Music and Cognitive Achievement in Children

Musical Building Blocks in the Brain

Matters of Opinion

Does Music Have Cognitive "Spin-offs"?

Briefly Noted

Is Everyone Musical?

Brain Cooperation

Recent Publications of Special Interest

Music is widely believed to have many benefits for children beyond those within the realm of music itself. These benefits are thought to contribute importantly to development by improving intellectual, motor, and social abilities and skills. This article reviews part of this topic, specifically the relationship between music education and cognitive achievement.

A scan of the research literature suggests the variable pursuit of this problem over the years, rather than a systematically enlarging body of research. With this in mind, let us consider studies that pertain to the single reason for music education that has exhibited continual and substantial increased emphasis in the modern period i.e., the view that music promotes cognitive development and abstract thought (see Matters of Opinion). Within this realm, we include topics such as reading, the mental rotation of representations of objects, and creative thinking. These tap into three of the many aspects of intelligence.

We begin with an older study on music and reading, published by Hurwitz, Wolff, Bortnick and Kokas in 1975 (1). The authors asked whether music training improved reading performance in first grade children. The experimental group received Kodaly training, which uses folk songs and emphasizes melodic and rhythmic elements. The control group consisted of children who were matched in age, IQ and socioeconomic status at the beginning of the study and who received no special treatment. The music instruction was extensive, five days a week for 40 minutes per day, for seven months. Students were tested on reading ability at the start of the school year and then tested again at the end of the year. After training the music group exhibited significantly higher reading scores than did the control group, scoring in the 88th percentile vs. the 72nd percentile. Incidentally, the benefits for the music group were not due to better teaching of reading because students who had the same teacher before, during and after music training showed greatly improved reading performance. Moreover, continued music training was beneficial; after an additional year of Kodaly training, the experimental group was still superior to the control group. These findings clearly support the view that music education facilitates the ability to read.

Although these results are impressive, both in terms of the use of control subjects and because the findings can be interpreted as a cause-effect relationship between music and reading, two questions immediately come to mind. First, was the enhancement of reading ability caused by music itself or simply by having a more varied school program, which happened to consist of music education. After all, the control group was left alone; had they been given some other special non-musical experiences, would they have improved as much as the music group? Second, how could music training possibly improve reading; the music group did not learn to read music but rather to listen, and recognize musical ideas, etc. We will consider both of these questions; an answer to the second will prove relevant to the first.

To understand how music education might benefit reading, we need a brief review of how children usually learn to read after they can understand a language. According to Frith (2) there are three stages: [1] visually recognizing words, [2] learning the correspondences between visual parts of words ("graphemes") and their spoken sounds ("phonemes"), and then [3] achieving visual recognition of words without going through the earlier stages. It is the critical second or "phonemic" stage that is of interest here. We are all familiar with children "sounding-out" syllables and words while they are learning to read (stage 2) which they discard when they reach stage 3. It seems that music facilitates reading by improving the second, phonemic stage.

The evidence comes from a recent study by Lamb and Gregory (3) who determined the relationship between musical sound discrimination and reading ability in first grade children. In addition to some standard reading tests, children were tested on their ability to "sound out" nonsense syllables that they viewed on cards (phonic reading) and pitch awareness, in which they heard pairs of musical notes or chords in sequence and reported whether they sounded the same or different. Also, the children were tested with notes that had the same or different timbres. Finally, their phonemic awareness was assessed by listening to spoken words and telling whether the words began or ended with the same sound. The experimenters then determined the relationships, between performance scores on the various tests. They found a high degree of correlation between how well children could read both standard and phonic material and how well they could discriminate pitch. Timbre awareness was not related to reading, showing the specificty of the findings.

