A B C D A MUSICOTERAPIA: março 2009

20090331

UMA VOZ QUE A ALMA ENCERRA | Inês Martins Ferreira

Publish at Scribd or explore others: Academic Work agrupamento de escol virgílio caseiro

"É verdade que há obstáculos na actividade da musicoterapia, e reconhece que «os resultados musicais alcançados com as sessões são mais satisfatórios e rápidos do que as alterações do seu comportamento», mas Margarida garante que quase todas as recordações que guarda do seu trabalho são boas. «Uma das mais marcantes passou-se durante um congresso em Beja, numa instituição de caridade dirigida por uma comunidade de freiras. Um grupo de crianças com deficiências mentais e motoras profundas apresentou uma peça musical fantástica, que tinha sido ensaiada sem ajuda de professores ou musicoterapeutas. O que demonstrou um esforço imenso e que deve ser valorizado por todos.»
...
Os resultados desta técnica inovadora estão à vista um pouco por todo o país em escolas, hospitais, associações e centros de apoio. Em Coimbra, a Associação de Paralisia Cerebral de Coimbra conta com um caso reconhecido de sucesso. Trata-se dos “5ª Punkada”, uma banda constituída por alunos da instituição, sob a orientação do musicoterapeuta Francisco Borges, que entretanto faleceu. No decorrer da Capital Nacional da Cultura 2003, estes jovens tiveram a oportunidade de subir ao palco e mostrar os seus dotes musicais a um «país de analfabetos musicais», como diria o maestro Virgílio Caseiro." (Inês Martins Ferreira)

Le sonore dans la relation therapeutique | Edith Lecourt

LE_SONORE_DANS_LA_RELATION_THER (...)

"Ce power-point introduit à l’importance du sonore dans la relation: les problématiques liées au sonore. Il présente une méthode d’exploration : la communication sonore en groupe, et son utilisation en thérapie (musicothérapie analytique de groupe)." (Edith Lecourt )

Terapia pela música | Música e Paralisia Cerebral

Terapia pela música | Revista Visão

Publish at Scribd or explore others: Articles Periodicals & Report gabriela rodriguez d associação portugues

"[...] Assim que entram na sala, ganham outro fôlego. Agarrados às cadeiras de rodas, os miúdos já sabem onde devem ficar durante a sessão. O mote é lançado pela terapeuta, que inicia os primeiros acordes da melodia Os Três Palhacinhos, que eles reconhecem igualmente através de pautas com imagens, afixadas nas paredes.
Ana Isabel, 13 anos, não tem atraso mental, mas a paralisia cerebral deixou-a sem coordenação dos membros e impossibilitada de falar. Embora não consiga seguir o ritmo na perfeição, acompanha a letra através dos desenhos e tecla os sons no órgão, graças a um capacete equipado com um ponteiro.
Atenta aos movimentos dos «protagonistas», Gabriela Rodriguez de Gil, argentina radicada em Portugal e há três anos a trabalhar no núcleo regional de Faro da Associação Portuguesa de Paralisia Cerebral, vai orientando a sessão de musicoterapia que dura, em média, 45 minutos. [...]"
Fonte: Soares, Clara (2003). Terapia pela música. Visão, 17 de Abril, 130-131

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A música e a criança com Necessidades Educativas Especiais [PPT]

PPT - 3 - Musicoterapia
Publish at Scribd or explore others: Academic Work portugal Educação

O desenvolvimento deste projecto (*) pretendeu trazer um contributo válido para a educação de crianças com Necessidades Educativas Especiais, em geral e, especialmente, a portadores de Paralisia Cerebral numa perspectiva de escola inclusiva, conceito este consagrado na Declaração de Salamanca (1994).
Azevedo, A. M. (2007) A Música, o Movimento e a Criança com Paralisia Cerebral: como intervir? Projecto elaborado no âmbito do Curso de especialização em Educação Especial: domínio cognitivo e motor. Escola Superior de Educação, Coimbra 2006/2007

(*) Nota: Esta apresentação faz parte de um trabalho mais abrangente que apresentarei parcialmente. Resultou de uma proposta de trabalho desenvolvida no âmbito de um curso de especialização em Educação Especial. Para qualquer informação mais detalhada, escreva para o e-mail abcdamusicoterapia@gmail.com. Obrigada.

