{"id":72037,"date":"2022-09-06T11:48:30","date_gmt":"2022-09-06T15:48:30","guid":{"rendered":"http:\/\/www.bu.edu\/sargent\/?page_id=72037"},"modified":"2022-10-03T08:25:20","modified_gmt":"2022-10-03T12:25:20","slug":"the-healing-power-of-music-from-bach-to-rock","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/sargent\/about-us\/our-publications\/inside-sargent\/inside-sargent-2022-2023\/the-healing-power-of-music-from-bach-to-rock\/","title":{"rendered":"The Healing Power of Music, from Bach to Rock"},"content":{"rendered":"
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BY STEVE HOLT<\/p>\n

C<\/span>hrissy Bellows secures a set of headphones over her ears and clips a hard plastic sensor to her left sneaker, then her right. She presses a button on her smartphone and stands up from the wheelchair that\u2019s been her main way of getting around since a hemorrhagic stroke restricted her ability to walk in 2016. Music begins to play, slowly at first, through the headphones\u2014in this case, it\u2019s oldies\u2014and Bellows starts walking inside her Newcastle, Maine, home.<\/p>\n

Holding on to her husband\u2019s arm for support, Bellows strolls along in lockstep with the rhythm of the song. (We do this automatically and subconsciously, it turns out.) If Bellows has trouble matching her steps to the beat, the sensors attached to her shoes send real-time gait data to her mobile device, and in turn, the music is mixed to aid her walking. And if she seems to have no trouble at all walking to the beat? The algorithm increases the tempo of the music to create a new therapeutic challenge.<\/p>\n

Bellows is among the nearly 800,000 Americans who have a stroke each year. More than half of stroke survivors over 65, like Bellows, have mobility limitations\u2014including trouble walking. Early studies suggest that those who use music in relearning to walk after a neurological diagnosis such as a stroke or Parkinson\u2019s disease move faster and with better gait than those who trained without music\u2014all while expending less energy.<\/p>\n

BU\u2019s Neuromotor Recovery Laboratory<\/a> is home to some of the most promising research into music-based gait training. The lab\u2019s founder and director, Lou Awad<\/a>, an assistant professor of physical therapy, has partnered with MedRhythms Inc.\u2014the Portland, Maine, start-up that developed the technology Bellows has been using\u2014to research how neurological diseases and injuries affect the ability of patients to walk to the rhythm of music. As the company\u2019s scientific advisor, he is also assisting MedRhythms with its clinical trials and in preparing the device for the commercial market. Awad says many stroke survivors may soon receive \u201cprescription music\u201d from their healthcare provider to work on their gait when they\u2019re on their own.<\/p>\n

Awad\u2019s Neuromotor Recovery Laboratory received its fourth grant in three years from MedRhythms Inc. in September 2021\u2014$1 million to continue studying results and additional applications of the company\u2019s \u201crhythm-based gait training\u201d technology. (Bellows tested the technology in her role on MedRhythms\u2019 patient advisory board and not as part of a clinical trial or for therapeutic outcomes.)<\/p>\n

\u201cMusic, and the rhythm of music, is one of the most powerful stimuli on Earth,\u201d Awad says. \u201cThe same way a capsule or an injection is the delivery method for some medications, the music is the delivery method for rhythm-based gait training.\u201d He adds that a partnership with Universal Music Group provides MedRhythms with access to the most diverse and culturally rich collection of music ever assembled for the purpose of providing prescription music to patients. When a patient selects a song, a proprietary algorithm screens it to be sure it meets minimum criteria to be used in rehabilitation and then mixes the music into an individualized track for each user.<\/p>\n

\u201cSo, if you really like Eminem\u2019s \u2018Till I Collapse,\u2019 we can use that song to help someone relearn how to walk.\u201d<\/p>\n

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photo by Dave Green<\/figcaption><\/figure>\n

A Booming Field of Study<\/h3>\n

Advancements in understanding the ways music benefits human brains and bodies have exploded in recent decades, Awad says, fueled by an increase in funding for studies on the topic. We now know, for instance, that the auditory and motor regions of the brain are more connected than once thought. Listening to rhythm causes us to move our muscles, at times without even knowing. (Think of the way you involuntarily tap your foot to the song playing in the lobby at the dentist\u2019s office.) As the auditory-motor connection has become clearer, therapists have started using music and beats to help people regain certain movements after a neurological or physical trauma\u2014a therapeutic intervention called rhythmic auditory stimulation.<\/p>\n

\u201cIn rhythmic auditory stimulation, you find a beat in the music that\u2019s aligned with the speed a person walks,\u201d Awad says. \u201cOnce they entrain or synchronize to the rhythm\u2014which is completely subconscious because of the auditory-motor connection\u2014you can progress the rhythm. Because the technology uses real-time gait analysis by wearable sensors, the training is adaptive and very individualized.\u201d<\/p>\n

In 2015, neurologic music therapists at Spaulding Rehabilitation Hospital in Boston began treating patients with rhythmic auditory stimulation. Stories of patient progress relearning to walk piled up, and demand for MedRhythms\u2019 therapy quickly outpaced the hospital\u2019s supply of trained clinicians. The start-up made plans to scale up by developing a digital therapeutic that could deliver the music therapy without the presence of a clinician. That\u2019s when Awad, then an associate faculty member at Harvard\u2019s Wyss Institute, got involved with MedRhythms, first joining the company\u2019s board of advisors and later its scientific advisory board.<\/p>\n

Awad came to BU in 2016 to start the Neuromotor Recovery Laboratory, which works to \u201cdevelop, study, and translate novel rehabilitation therapies and technologies for people living with impaired neuromotor control.\u201d Awad and Terry Ellis<\/a> (MED\u201905), chair of the physical therapy department, codeveloped a soft, wearable exosuit that uses robotics to assist those relearning to walk. On the MedRhythms project, Awad served as the lead principal investigator for two clinical trials in stroke rehabilitation in 2020 and says his role with the company \u201cis really to help shape and inform the application of that fundamental technology.\u201d<\/p>\n

The Next Steps<\/h3>\n

Results from initial clinical trials\u2014overseen by Awad and his team\u2014have shown that stroke survivors who use MedRhythms\u2019 digital app for gait training are able to walk faster and with a better gait, and also use less energy, after just a single session of training. The team is currently leading a large, multisite trial to support Food and Drug Administration authorization to distribute the technology commercially, which could happen as early as 2023.<\/p>\n

The genius of music-based gait training, Awad says, is it can be used for stroke rehabilitation anytime, anywhere.<\/p>\n

\u201cIn our world, in rehab, people often say you can\u2019t come to the clinic three times a week for one hour each time and expect to transform how you move, because the other 23 hours of the day you\u2019re not getting treatment,\u201d Awad says. \u201cTechnologies like this allow us to have an impact on real-world moving, where every step can be therapeutic. Walking to the mailbox can be therapeutic.\u201d<\/p>\n