In the United States, there are more than 780,000 strokes every year, causing more serious long-term disabilities than any other disease (Know Stroke). With the graying of the baby boomers and the rise in contributing diseases such as high blood pressure and diabetes, that number is expected to increase in the coming years. While preventing strokes is obviously a goal, the development of efficacious rehabilitation strategies is equally important. Music therapy has shown promise as a way to help stroke victims recover a variety of lost functionality.
A stroke occurs when normal blood flow to the brain fails. There are two main types of stroke - ischemic and hemorrhagic.
Ischemic stroke occurs when blood vessels are blocked, usually by a clot. This accounts for four in five strokes. Hemorrhagic stroke is caused by a broken or leaking blood vessel in the brain (NIH).
The effects of a stroke vary by its type, severity and location within the brain. A stroke may affect only one side of the body or part of one side. It can cause cognitive deficits, muscle weakness or paralysis. A stroke in the right half of the brain can cause visuospatial issues, impaired judgment and behavior, and short-term memory loss. A stroke in the left half of the brain can cause speech and language problems, slow and cautious behavior, and memory problems. A stroke in the cerebellum can cause abnormal reflexes, balance problems, and dizziness, nausea, or vomiting (Office on Women’s Health).
The total cost of stroke in the US is estimated at $43 billion per year. Rehabilitation accounts for an estimated 16% of that (NINDS). With strokes, there are the direct costs of providing medical care to patients and the indirect costs associated with lost productivity. In a study estimating the lifetime cost in the United States by type of stroke for individuals experiencing a first stroke in 1990, researchers found an average cost of $103,576 for all stroke subtypes. Indirect costs accounted for 58% of lifetime costs (Taylor).
There are three types of post-stroke rehabilitation: physical therapy, occupational therapy, and speech therapy. The goal of physical therapy is to help the patient relearn walking, sitting, lying down, or switching from one type of movement to another. Occupational therapy seeks to help the patient relearn eating, drinking, dressing, bathing, cooking, reading, writing, and toileting skills. Speech therapy aims to reclaim language and communication skills, including swallowing. There can also be psychological and psychiatric therapy that seeks to alleviate some mental and emotional problems that arise both directly and indirectly from the stroke (NINDS).
Music therapy is gaining acceptance in all three types of post-stroke rehabilitation. The concept of music affecting health and behavior can be found in the writings of Aristotle and Plato. The 20th-century discipline began after World Wars I and II, when community musicians of all types, both amateur and professional, went to veterans hospitals around the United States to play for the thousands suffering both physical and emotional trauma from the wars. The patients’ physical and emotional responses to music led the doctors and nurses to request that hospitals hire musicians. It was soon evident that the hospital musicians needed some prior training before entering the facility, and so the demand grew for a college curriculum (AMTA).
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