Sobre a influência da música ...

Em termos históricos, o interesse pela influência da música no ser humano encontra reminiscências nas civilizações da antiguidade.
As lendas da mitologia grega enumeram episódios sobre o poder calmante e terapêutico da música: Homero refere que Aquiles foi encontrado na sua tenda tocando em uma magnífica lira e cantando a sua cólera (Alvin, 1991:58); Orfeu, aprendeu a arte com o próprio Apolo, deus da música e da medicina. Ao ouvi-lo cantar as feras seguiam-no, as árvores inclinavam-se em sua direcção e até os homens mais irascíveis se acalmavam (Ribeiro).

Canta-se, também, que pela omnipotência da música [Empédocles] era capaz de apaziguar paixões (…) foi o que fez a jovem furioso, cantando versos da Odisseia. (Brun, 2002:83).

O interesse terapêutico da música também foi notado por filósofos, religiosos e médicos. Ascelepiades (128-56 a.C.) empregava a música para acalmar a excitação dos alienados opondo-se a tratamentos violentos (Asclepiades Of Bithynia); os Pitagóricos e os Coribantes usavam-na para expulsar os agentes causadores da doença e restabelecer a harmonia entre corpo e alma (npp. Rocha Pereira, 2001: 15). Aristóteles:

… believed that an emotional state could be relieved by rousing the same sort of feeling through music (Aristotle); the passionate, enthusiastic modes, for example, could be used to calm active audiences (Lippman apud Gurgel, 2003:12-14).

Em De Institutione musica Boécio (480-524) ocupa-se da influência da música sobre os estados violentos, referindo curas efectuadas por Pitágoras, a um alcoólico; Empédocles, a um louco e como, os pitagóricos, induziam o sono através de melodias doces (Potiron, 1961:38).
Contudo, a questão dos efeitos da música foi, também, alvo de preocupações. Tanto Platão como Aristóteles mostraram apreensão acerca dos efeitos de determinados tipos de harmonias, pelo que, se detiveram de forma pormenorizada, na análise do tipo de música – modos, ritmos e instrumentos – que poderiam ser permitidos numa civilização ideal (Mathiesen).

Este tipo de pensamento repercute-se ao longo da história e aparece, por exemplo, nos primórdios da era Cristã, quando São Clemente de Alexandria (160-220) e São Jerónimo (331-420) advertiram para que não se ensinasse música instrumental às crianças para não lhes perverter a alma (Freitas Branco, 1944:30). Já no final do século passado Kim Jong II (1912-1994), líder da Coreia do Norte, afirmava:
It is unthinkable that songs which the aristocrats of old days used while drinking could also suit the emotions of our youth who are building socialism (Howard).

Na actualidade, observam-se alguns movimentos de índole semelhante representados por pais, professores, médicos e religiosos, entre outros. O exemplo mais mediático é o que se tem desenvolvido nos E.U.A. onde “alguns pais e grupos de pais têm defendido uma censura sobre determinados géneros da música moderna” (Freemuse, 2004). Neste âmbito, o género musical que mais tem sido apontado é o heavy metal e os seus afins “new metal” (Lloyd, 2001): black, death, speed metal, entre outros, que nas últimas décadas, tem sido associado a padrões de personalidade e comportamentos anti-sociais (Christenson e Roberts, 2001). Neste contexto, a American Academy of Pediatrics alertou para a necessidade de se reforçar as investigações sobre o impacto da música rock no comportamento (Committee on Communication, 1989 apud Scheel, 1999:1), até porque, e de acordo com Strasburger (1999:111), “têm havido (…) uma intensa preocupação pública acerca de letras e vídeos violentos ou sexualmente sugestivos” (ibidem.).

