Times like these you need some “One Four Five”BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2342 (Published 28 March 2012) Cite this as: BMJ 2012;344:e2342
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It was delightful to read an article in the BMJ which suggested that music therapy may have positive impact on health outcomes and functions in a series of medical conditions including Acquired brain injury .
I had the privilege of looking after a young lady in her thirties with an acquired brain injury subsequently classified as being in a minimal-conscious state following formal SMART (Sensory Modality Assessment and Rehabilitation Technique) testing.
This lady remained bed bound, unresponsive and required maximum assistance for all activities of daily living for well over three months in a dedicated tertiary neurological rehabilitation unit.
Although the aforementioned lady did not have formal music therapy in-put from a trained personnel, she had one thing in her favour.
Her mum was an active participant in her daughter's overall rehabilitation. She not only visited every day, she ensured her daughter unfailingly 'listened' to her favourite music even though she appeared to be oblivious to this 'music medicine'.
This lady was not considered for 'wakefulness promoting agents' e.g. modafinil or zolpidem to help improve her consciousness level and it was felt she would eventually require long-term nursing home care.
To the surprise of everyone, by the 12th week, she started obeying commands, vocalising and moving all her limbs. She continued to make steady progress thereafter to the point of becoming independently mobile and requiring very minimal assistance with activities of daily living.
She was subsequently discharged from the neurological rehabilitation unit and continued her rehabilitation in an out-patient capacity to further promote her independence and her reintegration into society including return to full employment.
Some may say that the aforementioned scenario may be due to natural recovery but we cannot discountenance the very tangible input of her mum in the form of provision of regular and familiar music to facilitate recovery and rehabilitation gains. That this aspect of therapy was not formally documented in the prescription or medical note does not make it irrelevant.
The articles by Ray Moynihan (2012)  and Groch J (2008), recent cochrane reviews by Bradt J et al (2010)  and our our case index, challenge the pervasive view point that 'music is a form of entertainment, produced by professionals for the purpose of leisure, diversion and relaxation'(www.northeastcenter.com/information-bulletin-music-therapy-brain-injury-...). The potential beneficial impact of music on medical conditions like acquired brain injury remain grossly unappreciated.
May we suggest that future research into potential beneficial outcomes of music in conditions like acquired brain injury, depression, autism spectrum disorders etc should not be limited or restricted to formal music therapy.
Patient consent obtained
1. BMJ 2012; 344: e2342
2. Groch J. 2008. Music has the power to
ease the stroke-injured brain.
3. Bradt J, Magee W L, Dileo C, Wheeler B
L, McGilloway E. Music therapy for
acquired brain injury. Cochrane database
of systematic reviews 2010, Issue 7
Competing interests: No competing interests