Case Studies:

Music Therapists at The Portland Hospital help motivate young children through their rehab journey

Music Therapy is being adopted at The Portland Hospital to encourage young children with Cerebral Palsy who have undergone Spinal Dorsal Rhizotomy (SDR), to improve participation during post-operative physiotherapy sessions. SDR is a specialised neurosurgery that treats lower limb muscle stiffness (spasticity) in children with cerebral palsy, by dividing sensory nerve rootlets in the spinal cord. Intensive physiotherapy is crucial following SDR to practice movement patterns in the absence of spasticity and build up muscle strength.

At the Portland Hospital, which is part of HCA Healthcare, children receive three weeks of twice-daily physiotherapy post-SDR. A music therapist will join physiotherapy sessions once or twice a week to support rehabilitation. Music therapy is used to grab the child’s attention and improve participation with functional activities like crawling, kneeling, sitting and standing. Music therapy effectively facilitates physiotherapy sessions by offering distraction from a challenging task.

Music therapy also lends itself a unique opportunity for the child to build a relationship with the physiotherapist. It removes the hierarchy, making the relationship feel more balanced. Having music therapists involved with sessions can also encourage family involvement, allowing parents to engage with the music. They are also able to discuss the child’s musical preferences and play music with their child. Importantly, music therapy is easily accessible to children and parents.

“Music is motivating,” says Jonathan Fever, Chroma’s music therapist at Portland Hospital. “In these instances, physiotherapists (PTs) have a difficult job trying to get the ‘very young’ child to perform rehab exercises, partly because of their age, they may want to do something else, they may not understand why they’re doing it or it’s simply uncomfortable.

“But music helps facilitate movement. So I may use music to support them in standing by positioning instruments around the room and they could be standing and playing an instrument and moving and playing within a song – it’s motivating. Children generally do not ask ‘why is that drum there’ they just want to play it – it’s fun!”

Jonathan also implements a technique to sessions called ‘Song Story’ where the child can use their own character and understanding of the situation to explore their emotions through the story as they go through rehab. It is more of a psychological/emotional support that also allows the child to bring in others within the space and give them different characters.

He adds: “For example, one child made her physiotherapist a mouse in the story. The mouse began a very scary character but became less so as time went on. The child could not remember the PT’s name (or chose to never use it when sessions first began), but after a session or two, the child began to call the physio by name.

“Music therapy helps break down boundaries and create a sense of equality in the space, which a child needs to help support effective recovery outcomes.”