Group singing improves quality of life for people with Parkinson's: an international study.

Objectives: Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson's (PwPs) in Australia, UK and South Korea.Methods: The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson's health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p < .05.Results: ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes.Conclusion: This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson's. The findings are encouraging and warrant further research using more robust designs.

Does the Perception of Own Voice Affect Our Behavior?

This study aimed to investigate what are the factors that influence the perception of one's own voice, and if there are any differences using voice between speaking and singing. Further the study purported to examine how these attitudes affect individuals' vocal behavior in personal and social contexts. A total of 100 participants completed the survey which comprised 23 questions about demographics, music experience, speaking voice, and singing voice. The quantitative data were analyzed by correlations and paired t test. For qualitative analyses, content analysis was conducted. The results revealed an even distribution among negative, neutral, and positive attitudes regarding singing and speaking voices and their effects on vocal behavior. For their negative/positive perceptions of their voices, participants referenced factors related to vocal attributes, personal features, social or external validation, emotional quality of the voice, etc. Lastly, result showed that one's perception of the speaking voice has some influence on behaviors ranging from the personal (expressing oneself) to social (interacting with people) aspects. The findings of this study implies that one's attitude toward one's own voice substantially impacts one's personal, interpersonal and social-presentation.

Nighttime Walking with Music: Does Music Mediate the Influence of Personal Distress on Perceived Safety?

There is growing interest in identifying the environmental factors that contribute to individuals' perceptions of safety and sense of well-being in public spaces. As such, this study examined how music listening during nighttime walking influenced female university students' psychological state and perceptions of their campus. A total of 178 female university students with a mean age of 23.0 years participated in this study. One group of 78 students listened to prerecorded music while walking across their campus at night, while the other 100 students did not listen to music during nighttime walking. Immediately following their nighttime walking, participants were asked to rate their psychological state, perceptions on the safety of their campus, and the music (only for the music-listening group). For the non-music-listening group, significant correlations were found between the perceived safety of the campus and psychological states (both anxiety and psychological distress); the correlations were not significant in the music-listening group. The results indicate that music can mediate psychological states, supporting the proactive use of music as a psychological resource for coping with their perceptions of adverse environments. Given the limitations of this preliminary study, further studies with controlled music listening conditions, type of music, and environmental issues are suggested.

Differential Background Music as Attentional Resources Interacting with Cognitive Control.

We examined the effects of background music on cognitive task performances using different musical arrangements from an excerpt of Mozart's Piano Sonata K.448. The participants were 126 university students: 70 music majors and 56 nonmusic majors. Three types of musical arrangements were used as background conditions: rhythm-only, melody, and original music conditions. Participants were asked to perform cognitive tasks in the presence of each music condition. The participants' percentage of completed items and accuracy on these tasks were compared for music and nonmusic majors, controlling for the effect of perceived level of arousal and their performance during no background music. Whether a participant's perceptions of background music predicted their cognitive performance was also analyzed. We found that music majors demonstrated decreased task performance for the original background condition, while nonmusic majors demonstrated no significant differences in performance across the arrangements. When pitch or rhythm information was modified, emotional valence and arousal were perceived differently. Perception of the complexity of the background music depending on the arrangement type differed between music majors and nonmusic majors. While the perceived complexity significantly predicted nonmusic majors' cognitive performance, its predictive effect was not found in music majors. The findings imply that perceptions of musical arrangements in terms of expectancy and complexity can be critical factors in determining how arrangements affect concurrent cognitive activity, while suggesting that music itself is not a facilitating or detrimental factor for cognitive performance.

Music Therapy for Delinquency Involved Juveniles Through Tripartite Collaboration: A Mixed Method Study.

