Soft voice, frozen feet, shuffling gait, stiffness – the list of challenges that people with Parkinson’s face goes on and on. Medication can help. Exercise can help. MUSIC CAN HELP!
My name is Karen Skipper and I have been a music therapist for over 30 years. During my career, I have worked with people with many diagnoses and for the last 10 years I have worked extensively with people with Parkinson’s disease. I work with a group in Southern California called the “Tremble Clefs” and our goal is to address breathing, swallowing, voice quality, articulation and volume through singing. More on that later….
Music as a therapy can be found as far back as the writings of Plato and Aristotle. As a profession in America, musicians went to Veterans hospitals to perform for soldiers returning home from World Wars I and II who were suffering from physical and emotional trauma. The response was so positive that there was a push for hospitals to hire musicians. However, it became apparent that musicians required more training to truly be effective. The first music therapy college training program was created in the 1940’s.
Since that time, the profession has grown to over 5,000 board-certified music therapists in the United States. Music therapists work with people of all ages with a variety of needs and diagnoses.
HOW DOES MUSIC THERAPY HELP PEOPLE WITH PARKINSON’S?
Science has shown that when we listen to music we like, our brain releases dopamine. Parkinson’s, of course, is the result of the brain producing less dopamine and a loss of dopamine receptors.
So, since listening to preferred music causes dopamine production, it makes sense that it can therefore result in a reduction in some of the symptoms that can accompany Parkinson’s.
Here are some specific ways that music can help reduce some of the symptoms of Parkinson’s:
Speech:
- Speech is not only being able to form words. Speech includes volume, voice quality, breath, inflection and facial expression – all of which are impacted by Parkinson’s. Therapeutic choirs, such as Tremble Clefs, can use singing to practice these characteristics of speech in a fun and supportive environment. Find a Tremble Clefs group near you.
- In my work with people with PD, I often find that it is difficult to understand what someone is saying not only because of a quiet voice but because of “rate” of speech. In my experience, the speech of someone with PD often starts out clear and strong, BUT…as they continue with the sentence, it gets faster and softer and the words are not as clear.
- Enter RHYTHM. I am convinced that rhythm is a VERY useful tool for people with Parkinson’s. Our heart beats in rhythm. We breathe rhythmically. Try speaking rhythmically. If you need a drink of water, say it in a rhythmic, “sing/song” way OR just sing it. Ask your care partner if they can understand you better when you sing it.
Drooling/Swallowing:
- Drooling is annoying and embarrassing. It is not usually a result of excess saliva but rather of an inefficient swallow. Because of stiffness, people with Parkinson’s disease often do not have a strong swallow. Additionally, poor swallowing can result in aspirating food into the lungs resulting in a potentially life threatening condition called aspirational pneumonia.
- One easy way to reduce the chance of aspirating food is to dip your chin slightly before and while you swallow. Dipping your chin before and while you swallow positions your epiglottis so that it is more likely to block off access to the trachea (windpipe) thus lowering the risk of food or liquid getting into the lungs.
- Another exercise that can strengthen the muscles used for swallowing is to speak (I prefer singing) the word “RING” and hold out the “NGGGGGGGGGG”. If you note where you feel the muscle tension during this exercise, you will notice that it is the same muscles that we use when swallowing. Try holding the “NGGGGGGG” and changing from a “low” pitch to a “medium” pitch to a “high” pitch, all the while holding the “NGGGGGG” sound.
Freezing:
- Annoying to both the person with PD and the care partner, this is one of the most common complaints I get from people in terms of limiting their life style. There are several “tricks” that people use to get moving after “freezing”. One is to set a target and “step over” it. I use rhythm to help people get moving.
- A 1996 study showed that people with Parkinson’s who walked to a steady rhythm, with a strong beat, had a more even gait and took longer steps.
- This same concept, counting down from four (4 -3-2-1-GO) and clapping or singing a rhythmic song (When the Saints Go Marching In, or?????) can often help someone “unfreeze” and get moving.
- Again, RHYTHM is a great tool to get your body moving. A “normal” walking pace is around 80 beats per minute. This is not true for everyone, however, walking to a piece of music at 80 bpm will probably help you take longer steps and result in a more even stride length. And… don’t forget to swing your arms.
As with anything new – CHECK IT OUT WITH YOUR DOCTOR and SAFETY FIRST!
Don’t forget the “non-motor” aspects of Parkinson’s.
Apathy and depression can keep people with Parkinson’s from enjoying life. Engaging in music by singing, playing an instrument (harmonica and drums are two GREAT instruments for people with PD) or even listening to music you like will help you experience more pleasure in life and will give you a way to connect with others.
MAKE SOME MUSIC & MAKE SOME DOPAMINE & MAKE A POSITIVE CHANGE
Karen Skipper is a board-certified Music Therapist and Neurologic Music Therapy (NMT) Fellow who has maintained a successful private music therapy practice in Orange County, CA for over 30 years. Her advanced training in NMT gives her additional knowledge and expertise in the use of music to treat neurologic conditions such as Parkinson’s disease. She is the director of the Orange County Tremble Clefs, a therapeutic singing group for people with Parkinson’s and their care partners. She is excited to be working with PMD Alliance to help people with Parkinson’s live a better life.
Sarah, thank you for giving us an example of how to approach gratitude in a negative situation. You generated for me specific things I can say when times get tough.
This Thanksgiving, our family did a fun exercise: we used a string of gratitude leaves my daughter bought at Michael’s, and wrote something we are thankful for on our leaf. Then, after dinner, we read the leaves, and each person did a deeper dive into gratitude by saying who or what made that particular thing for which thry are grateful possible. It compounded the whole experience! Some of our 10 grandchildren were old enough to try it, too. For example, my leaf said “Travel.” Snd when it was my turn, I explained that my husband, who is a wizard with money, has made our travel possible, and that if our money management were left to me, we’d probably be living in a shack. 😊 I hope this exercise becomes a family tradition.
Skipper, thank you for a very interesting piece on the therapeutic value of music, especially singing, for people with Parkinson!s. The research is fascinating!
Thank you, Maureen, for the message about giving directly from my IRA. I recently checked with our financial advisor, and because our investments have done a little better this year, the amount of my minimum distribution increased. So I am sending an extra gift to the PMD Alliance in gratitude for all it does for me and others dealing with Parkinson’s. Merry Christmas!