Apesar de alguns alarmismos, como salientado pelo The Suicide Information & Education Collection (SIEC, 1999) em torno do fenómeno musical juvenil, não se poderá negligenciar o facto de determinados tipos de música terem estado associados a situações marginais, auto e hetero destrutivas e/ou de risco (Christenson e Roberts, 1999; Roe, 1999; Rentfrow e Gosling, 2003, entre outros), e de existir um acréscimo de letras e vídeos violentos e/ou sexualmente sugestivos (Strasburger: 1999:111). Um outro factor relevante, prende-se com o aumento dos valores do consumo musical dos jovens (Federal Trade Commission, 2000; Strasburger, 1999; Christenson & Roberts, 1998; Klein et al., 1993 e Roe, 1999).

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Nota: Este texto é um excerto da Tese de Mestrado A música como expressão e representação juvenil: entre o normal e o patológico (A. Margarida Azevedo), PORBASE

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Qual é a sua opinião?

20090330

Musicoterapia e Reabilitação | Doenças Neurológicas

Imagem: Sound therapy

Artigo:The Role of Music in the Rehabilitation of Persons with Neurologic Diseases: Gaining Access to `Lost Memory' and Preserved Function Through Music Therapy (Concetta M. Tomaino*)

Abstract

The music therapist must have an understanding of the various disease and neurological processes to adequately assess functional ability and plan appropriate use of music for the course of treatment. We have memories for not only the particulars of a song, such as the melody or lyrics, but also the rich associations that keep the melodies alive for us throughout our life. Memories are not actually lost with dementia or with other brain injuries; rather, the ability to retrieve and gain access to these is damaged. As we possess memories for factual information, we also possess memories or `motor templates' for physical movements. Through music therapy, we have the ability to help patients reintegrate the sense of movement that they have lost. Despite the increased acceptance and understanding of the therapeutic benefits of music therapy in work with persons with neurologic impairments and challenges, more research needs to done to demonstrate it's efficacy in application with a wide range of diagnosis.

The role of music ...

Music therapists working with persons with neurologic diseases, including multi-infarct dementia or Alzheimer s disease, have observed for years the dramatic responses that occur when familiar music is presented to these individuals. Attention is maintained, fragments of memories unfold, and a true connection to the ìself takes place. Even with a specific diagnosis, the range of abilities and disabilities related to a neurological disease can vary greatly with each individual. The music therapist must have an understanding of the various disease and neurological processes to adequately assess functional ability and plan appropriate use of music for the course of treatment.