This study introduces a music therapy project for young offenders through community collaboration and its efficacy through a mixed method. The project called Young & Great Music is carried out via collaboration among three parties, which are the educational institution, the district prosecutor's office, and corporate sponsor, forming a tripartite networking system. In this paper, we present an efficacy evaluation of the project's implementation with 178 adolescents involved with the juvenile justice system: 115 youth was on suspension of indictment and 63 youth was under supervised probation. Quantitative and qualitative measures were collected and analyzed to examine the efficacy of the project. The music therapy program was developed for 15 sessions based on the use of music to prompt positive resources through music making and song writing. The efficacy was examined using three scales; self-concept, resilience, and stress coping skills. The paired t-test showed that there were significant improvement in all three scales respectively (p < 0.000). In order to examine the group difference between suspended indictment and supervised probation groups, Welch-Aspin t-test was conducted due to unequal variance of the group. Results showed there was a significant group difference in self-concept (p = 0.006) and resilience (p = 0.022). The study further examined participant's experience of music and perceived benefits. Twenty participants had in-depth interviews about their music therapy experience which were recorded, transcribed and analyzed. Of the 109 statements derived from a qualitative content analysis of the interview transcripts, music making and song writing was repeatedly reported as helpful in gaining "new perspectives," "courage to challenge and pursuit," "perseverance," and "self-acknowledgment." The positive result of the study showed that the collaborative networking of regional and social resource to support for adolescents at-risk was successful. The results of this project are promising and suggest that other arts-based rehabilitation services and programs should be developed and implemented in juvenile justice system. For this, strategies for program sustainability for long-term facilitation are needed.

Corrigendum: Music Therapy for Delinquency Involved Juveniles Through Tripartite Collaboration: A Mixed Method Study.

[This corrects the article DOI: 10.3389/fpsyg.2020.589431.].

Individual Therapeutic Singing Program for Vocal Quality and Depression in Parkinson's Disease.

OBJECTIVE: Patients with Parkinson's disease (PD) frequently experience depression associated with voice problems. Singing involves the use of similar muscles and the neural networks associated with vocal function and emotional response. The purpose of this study is to enhance vocal quality and depressive symptoms of patients with PD using individual singing program. METHODS: The Individual Therapeutic Singing Program for PD (ITSP-PD) was conducted by a certified music therapist. In total, nine PD patients with a subjective voice problem or depression participated in 6 sessions over 2 weeks. We measured the Maximum Phonation Time (MPT) via the Praat test, the Voice Handicap Index (VHI), the Voice-Related Quality of Life (V-RQOL) and the Geriatric Depression Scale (GDS). RESULTS: In total, 8 out of 9 patients completed all the sessions; 6 out of 8 patients participated in the follow-up test after 6 months. A statistically significant change in MPT (p = 0.011) was observed between the pre- and post-tests. The VHI (p = 0.035) and the GDS (p = 0.018) were significantly lower in the post-test. In the pre-, post-, and follow-up tests, the MPT (p = 0.030), V-RQOL (p = 0.008), and GDS (p = 0.009) were significantly changed. CONCLUSION: The ITSP-PD based on neurological singing therapy for PD showed therapeutic possibility for vocal function and depression in patients with PD. Our findings suggest the need for a randomized study to examine the continuing positive effects of the ITSP-PD over a longer period of time.

Analysis of upper arm muscle activation using surface electromyography signals during drum playing.

This study measured surface electromyography of the biceps brachii and triceps brachii during repeated drum playing with and without a drumstick to better understand activation of the upper arm muscles and inform the use of instrument playing for motor rehabilitation. A total of 40 healthy college students participated in this study. All participants were asked to strike a drum with their hand and with a drumstick at three different levels of stroke: soft, medium, and strong. The stroke order was randomly assigned to participants. A sound level meter was used to record the intensity of the drum playing. Surface electromyography signals were recorded at every hit during drum playing both with and without the drumstick in each of the three stroke conditions. The results demonstrated that the highest muscle activation was observed in both biceps brachii and triceps brachii with strong drum playing with and without the drumstick. A two-way repeated measures analysis of variance showed that there was a significant main effect for stroke intensity in muscle activation and produced sound level. While higher activation of the triceps brachii was observed for drum playing without a drumstick, no significant differences were found between the biceps brachii and sound level. This study demonstrated via surface electromyography data that greater muscle activation of the biceps brachii and triceps brachii does not occur with the use of drumsticks in drum playing. With the drum sound controlled, drum playing by hand can be an effective therapeutic intervention for the upper arm muscles.

Changes in gait patterns induced by rhythmic auditory stimulation for adolescents with acquired brain injury.

