This month, music psychologist Dr Dawn Rose tells us about Songlines for Parkinson’s, an innovative project she and her research team have been working on with The Music Workshop Company’s Artistic Director, Maria Thomas.  
Dawn explains how the course offers a new way of using music to help people with Parkinson’s to manage some of their symptoms. 

Songlines for Parkinson's 

Songlines for Parkinson’s is a new music and movement based course designed for and with people with Parkinson’s to improve their quality of life. The core research team is based in Lucerne in Switzerland, but has joined forces with the University of Hertfordshire thanks to grants from the Swiss National Science Foundation and Parkinson Schweiz. 
On the course, people with Parkinson's and their care partners can enjoy music listening, music-making, and moving to music from all around the world. From Africa to Asia, across Europe and the UK, to North and South America — the sounds, rhythms, and songs from all these places are explored using various instruments, body drumming and types of dancing. 
Each week, the sessions include tasks and activities that we know from previous studies will help people with Parkinson’s, but these are delivered in a way that is fun and engaging, but also a challenge for the people taking part! 
Right from the start, we activate the sensory systems with sound (e.g., doing body drumming and vocalisations)—in particular the auditory-motor connections in the brain (connections between the parts of the brain that are involved in hearing and movement) —because this is an important part of movement therapy for people with Parkinson’s. The way it works is using regular sounds, such as a metronome or the beat in music, to activate our ability to synchronise our movement in time to the auditory stimuli. This is called 'cueing' and it can happen with music we hear or music we imagine (internalised cueing). Musical imagery is really the cutting edge of neurorehabilitation and part of what we do in Songlines is to try to develop that ability so that people with Parkinson’s can use, for example, the line of a song they know inside their minds, in an everyday situation such as crossing the road. They can simply sing the song inside their minds to help manage their steps, an episode of freezing, or to help motivate themselves to keep going. 
A collection of musical instruments including drums, egg shakers, maracas and bells
The second part of the weekly course involves a wide range of percussion instruments and doing some active rhythmic engagement. This means learning to play some rhythms, which involves aspects of tempo, repetition, synchronisation and even syncopation, as well as call and response type exercises and even some conducting! 
A woman conducting a percussion group
It can be surprisingly physical, so following this section we have an 'active rest', which involves a different member of the group sharing a song with a special meaning each week. During this section, which is called Message Stick, we listen to the song and then discuss our thoughts about it. The psychology underpinning this is that music sharing can help create a sense of connectedness within the group, but because it's a song, it can act as an anchor point (i.e., one step removed from simple personal sharing). 
At this point, I should really explain why that section is called Message Stick and the course is called Songlines! Well, Songlines now has two meanings: the first is from a book I read about how Aboriginal peoples in Australia use internalised songs to navigate time and space to go on walkabouts and carry messages from one place to another. I was really captivated by the idea that this was something people had been doing since ancient times, and I wondered if we could help people with Parkinson’s to develop their own internalised jukebox of songs that they could call upon whenever they needed to. The Message Stick is something the traveller is given so they can speak without interruption to pass on their message. The second meaning behind Songlines has developed organically as part of the development process when Jane, one of our Parkinson’s advisors, suggested all you need to do is think of your song line and there you have it! 
There are several other parts to each session, and the course lasts for 12 weeks.  
At the moment we are conducting the course as a research trial, but Maria is providing a similar course inspired by the research for people with Parkinson's, called Maria's Musical Movers currently running in Stevenage, Hertfordshire - you'll have to come along to find out more.  
Below is a photo of our line dancing rehearsal - with cowboy hats! 
a line dancing group

Our approach and the team 

To create this new approach to Parkinson’s care, we took an inclusive and interdisciplinary approach. 
The inclusive part is based on a concept known as patient and public involvement in research, or PPI for short. This is a participatory model of medicine that advocates shared decision-making, best illustrated by the phrase “nothing about me without me”, which demonstrates a fundamental shift in attitude, reducing the power differentiation between doctors and patients and moving towards empowering people who have a condition as the experts in what it's like to live with that condition. 
The interdisciplinary aspects involved widening the expertise of the core research team by consulting with a range of experts in other fields. Alongside me, as the principal investigator and a music psychologist, the core team consists of Dr Sabrina Köchli, the postdoctoral fellow and a sports scientist, and Marietta Ungerer, PhD student and a systematic musicologist. In addition, we partnered with Dr Caroline Whyatt and Dr Lucy Annett at the University of Hertfordshire, who are experts in movement measurements and Parkinson's research respectively. We also have a team of neurologists, neuroscientists and neurorehabilitation specialists, physical therapists, music and movement therapists from all over the world working on the project, and world-famous choreographer Andrew Greenwood of Switch to Move. He has worked with people with people with Parkinson's for over 20 years developing dance moves to challenge cognitive as well as movement skills. 
We must make a special mention for our very own Maria Thomas of The Music Workshop Company, who has over 20 years of experience in designing and facilitating music-based workshops. Dawn and Maria are both musicians and have a natural rapport that made working together on the new course a real pleasure. 
The bottom line is that we know it is hard for people with Parkinson’s to keep their morale up and to keep moving when their body and minds sometimes say otherwise. So, based on what our Parkinson’s advisors shared with us, we have tried to make a course that has practical applications for everyday life and most of all, is fun. After all, in the words of Alison, a person with Parkinson’s whom we sadly lost this year, music is non-invasive, easy to access and doesn't have any side-effects, so why not try it for yourself. 
Further reading 
Read more from Dr. Dawn Rose in her guest blog - How Music Benefits Children
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