One approach that may give you your rhythm back is music therapy — a type of therapy that uses music to address physical, emotional, cognitive, or social needs of individuals. How can music help with MS? Barbara Seebacher, PhD, a physiotherapist based in Innsbruck, Austria, explains: “There are three different brain centers responsible for the timing of movement: the motor cortex, the basal ganglia, and the cerebellum. One or another of these can be damaged by stroke, Parkinson’s disease, or multiple sclerosis.” Music can often supply the timing that has been damaged, helping your body to work more smoothly. Neurological music therapist Brian Harris, a founder of MedRhythms in Boston, says, “When you hear a rhythm, a song, or a metronome, it activates the auditory system, which activates the motor system at a subconscious level.” This process is called “entrainment.” Harris says, “The rhythm is telling your brain to tell your body to move. For people who have damage to the brain, using rhythm can engage undamaged areas to help people move. We have quantifiable data on this. People walk faster; they have longer strides. You can see the changes on neurological imaging.”
Music Therapy for Improved Walking
Dr. Seebacher has studied the effects of music therapy in people with MS and documented the benefits of imagined walking combined with music or metronome cues for walking with MS. Her trials, conducted within the department of neurology at the Medical University of Innsbruck in Austria, as part of her PhD program at the University of Brighton in the United Kingdom, included a total of 217 people with mild to moderate MS, some of whom were using canes or crutches, and some who used no walking aids. Seebacher had study participants listen to music and imagine walking. The participants imagined feeling themselves walking to music or to a metronome beat. The imagination part is called “motor imagery,” and the music or metronome is called “rhythmic cueing” or “rhythmic auditory stimulation.” A control group did the motor imagery without the rhythmic cueing. All groups showed improvement in their actual walking, but the music group improved more and had greater improvement in their fatigue levels and quality of life. (1)
Benefits of Music Therapy Beyond Walking
Music therapy has also been studied in stroke survivors and people with Parkinson’s disease for many years. Harris says, “The principle of motor entrainment can be applied to anything that’s movement related, not just walking. Function of the hands or mouth and tongue, including speech, can be improved using rhythm.” Some people can’t talk, but they sing. You can see videos of actual MedRhythms patients, many of whom have had strokes, walking and talking better with music. Music aids neuroplasticity. Harris says, “Music globally activates our entire brain. That’s why it’s applicable to all these illnesses.” Neuropsychiatrist Jon Lieff, MD, writes that music training improves “capacities related to perception, performance, and language.” He says learning, playing, or singing music “increases brain efficiency, with fewer neuronal units needed to encode information.” He says different aspects of music are processed in different parts of the brain. For example, timing is organized in the cerebellum. Pitch is “processed in different areas throughout the brain. Musical imagery is analyzed in the frontal lobe, and singing is mostly in the right frontal lobe.” Music can get the whole brain working together.
Music Improves the Ability to Remember
About half of people with MS have cognitive problems at one time or another. Music can help them remember and think. “Your brain likes to hold onto strong sensory input,” says Harris. “Music is strong sensory input. Think of the ABC song you learned as a child. The brain puts different bits of information together into larger pieces. The ABCs are 26 different letters, but you put 5 or 6 of them together, and the brain remembers the whole thing.” We can use this trick to help us remember. “With people who have memory deficits,” Harris says, “if you can find ways to make mnemonics out of a recipe or a list and put them in a song, you’ll remember them better. Change the words of a song you know to be the things you want to remember.” RELATED: How to Manage Thinking and Memory Problems in MS
How to Use Music Therapeutically
There are about a thousand neurological music therapists working in the United States, most of them in major medical centers. Many people with MS could benefit from working with one. According to Harris, “Rhythmic auditory stimulation is a standardized intervention. We take a client’s baseline walk. Then we start music at the baseline tempo. Once they entrain, in a few minutes, you increase the tempo by 5 to 10 percent and have them entrain at that tempo. Then increase it a bit more until they reach their goal. When they walk on the beat, their gait improves.” If you don’t have access to a trained music therapist, you can also do this on your own, walking to music or imagining yourself walking while listening to music. “It’s been shown in many studies that motor imagery recruits similar brain areas as actually doing the activity,” Seebacher says. She suggests imagining walking while trying out these scenarios:
Feel your whole body, your weight on your legs. Feel the swinging of your arms and legs, feel your upper body upright, the length of your steps.Imagine yourself walking upright with a rice bag on your head.Walk very energetically as if you were marching in the army.
Whether you’re actually moving or just imagining it, you need the right music. “It should be rather fast, between 80 and 120 beats per minute. For healthy people, 120 steps per minute is normal, while people with MS might be closer to 80,” Seebacher says. If you can play, sing, or tap out your own rhythm, that may be even better than listening. It recruits more of your brain, according to Dr. Lieff. Not every type of music is useful, though. Harris says it must be a regular 4/4 time with a strong beat, not a waltz (which is 3/4 time) or a tune with a beat that’s constantly changing. Also, you want music that arouses you, not relaxing music. Most pop music has a good rhythm and tempo for real or imagined walking. Harris adds that you should listen to music you like, because the emotional impact is important.