The effects of rhythmic auditory stimulation (RAS) on gait in adolescents with acquired brain injury (ABI) were investigated. A total of 14 adolescents with ABI were initially recruited, and 12 were included in the final analysis (n = 6 each). They were randomly assigned to the experimental (RAS) or the control (conventional gait training) groups. The experimental group received gait training with RAS three times a week for 4 weeks. For both groups, spatiotemporal parameters and kinematic data, such as dynamic motions of joints on three-dimensional planes during a gait cycle and the range of motion in each joint, were collected. Significant group differences in pre-post changes were observed in cadence, walking velocity, and step time, indicating that there were greater improvements in those parameters in the RAS group compared with the control group. Significant increases in hip and knee motions in the sagittal plane were also observed in the RAS group. The changes in kinematic data significantly differed between groups, particularly from terminal stance to mid-swing phase. An increase of both spatiotemporal parameters and corresponding kinematic changes of hip and knee joints after RAS protocol indicates that the use of rhythmic cueing may change gait patterns in adolescents with ABI.

Differential effects of type of keyboard playing task and tempo on surface EMG amplitudes of forearm muscles.

Despite increasing interest in keyboard playing as a strategy for repetitive finger exercises in fine motor skill development and hand rehabilitation, comparative analysis of task-specific finger movements relevant to keyboard playing has been less extensive. This study examined, whether there were differences in surface EMG activity levels of forearm muscles associated with different keyboard playing tasks. Results demonstrated higher muscle activity with sequential keyboard playing in a random pattern compared to individuated playing or sequential playing in a successive pattern. Also, the speed of finger movements was found as a factor that affect muscle activity levels, demonstrating that faster tempo elicited significantly greater muscle activity than self-paced tempo. The results inform our understanding of the type of finger movements involved in different types of keyboard playing at different tempi. This helps to consider the efficacy and fatigue level of keyboard playing tasks when being used as an intervention for amateur pianists or individuals with impaired fine motor skills.

Effect of Rhythmic Auditory Stimulation on Hemiplegic Gait Patterns.

PURPOSE: The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. MATERIALS AND METHODS: Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system. RESULTS: Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. CONCLUSION: Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

Analysis of surface EMG activation in hand percussion playing depending on the grasping type and the tempo.

Although instrument playing-based training has been repeatedly reported to improve functional hand movements including grasping, the attempts to present quantitative information on physiological mechanism of grasping have been relatively insufficient to determine the type and the intensity of the exercises involved. This study aimed to examine the muscle activation during hand percussion playing depending on the grasping type and the playing tempo. A total of twelve healthy older adults with a mean age of 71.5 years participated in this study. Surface electrodes were placed on three grasping-related muscles: Flexor digitorum superficialis, extensor digitorum, and flexor pollicis brevis. Participants were instructed to play with the egg shaker, paddle drum mallet and clave involving different types of grasp at three different tempi (i.e., 80, 100, and 120 bpm) and sEMG data were collected during each playing. Significantly greater muscle activation was generated with the small sphere type of egg shaker, compared to the handle type of paddle drum mallet and the small cylinder type of clave. Playing at faster tempo also elicited significantly greater muscle activation than at slower tempo. With regard to the rise time of muscle activation, while tempo significantly affected the rise time, the time to peak muscle did not significantly change depending on the grasping type. This study confirmed that grasping pattern and the tempo of movement significantly influence the muscular activation of grasping involved in instrument playing. Based on these results, clinical implication for instrument selection and structured instrument playing would be suggested.

Hand rehabilitation using MIDI keyboard playing in adolescents with brain damage: a preliminary study.

