By Rebekah Keenan, Neurologic Music Therapist, Chroma
Functional Neurological Disorder (FND) occurs due to a problem with the functioning of the nervous system, rather than by a specific physical neurological disease or disorder, and patients with FND can experience a wide range and combination of physical, sensory and/or cognitive symptoms that can be continuous, fluctuate or happen from time to time.
Common functional symptoms include, Physical/Motor Dysfunction, Sensory Dysfunction, Episodes of Altered Awareness and Concentration, Memory and Fatigue.
While treatment should always start with a clear and supportive explanation of the specific clinical features that have contributed to the FND diagnosis, there is clear evidence for the efficacy of certain treatments, for example, physiotherapy for the treatment of motor symptoms or occupational therapy for regaining confidence engaging in activities of daily living.
However, increasingly Neurologic Music Therapy (NMT) is also being used as a treatment for people with FND.
Chroma is currently working with STEPS Rehabilitation, a specialist residential and day rehab facility in Sheffield for clients with neurological conditions, acquired brain injury, spinal cord injuries, stroke, orthopaedic and other complex trauma injuries to support people with FND.
STEPS is seeing an increasing number of patients with FND referred to their service for short- and long-term rehabilitation. As well as traditional treatments such as physiotherapy, speech and language therapy, occupational therapy and psychology, STEPS Rehabilitation is offering FND clients the opportunity to also engage with NMT.
NMT is proving to be a useful intervention largely due to its multiple benefits. Because FND clients often present with a combination of neurological symptoms, NMT offers a unique approach to treatment in that it can address a wide range of symptomatology – physical/motor dysfunction, sensory dysfunction, speech dysfunction and cognitive problems. It can also help clients work through psychological and emotional symptoms.
I am currently working with a client with FND, and this case study perfectly exemplifies the positive impact of NMT.
The patient I am working with is a woman in her 50’s, a high-flying professional, fit and healthy. Six years ago, she experienced a gradual onset of symptoms that lasted a couple of years. She stabilised and life appeared to be back to normal until a year ago when she noticed symptoms recurring, which led to a fall after which things deteriorated and her anxiety increased.
The patient displayed physical/motor symptoms characterised by slow movements, which affected gait, walking and hand/arm movement and a combination of muscle weakness and muscle tension which increased stiffness.
Over a four-week intensive rehabilitation period, which consisted of one NMT session per week, we were able to help the patient make positive progress and improvement in the areas of motor movement.
She learnt techniques that she could continue to use after her short time at STEPS. Her anxieties around movement lessened and she appeared to focus less on affected areas of her body allowing movements to become more automatic.
The intervention covered:
NMT is proving to be an invaluable therapeutic intervention within the treatment of patients with FND. The wide range of techniques and adaptability to the individual and unique needs of patients make it an accessible and purposeful treatment.
Music and rhythm give patients a creative distraction and motivation within their rehabilitation as the focus is not solely on a person’s difficulties and in-affective function, but rather it is on the potential for regaining function.
As shown above, integrating NMT into any therapeutic team where the primary focus is on neurological rehabilitation can contribute to the assessment, treatment and continued rehabilitation of patients.
For more information email sayhello@wearechroma.com or call 0330 440 1838.