What does all of this mean? The findings support the conclusion that good pitch discrimination benefits learning to read by enhancing the second, phonemic stage of learning. Pitch change of verbal word components (formants) is thought to be the most important factor in conveying word information (4). The relationship to music education is straightforward, because such training invariably involves improvement in pitch discrimination. Therefore, the findings of Hurwitz et al that music training facilitates learning to read can be understood as being mediated by enhanced pitch discrimination. That timbre awareness is unrelated to reading suggests that the benefits to reading are not due to the increased richness of the educational experience but rather to some highly specific aspect of music education, i.e., pitch training. One might point out that the Lamb and Gregory study is correlational not causal because no music training was involved, only measures of various abilities. That is quite true. Any causal conclusions have to be based on other previous causal findings, such as the fact that learning to read requires the second phonemic stage. It seems unlikely that high scores on pitch discrimination were caused by good reading abilities, since the latter depend upon more basic processes such as the former. No doubt, further studies are needed. But the findings of both studies dovetail nicely and together provide evidence that music education facilitates reading and a mechanism by which music exerts its beneficial effect.

We next consider the effects of training with music on learning and creativity. Mohanty and Hejmadi (5) investigated the effects of various types of training of four and five year olds on learning the names of their body parts and on creativity as assessed by the Torrence Test of Creative Thinking, involving picture construction and picture completion. There were four matched groups: non-training control, verbal instruction in the names and uses of body parts, verbal instructions plus acting out movements, and the music/dance group in which instructions were given by song and acting out movements was done in the form of a dance. After twenty days of training, all experimental groups exhibited higher test scores than the control group. The music/dance group showed the greatest improvement in both learning about body parts and tests of creativity. Thus, improvement in cognitive abilities can result from a variety of training experiences but music is the most effective of these treatments. The means by which music, and the other training, produces improvement in the cognitive abilities studied remains to be determined.

Lastly, we turn to recent research on musical training and the abstract cognitive ability to mentally rotate objects, a means of assessing spatial abilities. Rauscher, Shaw, Levine, Ky and Wright (6) studied preschool children who received daily group singing lessons and weekly keyboard instruction. A matched control group received no special experiences. All children were tested using subtests of a standard intelligence test, one of which was a spatial task. After four months, the music group was superior to the control group on the test of spatial abilities but not on other tests of intelligence. Improvement was even greater eight months after the start of music training. The authors believe that this high degree of specificity in the improvement only of spatial abilities indicates that improvement was not due simply to the extra attention and enriched experiences of the experimental group, but rather specifically due to the fact that the experiences were musical in nature.

In summary, we have reviewed several studies that support the conclusion that musical training facilitates cognitive skills, including reading, abstract spatial abilities and creativity. In each case, there is an extramusical positive effect. Thus, it appears that music studied for good and sufficient reasons for its own sake (see the first two items in the list at the beginning of this article) has beneficial "side effects" on cognition. An examination of the extent to which music may or may not have such side effects on the other extramusical aspects of child development and behavior is a topic that will have to be left for succeeding issues.

(1) Hurwitz, I., Wolff, P.H., Bortnick, B.D., & Kokas, K. (1975). Nonmusical effects of the Kodaly music curriculum in primary grade children. Journal of Learning Disabilities, 8, 45-51.

(2) Frith, U. (1985) Beneath the surface of developmental dyslexia, In: K.E. Patterson, J.C. Marshall & M. Coltheart (Eds) Surface Dyslexia Hove, Lawrence Erlbaum Associate Ltd, pp. 301-330.

(3) Lamb, S.J., & Gregory, A.H. (1993). The relationship between music and reading in beginning readers. Educational Psychology, 13, 19-26.

(4) Lieberman, A.M., Cooper, F.S., Shankweiler, D.P., & Studdert-Kennedy, M. (1967). Perception of the speech code. Psychological Review, 74, 431-461.

(5) Mohanty, B. & Hejmadi, A. (1992.). Effects of intervention training on some cognitive abilities of preschool children. Psychological Studies, 37, 31-37.

(6) Rauscher, F.H., Shaw,G.L. Levine,L.J., Ky, K.N & Wright, E.L. Paper presented at the annual meeting of the American Psychological Society, Los Angeles, CA., August 13, 1994.

Our own private experience of the world is seamless, a smooth and continous flow of sensory impressions and perceptions of objects and events, sights and sounds. When we see an object, such as a red ball, we do not experience the shape of the ball separately from its color. And when we hear a violin, we do not perceive its pitch separately from its timbre. The notes in a chord are not heard as several individuals but rather in a more wholistic fashion. Yes, it is possible to learn to pay more attention to one feature of a composition at the expense of attention to other features. But this process does not fractionate the sound into its all of its separate constituents, the building blocks of music such as pitch, contour, interval, harmony, melody, timbre (tone color) , and rhythm.

