23.7. 1993 Vitoria-Gasteiz / Spain - World Federation of Music Therapy

(as Parkinson observed) it ceases temporarily on
voluntary movement of the limb. Bradykinesia describes
the extreme slowness of movement which is often the
most obvious feature of the disease. The slowness
initially affects particularly automatic movements such
as walking, arm swing, axial movements and body sway
and speech. Rigidity manifests itself as a feeling of
stiffness, which is often painful, and is described as
"cogwheel" in type. The postural difficulties which many
PD patients have later in the disease result in FX lack of
balance and falling, particularly in crowded places
where sudden changes of direction are needed. Many
of the clinca1 features of PD can be controlled - at least
in the early stages - by drugs, particularly those
containing laevo-dopa, but the rehabilitation of motor
deficits may also be helped by the physical therapies
and it is in this area that music may have an important
part to play as well as in helping patients to cope with
the emotional and psychological problems which always
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accompany this type of progresive disability.
My own interest in music with PD patients arose from
personal observation that playing rhythmic music on the
piano helped patients to walk more regularly to increase
the length of paces, to vary speed and to covercome
"freezing" episodes. It seems that the music, as Sacks
observed, has to be rhythmic but also to have a strong
melodic component, especially if the tune is pleasant. or
emotionally rewarding to the pacient. A similar effect
can be observed in movements of the upper limbs, as in
the case of a clergyman who had great difficulty in
performing the repetitive circular movements of
shaving with an electric razor. As a result of his music
therapy sessions he discovered he could perform this
movement without.any difficulty to the accompaniment
of the Blue Danube Waltz, a favourite piece of his.