Research

Research: Current Projects

 Effect of Vibrotactile and Music Stimulation on Dementia

This study is conducted by Dr. Lee Bartel, Susan Zorz, Danielle Nicholls and myself at the Glebe Centre in Ottawa, Ontario, Canada.

The purpose of this study is to evaluate Rhythmic Sound Stimulation (RSS) on the arousal of neural activity in persons with dementia: applied rhythmically to the body as low frequency sound and transmitted to the brain through the sensory system as well as the impact of listening to preferred music on a speaker. In this study half of the participants will receive low frequency sound stimulation at 40Hz to stimulate the brain through the somatosensory system (body). We plan to assess any effects of this stimulation on alertness, clarity, and short-term memory of persons with AD. The Sound Oasis VTS1000 has been selected to provide the 40-Hz somatosensory stimulation.  The other half of participants will listen to preferred music on a speaker for their treatment.


An explanatory sequential inquiry on music therapy and performance anxiety in University music education majors

(Pending REB approval)

The purpose of this study is to evaluate music therapy techniques in helping music education majors with the occurrence of performing anxiety. Performance anxiety is a significant concern for musicians at large, including music educators. Music therapy is a proven therapy to help reduce anxiety. While this therapy is valuable, there are few studies investigating the efficacy and benefit of music therapy to potentially reduce the frequency and/or occurrence of performance anxiety in University music students, including music education majors.

Research Questions

1)         What if any are the benefits of participating in individual music therapy on reducing the frequency and/or intensity of performance anxiety in                                University music education majors?

2)         What if any are the most beneficial music therapy techniques to reduce performance anxiety?

3)         What are the implications for University music educators and other music educators on including music therapy to reduce the incidence and/or                              occurrence of performance anxiety in musicians?


Scoping Review and Analysis of Singing in Palliative Care, Oncology and Bereavement Music Therapy

Collaboration with Ms. Rebecca Wright

This review is focused on the following question: What does the literature and research acknowledge as the role of singing as a therapeutic intervention in music therapy sessions with adults in palliative care, oncology and bereavement settings? It is a project for a peer edited book.


Rhythmic Sensory Stimulation and Alzheimer's Disease

Our team continues to explore Rhythmic Sensory Stimulation and Alzheimer's Disease through case studies. We have published a few papers on the research to date. They are listed below.

1. Clements-Cortés, A., Ahonen, H., Evan, M., Freedman, M. & Bartel, L. (2016). Short term effects of rhythmic sensory stimulation in Alzheimer’s disease: An exploratory pilot study. Journal of Alzheimer’s Disease, 52(2), 651-660. DOI 10.3233/JAD-160081 https://tspace.library.utoronto.ca/handle/1807/72411

This project was led by the Music and Health Research Collaboratory (MaHRC) in collaboration with the Baycrest Centre, and the Conrad Institute for Music Therapy Research at Laurier University. The Principle Investigator was Dr. Morris Freedman, Head of Neurology, and Medical Director of the Ross Memory Clinic at Baycrest; Professor in the Department of Medicine, University of Toronto. The project’s Principal Co-Investigators were Heidi Ahonen, PhD, Director of the Conrad Institute for Music Therapy Research; Professor, Wilfrid Laurier University; and Lee Bartel, PhD, Associate Dean-Research and Acting Director of MaHRC. I was the coordinator of this study and a research team member.

This study assessed the effect of stimulating the somatosensory system of Alzheimer’s disease (AD) patients at three stages of their illness with 40Hz sound. In this AB cross-over study design, 18 participants (6 mild, 6 moderate, 6 severe) each participated in 13 sessions: one intake and 12 treatment. Treatment A consisted of 40 Hz sound stimulation and Treatment B consisted of visual stimulation using DVDs, each provided twice a week over 6 weeks for a total of 6 times per treatment. Outcome measures included: St. Louis University Mental Status Test (SLUMS), Observed Emotion Rating Scale, and behavioural observation by the researcher. Data were submitted to regression analysis for the series of 6 SLUMS scores in treatment A and 6 scores in B with comparison by group.  The slopes for the full sample and subgroups in the 40Hz treatment were all significant beyond alpha =.05 while those for the DVD were not. A thematic analysis of qualitative observations supported the statistical findings.  40 Hz treatment appeared to have the strongest impact on persons with mild and moderate AD. Results are promising in terms of a potential new treatment for persons with AD, and further research is needed. 

2. Clements-Cortés, A. Ahonen, H., Freedman, M. & Bartel, L. (2017). The Potential of Rhythmic Sensory Stimulation Treatments for Persons with Alzheimer’s Disease. Music and Medicine, 9(3), 167-173.

