Melbourne Conservatorium of Music - Research Publications
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ItemThemes in Songs Written by Patients with Traumatic Brain Injury: Differences Across the Lifespan(Australian Music Therapy Association, 2005)This study aimed to identify age differences in the themes of songs written by patients with traumatic brain injury (TBI). Lyrics from 82 songs written by 11 female and 20 male patients aged between 5 and 60 years were categorised into eight themes and 24 categories. Incidence of categories and themes were calculated and compared across six age brackets. Results suggest that children, early adolescent, and middle adolescent patients with TBI focus on memories to a substantially greater degree than older patients. Early and late adolescent patient groups are most likely to be self-reflective, and to raise concerns about the future, when compared with other patient groups.
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ItemThe link between singing and respiratory health for people with quadriplegia(Australian Music Therapy Association, 2009)This article presents rationale and methodology for current music therapy research in spinal cord injury (SCI). Respiratory complications are the leading cause of illness and death following SCI and may cause long term hardship for those living with quadriplegia (DeVivo, Krause, & Lammertse, 1999). Music therapy intervention involving singing training may facilitate increased respiratory muscle strength and control for people with chronic C4-C5 quadriplegia. This, in turn, has implications for long-term respiratory health and voice quality. The effect of SCI on respiratory function and voice is discussed, as is the effect of vocal training on respiratory function. The music therapy literature on respiratory rehabilitation is reviewed and used to strengthen the case for investigation into the effect of singing training on respiratory and voice function in SCI. Finally, the methodology for a rigorous research study on this topic is presented.
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ItemNo Preview AvailableA Music Therapy Treatment Protocol for Acquired Dysarthria Rehabilitation(Oxford University Press, 2008-01-01)Dysarthria is a common form of speech impairment, affecting 20–50% of stroke patients and 10–60% of traumatic brain injury patients (Sellars, Hughes, & Langhorne, 2002). Very little research has been conducted on the effect of treatments for dysarthria and even less has been reported on rehabilitative music therapy interventions. In the current climate of evidence-based practice (Edwards, 2002) the music therapy profession needs to develop and rigorously test interventions designed to address specific disorders such as dysarthria. This paper discusses theoretical foundations for the use of singing interventions to treat dysarthria and presents a music therapy dysarthria treatment protocol incorporating vocal and respiratory exercises and therapeutic singing.
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ItemImprovisational music therapy approaches to coma arousal(Australian Music Therapy Association, 2000)The use of music therapy in coma arousal has become increasingly important as music therapy interventions are refined. This article reviews various music therapy methods for coma arousal, in particular, the application of improvisational music therapy for patients in altered states of consciousness. Clinical vignettes illustrate the goals of improvisational music therapy including: internal integration of physiological body rhythms, sensory stimulation and facilitation of communicative contact through music. The question of whether sensory stimulation is beneficial for people in coma is currently being debated in the medical literature. It is therefore of interest to music therapists to be aware of the prominent arguments in this debate and to have an understanding of how music therapy techniques can be employed to facilitate arousal and awareness.
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ItemDevelopment of a music therapy service in an Australian public rehabilitation hospital(GAMUT - Grieg Academy Music Therapy Research Centre (NORCE & University of Bergen), 2006)It is often challenging to find information about the details and development of clinical music therapy programs in other parts of the world. This article addresses a gap in the literature by describing the evolution of a neurological rehabilitation program over the past two years in Melbourne, Australia. After providing some local details on the development of rehabilitation music therapy in this part of the world, a brief rationale is offered for the place of music therapy in clinical rehabilitation services. This is followed by a detailed description of the implementation, operation and evaluation of the music therapy program established at the Royal Talbot Rehabilitation Centre in 2004. Music therapy in adult neurological rehabilitation is still an emerging area of practice in Australia. Although the first music therapy service for adult rehabilitation was piloted and developed here over 13 years ago, few rehabilitation facilities currently employ music therapy as a standard part of rehabilitation service. Although research and practice of music therapy in rehabilitation internationally is relatively new, it has been practiced for around 20 to 30 years in the United Kingdom and the United States of America respectively. The scarcity of music therapy positions in rehabilitation facilities in Australia is possibly a reflection of the lack of understanding of music therapy on the part of funding bodies and the shortage of rigorous music therapy research in this field. The establishment of new music therapy positions in rehabilitation facilities reflects the development of music therapy in neurorehabilitation internationally in terms of research, clinical practice and publications.