Because our experience is so immediate, clear and effortless, we tend to take it for granted. However, the integrated nature of our musical and other experiences constitutes a major puzzle for brain scientists who search for the answer to how our brains apparently effortlessly meld all of these aspects of sound into a meaningful whole, that presents to us personally ... music. An unlikely answer is that our brains are specialized for music so that each of music's building blocks is processed by a different part of the brain. The simultaneous activation of these many special purpose processors would constitute the wholistic experience. In other words, there is no little neural person in our brains who is listening to the music and then telling us what it is. Although this type of idea has often been popular, it leaves us with having to explain how the little brain genie achieves wholistic perception of music, and so explains nothing.

An increasing amount of research findings support the first theory, that the brain is specialized for the building blocks of music. In the first issue of Musica Research Notes, we reviewed the evidence that the highest level of the auditory system, the auditory cortex, processes pitch rather than raw sound frequencies (see "A Note on Pitch", volume 1, number 1, Spring, 1994). Additionally, there are individual brain cells that process melodic contour, the pattern of increasing and decreasing notes in music (1). Cells have been found in the auditory cortex that seem likely to process specific harmonic relationships, such as the simultaneous presentation of the second and third harmonics of a note (2). Temporal, including rhythmic, aspects of sound streams also seem to be handled by certain cells in particular parts of the auditory cortex (3).

Findings from humans who have suffered damage to the auditory cortex by stroke or by surgery to correct intractible epilepsy are particularly fascinating. For example, damage to the right hemisphere selectively impairs the ability to process timbre (4). Also, the processing of melody and rhythm can be separated by specific brain lesions. Some patients show impaired discrimination of melodies while they have normal discrimination of rhythms, and vice versa for lesions in different regions (5). And even different aspects of the processing of temporal information seem to be handled by different parts of the auditory cortex, rhythm by the left hemisphere and beat (meter) by the right hemispheres (6).

These dissociations of the elements of music in neurologically impaired persons provide strong support for "building block" theory but might be questioned by some on the grounds that the findings do not come from normal people. This is not a very strong criticism because such patients can show completely normal levels of performance on the capabilities that remain. In any event, there are findings from intact people that support and complement these neuropsychological findings. It is possible to determine which areas of the brain are active during various tasks, including listening to music. One powerful method is to measure increases in the regional distribution of blood flow to parts of the cerebral cortex because these reflect the increased metabolic needs of brain cells that are active. In a recent study, normal subjects were tested in two passive listening conditions, noise bursts or music matched for sound frequencies, and two active judgement conditions, comparing the pitch of the first two notes of melodies or the first and last notes of melodies (7). Listening to melodies produced an activation of the right temporal (auditory) hemisphere relative to the left ("language") hemisphere. Comparing notes, which also involved short term memory, also showed a preferential activation of the right auditory cortical system, plus some other areas of the right hemisphere. These findings indicate that there are specialized neural substrates in the auditory cortex of the right hemisphere that process melodies vs. other non-melodic sounds.

Space limitations preclude a more comprehensive review. However, these examples should suffice to highlight the many types of evidence, from animals, the neurologically impaired and the normal human, that the brain contains an organization that is specialized to process the individual elements of music, the building blocks of music. These findings have relevance to basic neurobiological problems, to clinical and therapeutic approaches to treatment and last, but not at all least, to the realization that music has a deep biological basis.

(1)Weinberger N.M. & McKenna, T.M. (1988).Sensitivity of single neurons in auditory cortex to contour: toward a neurophysiology of music perception. Music Perception, 5:355-390.

Espinoza,I.E. & Gerstein, G.L. (1988). Cortical auditory neuron interactions during presentation of 3-tone sequences: effective connectivity. Brain Research, 450: 39-50.

(2) Sutter, M.L., & Schreiner, C.E. (1991). Physiology and topography of neurons with multipeaked tuning curves in cat primary auditory cortex. Journal of Neurophysiology, 65: 1207-1226.

(3) Hose, B., Langner, G., & Scheich, H. (1987). Topographic representation of periodicities in the forebrain of the mynah bird: one map for pitch and rhythm? Brain Research, 422: 367-373.