Background: Rhythmic Sensory Stimulation (RSS) is a treatment being implemented for persons diagnosed with a variety of disorders such as fibromyalgia and Alzheimer’s disease (AD). This paper provides qualitative results of observations and interactions of AD study participants who received both RSS and visual stimulation sessions for 6 weeks. A case vignette is also provided.
Objective: The study proposed that RSS could stimulate the auditory and somatosensory system at 40Hz with the potential for improvements in cognition for persons with AD.
Method: 18 participants at three stages of AD participated: mild, moderate and severe. Participants received a total of 13 sessions in this AB cross-over design study. Qualitative content analysis was used to analyze the qualitative data.
Results: Qualitative findings from the study support RSS as a potential treatment for persons with AD to increase alertness,stimulate discussion, and increase interaction and awareness of surroundings.
Conclusion: Further research is needed to explore the effect of the frequency within the sessions provided, the duration of effects, and whether AD severity interacts with the RSS treatment. Further investigations could lso study the effect of auditory 40Hz stimulation alone, as well as the inclusion of music listening during the RSS sessions.


3. Clements-Cortés, A. Ahonen, H., Evans, M., Tang-Wai, D., Freedman, M. & Bartel, L. (2017). Can Rhythmic Sensory Stimulation Decrease Cognitive Decline in Alzheimer's Disease?:  A Clinical Case Study. Music and Medicine, 9(3), 174-177.

Background/Objectives: To present Rhythmic Sensory Stimulation (RSS) as a potential new treatment of Alzheimer’s disease (AD).
Design: Longitudinal case study over a 3-year period.
Setting: RSS was provided both in a long-term care/research facility and in-home.
Participant: A 92 year old female with AD.
Intervention: Treatments consisted of RSS resulting in gamma frequency entrainment, provided with two different treatment devices over 3 years.
Measurements: Quantitative and qualitative measures were used including: MMSE, SLUMS, interviews, observation notes and a participant question sheet.
Results: MMSE scores since diagnosis 3 years earlier, as well as cognition, clarity, and awareness were reported by the subject’s husband, to have remained unchanged.
Conclusion: Although further research is warranted, this case suggests that RSS has potential to help maintain cognition in AD.


Taking Flight: Music Therapy Internship Experiences from the Eyes of the Pre-Professional

I am currently exploring a similar study of Pre-professionals' internship experiences in the United States. Below is the internship study paper on the Canadian experiences completed and published.

Clements-Cortés, A. (2015). A survey study of Pre-professionals’ understanding of the Canadian music therapy internship experience. Journal of Music Therapy, 52(2), 221-257.

This study aimed to: 1) assess the skills, competence, comfort, concerns, issues, challenges, and anxieties of Canadian undergraduate students at two stages in the internship process (pre- and post-internship); and 2) examine whether these perceptions are consistent with published research on internship. Thirty-five pre-professionals, from a pool of 50 eligible respondents (70% response rate), completed a 57-question survey using a five-point Likert scale ranking pre- and post- internship experience and participated in an interview post study. Survey results indicate a statistically significant increase in pre-professional’s perceived clinical, music and personal skill development from pre- to post-internship. Areas of desired skill development included: counselling, functional guitar, and clinical improvisation. Recommendations for educators and supervisors are provided with respect to areas of focus in undergraduate education and during clinical internship.


Music and Rhythm Based Mobility Training to Reduce Falls in Persons with Cognitive Impairment and Alzheimer’s Disease

This study is conducted by Dr. Corene Thaut, Dr. Michael Thaut and myself as part of the work at the Music and Health Research Collaboratory, University of Toronto, Canada.

The purpose of this study is to investigate whether a Rhythmic Auditory Stimulation (RAS) based ambulation and exercise program will decrease the number of falls and/or increase cognitive performance in persons diagnosed with mild cognitive impairment (MCI) and/or Alzheimer’s disease (AD), with a history of a minimum of 1 fall within the past 3 months on the date of admission to the study (July to September 2017).  Changes in gait parameters commonly used to evaluate fall risk, including cadence, stride length, and velocity, will be assessed.

Research Questions:

1) Does a  RAS based rhythm and music sensorimotor ambulation and exercise program , based on Neurologic Music Therapy (NMT) techniques, reduce the incidence of falls in persons diagnosed with mild cognitive impairment (MCI) and or Alzheimer’s disease (AD)?

2 Does a  RAS based rhythm and music sensorimotor ambulation and exercise program have any short-term effects on cognitive ability in persons diagnosed with MCI and/or AD?

3)  Does a  RAS based rhythm and music sensorimotor ambulation and exercise program have any short or long-term effects on cognitive ability in persons diagnosed with MCI and/or AD?

Hypothesis: 

A music and rhythm based mobility training using Rhythmic Auditory Stimulation will reduce the incidence of falls in persons with MCI and/or AD.