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ItemMusic Therapy Methods with Children, Adolescents, and Adults with Severe Neurobehavioral Disorders Due to Brain Injury(Oxford University Press, 2011-05-01)The purpose of this paper is to illustrate the application of music therapy intervention in neurobehavioral treatment programs with pediatric, adolescent and adult populations through the presentation of six case reports, with special reference to post-traumatic amnesia. Severe behavioral disorders stemming from brain injury are challenging for both the affected individual and their support network. Managing neurobehavioral disorders requires specialist skills and knowledge of various strategies to minimize behavioral incidents and decrease episodes of agitation. Music therapy interventions are effective in increasing orientation and decreasing agitation in people with post-traumatic amnesia following brain injury (Baker, 2001). However, there is little published guidance or research on music therapy interventions for use in interdisciplinary rehabilitation programs for patients with short-term or chronic neurobehavioral disorders following traumatic brain injury. Music therapy is well-placed as a part of interdisciplinary rehabilitation with this population, offering opportunities to enable emotional expression and improve pragmatic communication skills and social interaction. This case material provided illustrates how music therapists integrate family members into treatment programs, and work with others to enable multidisciplinary and interdisciplinary outcomes.
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Item[Review of the book Music therapy and traumatic brain injury: A light on a dark night, by Simon Gilbertson and David Aldridge](Taylor and Francis Group, 2009-01-01)
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ItemAssessment of Breathing Patterns and Respiratory Muscle Recruitment During Singing and Speech in Quadriplegia(Elsevier, 2011-02-01)OBJECTIVES: To explore how respiratory impairment after cervical spinal cord injury affects vocal function, and to explore muscle recruitment strategies used during vocal tasks after quadriplegia. It was hypothesized that to achieve the increased respiratory support required for singing and loud speech, people with quadriplegia use different patterns of muscle recruitment and control strategies compared with control subjects without spinal cord injury. DESIGN: Matched, parallel-group design. SETTING: Large university-affiliated public hospital. PARTICIPANTS: Consenting participants with motor-complete C5-7 quadriplegia (n=6) and able-bodied age-matched controls (n=6) were assessed on physiologic and voice measures during vocal tasks. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, the Voice Handicap Index, and the Perceptual Voice Profile. RESULTS: The group with quadriplegia had a reduced lung capacity (vital capacity, 71% vs 102% of predicted; P=.028), more perceived voice problems (Voice Handicap Index score, 22.5 vs 6.5; P=.046), and greater recruitment of accessory respiratory muscles during both loud and soft volumes (P=.028) than the able-bodied controls. The group with quadriplegia also demonstrated higher accessory muscle activation in changing from soft to loud speech (P=.028). CONCLUSIONS: People with quadriplegia have impaired vocal ability and use different muscle recruitment strategies during speech than the able-bodied. These findings will enable us to target specific measurements of respiratory physiology for assessing functional improvements in response to formal therapeutic singing training.
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ItemThe Effect of Singing Training on Voice Quality for People With Quadriplegia(Elsevier, 2014-01-01)Objectives: Despite anecdotal reports of voice impairment in quadriplegia, the exact nature of these impairments is not well described in the literature. This article details objective and subjective voice assessments for people with quadriplegia at baseline and after a respiratory-targeted singing intervention. Study Design Randomized controlled trial. Methods: Twenty-four participants with quadriplegia were randomly assigned to a 12-week program of either a singing intervention or active music therapy control. Recordings of singing and speech were made at baseline, 6 weeks, 12 weeks, and 6 months postintervention. These deidentified recordings were used to measure sound pressure levels and assess voice quality using the Multidimensional Voice Profile and the Perceptual Voice Profile. Results: Baseline voice quality data indicated deviation from normality in the areas of breathiness, strain, and roughness. A greater percentage of intervention participants moved toward more normal voice quality in terms of jitter, shimmer, and noise-to-harmonic ratio; however, the improvements failed to achieve statistical significance. Conclusions: Subjective and objective assessments of voice quality indicate that quadriplegia may have a detrimental effect on voice quality; in particular, causing a perception of roughness and breathiness in the voice. The results of this study suggest that singing training may have a role in ameliorating these voice impairments.
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