BACKGROUND: As a sequential, programmed movement of fingers, keyboard playing is a promising technique for inducing execution and a high level of coordination during finger movements. Also, keyboard playing can be physically and emotionally rewarding for adolescents in rehabilitation settings and thereby motivate continued involvement in treatment. OBJECTIVE: The purpose of this study is to evaluate the effects of keyboard playing using Musical Instrument Digital Interface (MIDI) on finger movement for adolescents with brain damage. METHODS: Eight adolescents with brain damage, ages 9 to 18 years (M = 13 years, SD = 2.78), in physical rehabilitation settings participated in this study. Measurements included MIDI keyboard playing for pressing force of the fingers and hand function tests (Grip and Pinch Power Test, Box and Block Test of Manual Dexterity [BBT], and the Jebsen Taylor Hand Function Test). RESULTS: Results showed increased velocity of all fingers on the MIDI-based test, and statistical significance was found in the velocity of F2 (index finger), F3 (middle finger), and F5 (little finger) between pre- and post-training tests. Correlation analysis between the pressing force of the finger and hand function tests showed a strong positive correlation between the measure of grip power and the pressing force of F2 and F5 on the Grip and Pinch Strength Test. All fingers showed strong correlation between MIDI results and BBT. For the Jebsen Taylor Hand Function Test, only the moving light objects task at post-training yielded strong correlation with MIDI results of all fingers. CONCLUSIONS: The results support using keyboard playing for hand rehabilitation, especially in the pressing force of individual finger sequential movements. Further investigation is needed to define the feasibility of the MIDI program for valid hand rehabilitation for people with brain damage.

Relationship between output from MIDI-keyboard playing and hand function assessments on affected hand after stroke.

BACKGROUND: While a number of studies have tested the therapeutic effectiveness of playing musical instruments, such as the electronic keyboard using Musical Instrument Digital Interface (MIDI), it is still unclear whether outcomes of electronic keyboard playing are related to hand function tests. OBJECTIVE: The purpose of this study was to investigate the correlation between MIDI-keyboard playing and hand function tests, including grip strength, Box and Block test (BBT), and Jensen-Taylor Hand Function Test (JTHF). METHODS: A total of 66 stroke patients were recruited from medical centers and were classified into acute (n = 21), subacute (n = 28), and chronic (n = 17) recovery stages. The participants' mean age was 60.5 years. The MIDI-keyboard playing protocol based on sequential key pressing was implemented. All hand function tests were performed by certified occupational therapists. RESULTS: MIDI scores from participants at all three recovery stages were significantly correlated with BBT and grip strength. Overall, MIDI-keyboard playing scores demonstrated moderate to high correlations with hand function tests except for participants at the chronic stage and the JTHF, which showed no correlation. CONCLUSIONS: These findings suggest that MIDI-keyboard playing has great potential as an assessment tool of hand function, especially hand dexterity in acute and subacute stroke patients. Further studies are needed to refine the specific keyboard playing tasks that increase responsiveness to traditional hand function tests.

Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients.

BACKGROUND: Rhythmic auditory stimulation (RAS) improves gait velocity, cadence, and stride length in hemiplegic stroke patients, yet little is known about the effectiveness of RAS on standing balance. OBJECTIVES: To examine and compare the effectiveness on standing balance and gait parameter of two different types of gait trainings, gait training with RAS versus gait training without RAS, was compared in two groups of hemiplegic stroke patients over a three-week period (RAS group, n = 8; control group = 8). METHODS: Sixteen hemiplegic stroke patients were included in the study. Standing balance was measured by using Biosway®. Stride length, gait velocity, and cadence were calculated from the number of steps and required time for a 10 m-walk. RESULTS: Pre- to post-test measures showed a significant improvement in RAS group for overall stability index (p = 0.043), mediolateral index (p = 0.006), anteroposterior index (p = 0.016), gait velocity (p = 0.012), stride length (p = 0.03) and cadence (p = 0.012) over the control group. CONCLUSIONS: The results of this study showed that RAS was an effective therapeutic method to improve gait velocity, stride length, cadence, and standing balance in hemiplegic stroke patients.

Finger exercise with keyboard playing in adults with cerebral palsy: A preliminary study.

The purpose of this study is to examine the effects of Therapeutic Instrument Music Performance (TIMP) for fine motor exercises in adults with cerebral palsy (CP). Individuals with CP (n = 5) received a total of twelve, 30-min TIMP sessions, two days per week for six to nine weeks. Pre- and post-Music Instrument Digital Interface (MIDI) data were used as a measure of hand function. Pre-velocity was significantly different from the normative data obtained from typical adults (n = 20); however, post-velocity did not yield significance, specifically in the second and fifth fingers, indicating improvement in hand function for the adults with cerebral palsy. The finding implies that TIMP using keyboard playing may effectively improve manual dexterity and velocity of finger movement. Based on these results, future program development of instrumental playing for adults with CP is called for to enhance both their independent living skills and quality of life.