Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, August 23, 1993 TAG: 9308210039
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: By LINDA SHOCKLEY
DATELINE: LENGTH: Long
"When you have a patient who can't speak begin to sing, the tears come down their face," says Angela Thompson, the senior member of the music-therapy team at the Veterans Affairs Medical Center in Salem.
"It's so discouraging to think that you can't speak, especially when you can hear everything," Thompson says. "So, even patients who were pessimistic about music therapy find themselves encouraged. Sometimes the patients arrive early and wait outside the door until we get here."
Music therapy has played a major role in rehabilitating Henry Edgar "Buddy" Knowles Jr., an outpatient at the VA Medical Center who received a double whammy of strokes.
Knowles suffered a stroke on his right side at age 42, followed soon afterward by a second stroke on his left side. The prognosis offered him six months to live.
Now, 19 years years later, Knowles lives independently in his own apartment, drives a motorized wheelchair, attends church regularly, plays the piano and electric keyboard, sees friends often and loves listening to music. "I listen to Q-99: oldies but goodies," he says. "I love 'em!"
Knowles says the strokes have slowed him down to the point that he's done "a day's work by the time I dress," but his determination and good cheer have proved inspirational to the staff at the VA. He works closely with the team of two music therapists and an intern.
Working with the keyboard has improved Knowles' hand-eye coordination, finger spread, flexibility and strength and his memory.
"The speed and accuracy of my brain has improved so much that I never would have believed it had it not happened to me," he said. "It also helps me relax and once I relax, I can control my movements and concentration better. Whenever I get depressed, I work it out on the keyboard. I have a keyboard at home, and sometimes I just get lost in it."
While a love of music or past musical experience isn't necessary for successful music therapy, they help.
Knowles has the natural rhythm that enabled him to be a drummer during his college days at Virginia Tech.
A former salesman of manufactured furniture and housing, Knowles spent considerable time driving the highways of Virginia, West Virginia, Arkansas, Missouri and Massachusetts.
"The radio was always on when I was driving," Knowles said. "It always relaxed me.
"After the strokes, I was afraid to get out of bed. I was afraid to do anything. But the radio still woke me up each morning."
While specific health benefits of music may be debated, people do seem to feel better when listening to their favorite rhythms.
But music therapy differs from musical activities in that music therapy is a diagnostic tool used for measuring health changes; while activities like socials, where people sing and dance, aren't used for recording medical information.
Music therapy, specifically with stroke patients, strives to strengthen muscles, enhance breathing, improve communication skills, increase and maintain mobility of joints, maximize cognition skills and improve coordination.
It also has benefits in daily living: A person who improves memory and motor skills through practicing on a keyboard or performing with light hand bells, also will be better able to converse and cook.
"The side effects of self-esteem are so important," said Thompson. "Buddy feels better about himself, he does more in the community and he's always accomplishing something new. Music therapy helps to improve coping strategies and the quality of life as well as the basics."
The music therapists, who are board-certified, measure mass grasp and finger strength and cognitive skills such as identifying subjects on cards (to determine comprehension of subjects, letters and colors). Speech articulation also is measured, although the work of music therapists complements rather than eliminates the work of physical and speech therapists.
The VA music-therapy team carries a patient load of 25 to 35 who receive treatment two to three times a week, though some require as many as seven sessions weekly.
Music therapy got its start in the 1950s in Topeka, Kan., and at first was distrusted and sometimes discredited in the medical community. But now, much support for the field is coming from doctors, particularly in the care of stroke patients and those suffering from dysfunctions such as Parkinson's disease, Huntington chorea, Alzheimer's disease, supranuclear palsy, multiple sclerosis and dementia.
Therapists work closely with doctors, nurses, physical therapists and other specialists. Radford University and the Shenandoah Conservatory offer the only certified programs of music therapy, a four-year program, in Virginia.
As Knowles and music-therapy intern Melissa McDaniel play a self-designed duet on the electric keyboard, there's lots of laughter before they settle into a spirited and soulful medley of "Summertime," "September Song," "Winter Wonderland" and "April Showers." Knowles has less feeling in his left hand, so McDaniel helps to support that wrist as she whispers, "go slowly." Applause follows, demonstrating one reason why music therapy is effective.
"We try to individualize the program to each patient's needs. We offer music from their eras because it facilitates memories . . . of people and dancing. It's more fun for them and more effective all around," says McDaniel.
"People don't realize how important it is to be independent until they lose it. Music therapy helps patients regain that independence in their lives."
by CNB