Abstract
Following an overview of the epidemiology and clinical features of traumatic brain injury and stroke, standard rehabilitation programmes are discussed, with consideration of the therapeutic aims and outcomes of these interventions. The physical, cognitive, communicative, social and psychological consequences of neurological impairment are explained, and the role of music therapy in rehabilitation programmes is introduced. A review of the literature on music therapy and TBI and stroke from 1983–96 includes details of more recent developments and research in Europe and the United States of America. Models of intervention are discussed, such as rhythmic re-training of upper limb movements and gait; treatment of aphasia; and the treatment of the psychosocial effects of TBI and stroke. Links with theoretical frameworks such as environmental enrichment are considered.
The model of intervention for TBI and stroke developed recently in Scotland is discussed in detail. The value of improvisation in enhancing self-esteem and achievable outcomes is emphasised, as well as the importance of using familiar music to enhance reminiscence and motivation in people with intact musical memories. Case studies will demonstrate how a model of intervention has emerged. Research with people with stroke, recently completed in Scotland, is summarised, and future directions for music therapy provision and research in the UK discussed.
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