Gait instability is often a symptom of a brain accident, such as a stroke.  There are two areas that have the biggest impact on walking impairment after such an accident, proprioception and being able to properly sequence the gait cycle.

Sequencing is one of the most important and integrated aspects of our lives.  From the firing of our neurons to the actions we take, from the sentences we speak to how we eat with a fork, everything in our lives is in some form, a sequence. Any type of brain incident causes a myriad of sequences to be disrupted.  Yet once the event has occurred and therapy begins it can be more difficult to assess at what levels our functional sequences need to be addressed. When working on improved walking, therapists often encourage patients to take a “step”, forgetting that the wiring previously used for the sequencing of that “step” has been damaged.  Unintentionally, this often leads to compensatory patterns that are far from “normal” walking.  Practicing the individual movements involved in taking a “step” is paramount to helping the brain rewire the appropriate sequence for walking.

Proprioception is the ability to sense stimuli arising within the body regarding position, motion, and equilibrium. The sense of proprioception is disturbed in many neurological disorders.  In the case of walking after a stroke, the area most affected by loss of proprioception is the foot on the weaker side.  This is often the most difficult area to improve, yet without it, it becomes virtually impossible to regain independent functional walking.  If you can’t tell where your foot is in space how do you know if you are, or aren’t, walking correctly?  And more importantly, how can you appropriately engage in your own therapy? This should be one of the first areas addressed when working on regaining walking.

The vestibular system is a sensory system that is responsible for providing our brain with information about motion, head position, and spatial orientation; it also is involved with motor functions that allow us to keep our balance, stabilize our head and body during movement, and maintain posture. Thus, the vestibular system is essential for normal movement and equilibrium. In many people with neurological disorders this system becomes impaired and impacts one’s ability to return to normal walking function.

Through our experiences working in both acute and chronic stroke care, we have identified 5 core exercises for relearning a more functional gait pattern and improved proprioception, irregardless of where you are in your recovery process. These make up The Conklyn Method of Gait Reintegration. We have also identified peripheral exercises that work to improve both proprioception and vestibular function.  Combined these can lead to a more independent and “normal” walking pattern.

We define Music Therapy as the use of music to achieve one’s current full health potential, whether physical, psychological, communicative, social and/or neurological.

The American Music Therapy Association defines music therapy as the following:

“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”

The World Federation of Music Therapy defines music therapy as the following:

“Music therapy is the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals, groups, families, or communities who seek to optimize their quality of life and improve their physical, social, communicative, emotional, intellectual, and spiritual health and wellbeing. Research, practice, education, and clinical training in music therapy are based on professional standards according to cultural, social, and political contexts. Source: WFMT, 2011.”

These, and other definitions, have changed and evolved through the years with new understanding and knowledge gained through research and clinical trial.  However, the following lines from “An Introduction to Music Therapy” (Davis, Gfeller & Thaut, 1999) remain true:

“Given the various ways in which music is used as a therapeutic tool, it is difficult to articulate a brief yet comprehensive definition of music therapy.” (pg. 6)

“The effectiveness of music as a therapeutic tool that is applied for particular use depends on the skill and knowledge of the therapist.” (pg. 6)

Just as in any other profession Music Therapists have a wide range of skills (these include musical, clinical and adminstrative), use a wide range of tools (musical: such as instruments and genres/types of music, clinical: such as behavioral or humanistic approaches, administrative: such as particular assessments and documentation), and serve a wide range of populations using their skills to address a myriad of goals and objectives.