Buchfellner, E., Lepplesack, H-J., Klump, G.M., & Hausler, U. (1989). Gap detection in the starling (Sternus vulgaris): II. Coding of gaps by forebrain neurons. Journal of Comparative Physiology, 164: 539-549.

Ison, J.R., O'Connon, K., Bowen, G.P., & Bocirnea, A. (1991). Temporal resolution of gaps in noise by the rat is lost with functional decorticaiton. Behavioral Neuroscience, 105: 33-40.

(4) Samson, S. & Zatorre, R.J. (1994). Contribution of the right temporal lobe to musical timbre discrimination. Neuropsychologia, 32: 231-240.

(5) Peretz, I., (1990). Processing of local and global musical information in unilateral brain-damaged patients. Brain, 113: 1185-1205.

(6) For a general review of brain specializations for music see Peretz, I., & Morais, J. (1993). Specificity for music. In: F. Boller, & J. Grafman, (Eds.) Handbook of Neuropsychology, 8: Amsterdam, Elsevier Science Publishers.

(7) Zatorre, R.J., Evans, A.C. & Meyer, E. (1994). Neural mechanisms underlying melodic perception and memory for pitch. The Journal of Neuroscience, 14: 1908-1919.

Does Music Have Cognitive "Spin-offs"?

In the previous issue of MuSICA Research Notes (Volume 1, Issue 1, Spring 1994), this column addressed the question of whether music is a "cultural add-on" or a "biological imperative". A review of research publications strongly supported a deep biological basis for the universal presence of music. This was bolstered by a more detailed analysis of the surprisingly high level of musical capabilities in infants ("The Musical Infant"). In that issue, an exploration of this biological theme is extended in an article on brain specializations for several of the building blocks of music, such as melody ("Musical Building Blocks in the Brain"). Additionally, we expand the scope of inquiry to the question of the possible effects of music on intellectual abilities in children (see "Music and Cognitive Achievement"). This column is intended to assist thinking about this question by providing a broad historical context and pointing out the distinction between the types of findings needed to distinguish between correlation and causality.

Many reasons have been advanced for providing music education to children. In a highly interesting survey of this topic, Draper and Gayle (1987) provided a list obtained from 108 textbooks of music education published between 1887 and 1982 (1). While it would be of interest to have an update from 1982 to the present, this is not critical to the major point, that music is thought to have substantial non-musical educational benefits. The reasons advanced for music education in children are:

Self-expression and creative pleasure

Develops an aesthetic sense

Motor and rhythmic development

Promotes cultural heritage

Promotes vocal and language development

Promotes cognitive development and abstract thought

Teaches social and group skills

There are three important points. First, note that the reasons can be divided into two categories: (a) within music and the arts (self expression/creative pleasure and aesthetic sense) vs. (b) extramusical (the last five on the list). Second, as these reasons have been advanced since at least 1887, the idea that music has benefits for children that extend beyond music and the arts themselves is an idea of very long standing. Third, Draper and Gayle found some significant differences in the emphasis placed on these reasons over the years and also some constancies.

There was no change in the percent of books that listed self-expression and motor development. These reasons were found in 65-70% of all texts over the almost 100 years surveyed. In contrast, the emphasis on all of the other reasons changed. Summarized simply, there was a plunge in "develops an aesthetic sense" and increases in the other four reasons, i.e., "cultural heritage", "vocal/language development", "cognitive development/abstract thought" and "social/group skills".

This pattern of changes suggests that shifts in emphasis reflect changes in societal values, probably based on many factors including increased learning about and awareness of factors that influence educational achievement and social adjustment. In fact, it is reassuring that new knowledge influences and informs the reasons for promoting music education. For example, Draper and Gayle point out that an increase in emphasis on the benefits of music for language and vocal development during the period of 1964-1972 coincides with "...the attempt to erase socioeconomic differences with early intervention." That attitudes about music education change with societal evolution is not in itself particularly surprising. But the detailed nature of the changes has implications for potential improvements in general education , particularly if they are based on empirical studies and scientific evidence.

