Ever since Dr Alex Street cycled down to his local music shop at the age of 12 and signed up for classical guitar lessons, he’s been hooked on music.
His dreams of training as a classical musician were thwarted, however, when he was struck down with musician’s dystonia, a muscular neurological condition, while studying for his music degree. The fingers of his right hand stopped moving and he couldn’t play his guitar for three years.
Alex’s musical experience stood him in good stead, though, when he decided to channel his passion for music in a different direction – training as a music therapist. 'All of that involvement, whether in performance or studio work, helped immeasurably with working as a clinician,' he says. 'It’s all about having to interact with lots of different people from different socio-economic backgrounds and cultures.'
After qualifying as a therapist, Alex began working with people with neurodisabilities, and it was here that he started to explore a fundamental question. We all know that music has the power to lift our spirits and move our souls. But does it have the power to make us well?
"As music therapists, we [help] patients solve problems so that they can walk, think, speak again."
Since Alex joined ARU in 2012, he and his colleagues in the Cambridge Institute for Music Therapy Research have been combining music therapy and neuroscience to delve more deeply into the mysteries of the human brain. Alongside projects focusing on mental health, dementia, and autism spectrum disorder, one of their goals is to understand how music can heal the brain after a brain injury or stroke. 'As music therapists, we work together with other clinicians in what is essentially problem solving,' says Alex, 'helping patients solve problems so they can walk, think, speak again.'
The institute is using pioneering technology such as electronic imaging through electroencephalograms (EEG) to record the impact of music on brain activity. 'A lot of research has been conducted into the effects of music on the brain,' explains Alex. 'We understand more and more about it, including the effects of melody and rhythm, and we’re contributing to the evidence base in terms of how music can be used in neurorehabilitation. With our combination of expertise, we’re very well positioned to design studies that will collect the kind of robust data that the scientific community will pay attention to.'
One of the studies is looking at the impact of music therapy on stroke patients in their own homes, focusing specifically on arm function.
The results have been startling. One elderly stroke patient told Alex bluntly when he first met him that he didn’t like music and couldn’t play it. But after two regular weekly sessions at his home, carrying out repetitive movements in time to specially composed music, he started to make visible progress.
"A man came in with his family. He'd lost the ability to speak due to his stroke. [But] we started to sing 'She'll be coming round the mountain'. He sang, and burst into tears."
'His wife would come home and he’d say, ‘Look, I can do this now',' says Alex. 'And he’d reach up and touch his mouth, which meant he was able to use cutlery more effectively and get dressed more easily. It didn’t change his outcome measure score, which was not sensitive enough to detect these changes, but it increased his independence and changed his feeling of recovery and hope.'
Such moments inspire Alex to continue his quest for evidence. He is now going into Addenbrooke’s Hospital in Cambridge two days a week to work with stroke patients. As far as he knows, he’s the only music therapist working in an NHS hospital in the UK.
Alex hopes his work at Addenbrooke’s will help to determine how music therapy can help stroke patients and people with traumatic brain injuries on the road to recovery. 'I was quite sceptical at first but you can under-recognise the skills you bring in,' he says. 'One example was a man who came in with his family. He’d lost the ability to speak due to his stroke. I said ‘Let’s just sing a simple song’. So we started to sing ‘She’ll be coming round the mountain’. He sang and burst into tears. We then moved straight on to speaking while tapping his left hand in a regular pulse. We found that he could still say what he wanted to while doing this, although it took an enormous amount of effort.'
And it seems that music can continue to play an important part in patients’ lives. 'His family contacted me after he was discharged,' smiles Alex. 'They said: We’re still singing!'
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