The medical needs of neurologic patients appropriate for referral to music therapy include: memory deficits, depression, balance/gait problems, fine motor problems, agitation/aggressive behaviors, acute or chronic pain, poor attention, decreased vocal projection, expressive aphasia, poor motivation, reduced muscle strength, Alzheimer's disease, multiple sclerosis, Parkinson's disease, and stroke. The use of music as a therapeutic tool for persons with neurologic disease has tremendous potential because of the many ways the individual properties of music i.e.,rhythm, melody, and harmony, induce sometimes predictable neurologic responses. Some examples of this are auditory cueing for gait (Thaut & Mcintosh, 1992), and the use of music as a retrieval mechanism for those with memory impairment (Tomaino, 1998).
Of the elements of music the two which have the most immediate effects on function are, rhythm and melody (by melody I am referring to the power of a familiar melody to trigger emotional responses and long-term memory retrieval) Various rhythmic stimuli can trigger motor function and help in initiation in persons with stroke and Parkinson s disease. In the book Music and the Brain, by Critchley and Henson (1977), N. Wertheim states: ìThere is no meaning to a rhythm without a message and the impact upon the listener depends on this message carried by the rhythm, or else lent to it by the listener himself.. We know that this particular area of the brain stem, the reticular system, is concerned with a regulation of the cortical electrical rhythms...there are abundant connections between the reticular formation and the auditory pathways. It may be that the rhythmical component of the auditory input has an impact on the whole cerebral cortex and also on large subcortical areas, via the extensive connections of the reticular formation with all these regions.
People's experience with music throughout their lives can influence how they will respond to rhythm and sounds presented during therapy sessions. At times rhythmic cueing can be as simple as a metronomic beat but at other times a person may be more responsive to the more complex rhythms of African drumming. This indicates that rhythmic processing may serve to cue attention as well as initiation, however more research needs to be done to understand how complex rhythms are processed by the cortex as well as subcortical regions. There is a strong connection between the auditory system and the limbic system. This biological link makes it possible for sound to be processed almost immediately by the areas of the brain that are associated with long-term memory and the emotions (Tomaino, 1993). Because processing occurs and/or is mediated at a subcortical level, some information processing is possible despite higher cortical damage. This is evidenced clinically by the strong emotional responses to familiar music we observe in person in persons with memory deficits, such as traumatic brain injury, multi-infarct dementia or Alzheimer's disease. Familiar songs become a tool for connecting to seemingly lost parts of the personality by providing a necessary link to the "self".
We have memories for not only the particulars of a song, such as the melody or lyrics, but also the rich associations that keep the melodies alive for us throughout our life. Memories are not actually lost with dementia or with other brain injuries; rather, the ability to retrieve and gain access to these is damaged. Music, then, can provide access not only to specific moods and memories, but also to the entire thought-structure and personality of the past. In a clinical study (Tomaino, 1998), when personally preferred music was presented to persons with medium to late stage Alzheimer's Disease, each participant demonstrated the ability to spontaneously verbalize fragmented information about their past. One of the participants, Molly, who was non-verbal at the beginning of the music therapy intervention, began to speak after hearing an Irish tune repeated for the third time. Although she only stated "That' s nice". It was the first coherent remark she had made. At that point the therapist asked Molly where she was from and she replied from Ireland and then continued to talk about her family and what a nice town it was. Even though the phrases were fragmented the images and ideas Molly was trying to present were clearly connected.
As we possess memories for factual information, we also possess memories or ìmotor templates" for physical movements. Many adults are institutionalized following a stroke that leaves them with a weakness or paralysis on one side of the body. Even persons with dementia may lose the ability to initiate movements. By stimulating a similar but neurologically different physical activity, music, with a strong rhythmic base, can allow for spontaneous movement, thus keeping limbs and joints free from possible atrophy and contractures. Music, and in particular rhythm, can play a essential role in treatment by providing the necessary cues to reintegrate the sense of movement. The loss of neurologic function can trigger the activation of compensatory mechanisms, which have been lying dormant within the brain, to partially or completely ` take over' the absent function. This phenomenon is known as `neural plasticity'. There are many alternate nerve pathways and connections that can be used to re-establish behaviors. Damasio (1994) indicated that neurologic function includes the recruitment of certain neural pathways, depending on the type of stimulus or the subsequent response. In persons with hemiparesis ( a weakening of one side of the body) it may be possible to stimulate alternate motor pathways with the "right" music/rhythm. For example, walking and dancing, though both physical movements, use different postural schema. Through music therapy, we have the ability to help patients reintegrate the sense of movement that they have lost. The following clinical example illustrates this point:
Sam was a man in his late 60's recovering from a recent stroke. He was on physical therapy and was considered a ìguarded walker --he could walk independently with a quad cane. The discharge team was concerned that Sam's uneven gait might cause him to stumble if he walked on an uneven surface like a typical concrete pavement. His was referred to music therapy in hopes that he could improve his proprioception and regain his ability to lift both legs enough to manage the challenges of walking out-of-doors. Sam was able to communicate well and provided information about his past experiences with music including how, as a teenager, he used to go dancing every week. However, he had not danced in over 40 years. The physical therapist tested Sam's gait and I found some music with a tempo that matched the pace of his stride. The music was familiar to him and he felt comfortable walking to the tempo. As he became more confident of his movements, he began to add dance steps, sliding his feet or clicking his heels. As the sessions progressed, he became more inventive in his movements and within several weeks, of meeting two times a week, he began to lift his left foot off the floor. He was not aware of this but stated that he was able to feel the tempo in his leg and thought that he was able to actually feel the floor with his left foot. Previously he had mentioned that one of the most frustrating things for him was to go to the entertainment programs here and have his right foot tap away, while his left foot remained immobile. He was regaining sensation in that side. We worked together, twice a week for two months. At the same time he continued in physical therapy where the therapist used Sam's internal memory of the music to cue his gait. Sam was soon discharged and moved to an apartment in the community.
Despite the increased acceptance and understanding of the therapeutic benefits of music therapy in work with persons with neurologic impairments and challenges, more research needs to done to demonstrate it's efficacy in application with a wide range of diagnosis. Clinical research in parallel with basic scientific studies which investigate the underlying neural mechanisms stimulated by components of music must continue so that a new understanding of music and the brain will emerge. This knowledge may influence how music can best be applied therapeutically. As technology advances, especially in the area of neuro-imaging, and as clinical research continues, we will be able to fully understand the multiple processes of memory, the complexity of neural networks, and mostly, how music connects to essential neurologic function.

