THE hand therapy room at the Cheras Rehabilitation Hospital (CRH) is small but spacious with just a few pieces of furniture.
A karaoke set, a keyboard with each key tagged with a different colour and a cajon are in one corner.
The items will only be used for the music and movement therapy, which has been conducted at the hospital since 2015. The room may look uninteresting but transforms during the music therapy session because of the songs and laughter from patients undergoing treatment at the facility. Among them is Nur Aina Natasha Azman from Bandar Tun Hussein Onn, Cheras.
Nur Aina, 18, was a bright and active student at SMK Bandar Tun Hussein Onn 2. She suffered a brain injury after a motorcycle accident during a weekend family outing in Muar, Johor in 2014.
Her mother Junainah Bhak says Nur Aina, fondly called Asha by her family, was in a coma for 18 days and was left paralysed from the neck down. Her memory and ability to speak were also affected.
“I was researching for physiotherapy treatments for Nur Aina when I discovered the various programmes at CRH, including the music and movement therapy to facilitate the healing process.
“Apart from physiotherapy, Nur Aina also takes part in music therapy sessions at the hospital since 2016,” says Junainah.
Nur Aina attends the sessions once a week. The hour-long group activity is conducted by physiotherapists and comprises various activities to improve coordination and motor skills as well as social interaction.
In one of the activities, patients are encouraged to sing along to children’s songs and clap according to the beat of the cajon played by a therapist. In another activity, they are encouraged to play with plastic cups or stretch lightly while singing.
“After the accident, Nur Aina is like a small child who has to re-learn everything, including basic skills such as holding a cup and standing.
“The impact of music therapy on my daughter is amazing. I can see her progress day by day. It has helped her talk again and I can still remember the day I first heard her humming and singing to the tune she learnt during therapy.
“I’ve seen significant improvements in her self-confidence and her interaction with family members, and other people,” says Junainah. “What matters most is that Nur Aina is getting well and is happy. Seeing the smile on her face during therapy makes me feel so happy and blessed,” says the mother of four.
HELP IN HEALING PROCESS
A 2017 study on the applicability of sound art as therapy for Alzheimer patients done by Dr Kamal Sabran, a fellowship researcher at the School of Arts, Universiti Sains Malaysia, indicates that creative outlets such as music has an impact in the healing process although its function as a therapeutic tool is often neglected or, at the very best, misunderstood.
“The use of the arts in healing does not contradict the medical view in bringing emotional, somatic, artistic, and spiritual dimensions to learning. Rather, it complements the biomedical view by focusing on not only sickness and symptoms themselves but the holistic nature of the person,” says the study.
Music therapy in Malaysia is not new but its implementation is very limited, especially in government hospitals due, to the lack of specialists in the field, says Foo Kok Wee, chief of the physiotherapy unit at CRH.
At the hospital, music therapy is usually integrated with the overall rehabilitation programme of a patient.
“Children with cerebral palsy or people who have suffered a stroke or traumatic brain injuries are among those recommended to go for the therapy apart from other rehabilitation treatments,” says Foo.
“Since day one, we have been working closely with Dr Indra Selvarajah, a music therapy lecturer at the Department of Music, Universiti Putra Malaysia, to develop the music therapy programme. The programme will help patients improve their physical and emotional wellness.
“Asking a young stroke patient to stretch his arms or to lift his hand is not always easy. This is where music helps. Encouraging a patient to lift his hand to a beat or rhythm in a relaxing and fun environment makes the difference.
“We want patients to do the therapy without them realising that they are actually doing something effective to improve their motor skills,” she says.
EFFECTIVE ALTERNATIVE
Indra, who is the Malaysian Music Therapy Association founding president, says music therapy in a hospital setting has been effective in triggering a positive impact both physiologically and psychologically, especially in children with special needs, cancer patients, people with chronic pain or those in palliative care.
“The positive impact will lead to improved bonding between patients and caretakers as well as health practitioners. It will also boost the effectiveness of the Kamal says studies show that auditory simulation for people with Alzheimer’s and dementia is effective for mood enhancement, relaxation and cognitive abilities.
Music therapy is meant to improve patients’ physical and emotional wellness. overall healing process.
“Patients are already going through a traumatic period. We hope that music, being light and soothing, can help them cope and go through their healing process,” says Indra, adding that the validated music therapy programme at CRH formally started in 2017 and is done with the help of her students and volunteers from the University of the Third Age programme (a programme under the Lifelong Learning for Older Malaysians project at UPM).
MUSIC THERAPY FOR
ALZHEIMER’S PATIENTS
KAMAL Sabran says that according to the New Hampshire Arts-in-Healthcare Survey report in 2013, “arts-and-health is a diverse, multi-disciplinary field dedicated to transforming health and healing by connecting people with the arts at key moments in their lives”.
This research field — labelled “arts of medicine” or “integrative arts medicine” — integrates literary, performing, and visual arts and design into various healthcare and community settings for therapeutic, educational, and expressive purposes.
“Evaluations, observations, and research findings demonstrate that there are both instrumental and intrinsic benefits of arts in healthcare.
And the use of art as part of the therapeutic process for a person with Alzheimer’s disease is currently the most popular in this research field,” says Kamal.
“According to a recently published study in The Journal Of Prevention Of Alzheimer’s Disease, the part of the human brain responsible for music or sound is not affected by Alzheimer’s,” he adds.
Kamal says various studies show that auditory simulation for people with Alzheimer’s and dementia is effective for mood enhancement, relaxation and cognitive abilities. Specifically, music therapy may help Alzheimer’s patients in:
• Improving socialisation and motivation.
• Reducing restlessness or wandering.
• Improving word recall.
• Stimulating long-term memory skills.
• Increasing self-esteem.
• Triggering enjoyable feeling.
• Managing the urge to self-harm.
A 2009 study indicates that the music which the Alzheimer’s patient enjoyed when he or she was younger is best to stimulate reminiscence, says Kamal.
“Background sounds (be it reminiscence music, classical music, recorded sounds of nature, or a tabletop fountain or waterfall) and white noise stimulating sound or music playing in the background while other activities are going on improve the mood, and even the memory of people with all forms of dementia,” he adds.
What makes music or sound an effective alternative treatment for healing?
“Sound travels about four times faster through water than it does through air. Since our bodies are about 70 per cent water, sound becomes a first choice for a natural therapy.”