Neurologic music therapy in upper-limb rehabilitation in children with severe bilateral cerebral palsy: a randomized controlled trial

BACKGROUND: After receiving neurologic music therapy, functional improvements in children with severe bilateral cerebral palsy have not been found in the literature. Musical training with instruments allows interrelationships between movement, emotions and cognition for task-based learning, in order to improve motor control. AIM: To understand whether neurologic music therapy has an impact on the functionality of children with severe cerebral palsy. DESIGN: A randomized controlled assessor-blind trial was carried out. SETTING: Children were recruited and treated in their own community center. POPULATION: Eighteen children with severe bilateral cerebral palsy between 4 and 16 years old were studied. METHODS: The intervention group (N.=18) received music therapy for 16 weeks, in addition to its usual physiotherapy input. Two music therapists implemented a neurologic music therapy program of therapeutic instrumental music performance. The control group (N.=9) received its usual therapeutic input, similar to the intervention group, but not neurologic music therapy. Overall and specific "Chailey levels of Ability" were quantified, as well as the locomotor stages. RESULTS: Significant improvements in the overall and specific "arm and hand position" as well as "activities" from the Chailey Levels of Ability and the locomotor stages were observed (P<0.05) in the group which received the music therapy. All these improvements persisted after 4 months. The control group showed no improvements after a four-month follow-up. CONCLUSIONS: Optimized intervention of neurologic music therapy can improve the functionality of children with severe bilateral cerebral PAW. CLINICAL REHABILITATION IMPACT: Music therapy is a useful tool in rehabilitation and its positive effects remain four months after completing the treatment.