As 100 years is a very long time over which to appreciate changes in attitudes and beliefs and apply them to modern times, let us look more closely at the shifts of emphasis in music education for children. If one examines the results of the survey as broken down by Draper and Gayle for the three most recent periods covered, 1964-1972, 1973-1978 and 1979-1982, the overall picture changes markedly. The four reasons that received increased emphasis over 100 years have not all simply increased continually in modern times. "Language development" actually decreased substantially, "cultural heritage fluctuated and "social skills" increased considerably to 1973-1978 and then held steady. The only rationale that increased continually and greatly over this modern period was "promotes cognitive development and abstract thought."

We may ask, then, about the extent to which changes in emphasis over the years reflect scientific findings about, e.g., the extramusical benefits of music education. Although this is a simple question, its answer is necessarily complex. Tracking down the bases for attitudes about music education over time would require years of research and volumes for analysis and presentation. A more manageable question of considerable interest deals not with the bases for changes in emphasis but more simply with whether or not there is any objective evidence that music education has extramusical benefits. (see "Music and Cognitive Achievment in Children"-this issue.)

In considering this question, a distinction needs to be made between "correlation" and "causality". Correlation simply refers to a non-random relationship between two things; they "go together" but one does not necessarily cause the other. In short, one can't legitimately infer causes from correlations. A causal relationship also consists of some systematic relationship between two items, events, etc. However causality also requires that there be a link in time between the two related things, that is, the alleged cause precedes its alleged effect. Moreover, if the hypothesized cause is provided, then the hypothesized result should occur. Thus, while correlations between music and extramusical cognitive benefits are of great interest, by themselves they yield little insight into causality, although they may lead to new and important lines of inquiry, ultimately including questions of causality.

In summary, a full understanding of the roles of music in life should include knowledge of all of the effects of music exposure and music education. This includes effects that are largely restricted to music and the arts and also to other aspects of the human intellect and behavior. By taking a systematic and rigorous scientific approach to these issues, it should be possible to achieve this full understanding.

(1) Draper, T.W. & Gayle,C. (1987) An Analysis of historical reasons for teaching music to young children: Is it the same old song? In: J.C. Peery, I.W. Peery & T.W. Draper (Eds.) Music and Child Development,New York: Springer-Verlag, pp. 194-205.

Is Everyone Musical? A timely and highly readable set of articles has recently appeared in the British journal The Psychologist (August, 1994). It consists of a "target" article (whose title starts this paragraph) by three well known music researchers, John SlobIs , Jane Davidson and Michael Howe and invited commentaries and critiques by other highly regarded scientists and musicians, John Davies, David Hargreaves, John Radford, Bruce Torff and Ellen Winner. The debate is hot and heavy, but always couched in restrained language. The issue ... Is musical accomplishment based largely on innate "talent"? Sloboda et al assemble evidence from several aspects of music and psychology to argue that the role of inborn "talent" is greatly overstated. Their conclusions are based on widespread musical skills in non-Western cultures, the strong musical abilities of western students lacking a musical education, the lack of childhood indicators of adult musical success, the thousands of hours of practice required to attain skill, and the beneficial environmental effects of early music exposure to infants and young children. The "talent" approach, they claim, is to the harm of many children who might otherwise pursue music education with greater vigor in greater numbers. While the authors acknowledge that a child, or older music student, who is pronounced to have talent by senior musicians and music education might find this pronouncement to be motivating, others who do not receive this appellation of worth are less likely to undergo the rigors of study and endless hours of practice. The authors also argue that this unsupported and unwise practice is treasured and protected by the cultures of musical conservatories. Sloboda et al do provide an ample "target" for the ensuing critiques and alternative perspectives, topped by a final rejoinder from the authors. These articles are highly recommended.

Brain Cooperation. A new and powerful technique has been devised that reveals the extent to which different regions of the human brain cooperate during musical activities such as listening and composing. Professor Hellmuth Petsche and his associates at the University of Vienna are able to determine the "coherence" of brain waves at many sites in throughout the cerebral cortex (Music Perception, 1993, 11, 117-151). Systematic patterns of cooperative function have been found for individuals and these patterns can be different when the same person uses different listening strategies. For example, one subject focuses on the sound patterns without attending to their structure when listening to Schoenberg but also attends to pattern and structure in Mozart; his brain waves show differences in their pattern of cooperativity in these cases. The amount of brain coherence increases greatly during composition relative to listening. We look forward to further reports.

