners across the US. Some complained about the instrumental versions of popular tunes that were specially recorded for broadcast, in extreme cases claiming that they contained subliminal messages, or caused them to wallow in memories of failed relationships. One listener - described as 'horny' - claimed that a song played on the station pushed her 'hot button!' and this led to an unsuccessful lawsuit by the complainant against the broadcaster.
Each chapter in the book covers various periods of discovery and development that resulted in new music and ways in which it was used - 'Violins from Space' describes 'synthesized brainscapes' and 'Space Music' that could realign the spine, strengthen the immune system and teach Ukrainian students to speak and read English. The beginning goes back to Greek mythology - the singing sirens and Aeolian harp, leading to the term 'Aeolian Mood.' George Philipp Telemann's challenge to sacred and secular barriers with 'Musique de Table' is mentioned, with the use of simpler melodic lines designed as light, background music. Mozart was commissioned to compose music that would not disturb conversations or digestion. Johann Sebastian Bach was called upon by Count Kaiserling in Dresden to teach his apprentice some clavier pieces that might help with his insomnia. The name of this person was Goldberg - hence, The Goldberg Variations. Personally, I have used both Music for Airports and The Goldberg Variations to help me sleep from time to time over the years.
According to current academic publications and developments within the music industry and health and wellbeing, there is quite a scramble to launch new devices that will deliver the right music for the job at the times when needed. Artificial intelligence is everywhere and, I have observed, various music organisations, including orchestras, are embarking on projects in the community and hospitals to improve mood, wellbeing, etc, to just about every patient population there is. It's not Muzak - or is it? What has changed since all that Joseph Lanza draws our attention to? As my sitar teacher at City once quoted: "In order for things to change, things must stay the same."
Three participants have completed our single case design study: 'The neural mechanisms of a music intervention for chronic arm hemiparesis following stroke: A single case series EEG study.' They received 15 X home-based upper limb training exercises in 3-weeks using specially configured Garageband touchscreen instrument exercises. They underwent pre-/post-EEG in our lab and standard outcome measures in their homes.
This is the first ever case of this intensity of music intervention being delivered in the home anywhere in the world (unless somebody has information I am unaware of).
We published results from the first biomedical music therapy feasibility study in the UK in 2017
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
Did music therapy help with anything else? 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
Copyright © All Rights Reserved