References:
Damasio, A. R. (1994). Descartes ' error.- Emotion, reason and the human brain. New York: Grosset-Putnam Books.
Wertheim, N.(1977) Is there a anatomical Localization for Musical Faculties. In Critchley and Henson (eds.)Music and the Brain. London: William Heinemann Medical Books. p.293.
Thaut, M. H., & Mclntosh, G. C.(1992). Effects of rhythmic auditory cueing on stride and EMG patterns in normal gait. Journal of Neurologic Rehabilitation, 6, 185-190.
Tomaino, C. M. (1993). Music and the limbic system. In F. J. Bejjani (Ed.), Current research in arts medicine. Chicago: A Cappella Books.
Tomaino, C. M. (1998). Music on their minds: A qualitative study of the effects of using familiar music to stimulate preserved memory function in persons with dementia. Unpublished doctoral dissertation, New York University. New York.
Tomaino,C.M. (1998). Music and Memory. In Tomaino (ed.) Clinical Applications of Music in Neurologic Rehabilitation. St. Louis: MMB Music, Inc.
Tomaino, C.M. (1999). Active Music Therapy. In C.Dileo, (Ed.) Music Therapy and Medicine: Theoretical and Clinical Applications. American Music Therapy Association, Inc.

This article can be cited as: Tomaino, C. (2002) The Role of Music in the Rehabilitation of Persons with Neurologic Diseases. Music Therapy Today (online), August, available at http://musictherapyworld.net

*)D.A., MT-BC Director, The Institute for Music and Neurologic Function, Vice President for Music Therapy at Beth Abraham Health Services 612 Allerton Avenue Bronx, New York 10467 USA (718) 519-4236 ctomaino@bethabe.org http://www.musichaspower.org

Música pode retardar Alzheimer, diz estudo

Foto: The Plain Dealer, Lisa DeJong/AP

Estudos feitos nos Estados Unidos indicam que pacientes com Mal de Alzheimer talvez possam retardar o desenvolvimento da condição por meio de Musicoterapia.

O pesquisador Petr Janata, da Universidade da Califórnia, monitorou a atividade cerebral de um grupo de voluntários enquanto ouviam música e concluiu que a região do cérebro associada à música também está associada às memórias mais vívidas de uma pessoa. A área do cérebro parece servir de centro que liga música conhecida, memórias e emoções.

Seu estudo foi publicado na edição online da revista científica Cerebral Cortex e será incluído na edição impressa da revista, ainda neste ano. [...] (Continue a ler em Terra Networks Brasil)

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