Children and Education

Faienza, C. Music, Speech and the Developing Brain: The Case of the Modularity of Mind, 1994. Edizioni Angelo Guerini e Associati, Verona, Italy. (B)

Trehub, S.E.; Unyk, A.M.; and Trainor, L.J. Maternal singing in cross-cultural perspective. Infant Behavior and Development, 1993, 16, 285-295.

           Abstract: Mothers were recorded as they informally sang a song of their choice, once to their infant and once in the infant's absence. Paired excerpts from different mothers were then presented to adult listeners, who were required to identify the infant-directed song in each pair. In Exp 1, with 16 singers and 20 listeners (10 men and 10 women) of North American origin, infant-directed excerpts were identified with a high level of accuracy. 12 mothers in Exp 2, all of Indian descent, sang Hindi songs in both contexts. 20 male and 20 female listeners (20 native speakers of Hindi and 20 locally born and reared adult native speakers of English) identified the infant-directed excerpts significantly better than chance, with women outperforming men and native Hindi speakers outperforming native English speakers. Findings document a distinctive style of singing to infants, some aspects of which are recognizable across cultures and musical systems.

Music Perception and Cognition

Raffman, Diana, Language, Music and Mind, 1993, MIT Press; Cambridge, MA. (B)

Tighe, T.J.; and Dowling, W.J. Psychology and Music: The Understanding of Melody and Rhythm, 1993 Lawrence Erlbaum Associates, Inc. Hillsdale, N.J. (B)

Neuroscience

Cohen, D.; Granot, R.; Pratt, H.; and Barneah, A. Cognitive meanings of musical elements as disclosed by event-related potential (ERP) and verbal experiments. Music Perception, 1993, v.11, 153-184

           Abstract: Cortical and verbal responses to harmonic and melodic intervals were determined in adults who were knowledgeable in music. Three experiments were performed with each method, using the same musical material: isolated harmonic intervals; 9 pairs of melodic intervals comprising combinations of 3 intervals; and 27 pairs of harmonic intervals. Results show specific brain responses to intervals, even without context, indicating that intervals may be viewed as meaningful words, even when presented in isolation.

Polk, M.; and Kertesz, A. Music and language in degenerative disease of the brain. Brain and Cognition, 1993 22, 98-117.

           Abstract: Music and language functions were studied in a 58-yr-old male musician and a 53-yr-old female musician with degenerative disease. The patients were tested on a standardized language battery and a series of music tasks. In the man with left cortical atrophy, expressive music functions were spared with impaired reception of rhythm. The woman with posterior cortical atrophy, greater on the right, had severe expressive music deficits, but intact rhythm repetition. The double dissociation supports the existence of independent cognitive systems, one consistent with conventional left lateralization models of language, temporal sequence, and analytic music processing and another with a right lateralization model of implicit music cognition.

Therapies

Edgerton, C.L. The effect of improvisational music therapy on the communicative behaviors of autistic children. Journal of Music Therapy, 1994, 31-62.

           Abstract: This study examined the effectiveness of improvisational music therapy on autistic children's communicative behaviors. Eleven autistic children (aged 6-9 yrs) participated in individual improvisational music therapy sessions for 10 weeks. The Checklist of Communicative Responses/Acts Score Sheet (CRASS) was designed and used to measure the Subjects' musical and nonmusical communicative behaviors. Results support the efficacy of improvisational music therapy in increasing autistic children's communicative behaviors. Significant differences were found between the Subjects' 1st session CRASS scores and those of their last sessions.

Gunsberg, A.S. Play as improvisation: The benefits of music for developmentally delayed young children's social play. Early Child Development and Care, 1991, 66, 85-91.

           Abstract: This paper describes the technique of Improvised Musical Play (IMP), a teaching application of music to integrate developmentally delayed and nondelayed young children (aged 3-5 yrs). During the early stages of social play, music draws children into the play area and engages them in the process of exploration and experimentation. During the subsequent Unified Action Phase of IMP, the children discover an agreed-upon course of action that almost everyone follows, often in unison to the music. In IMP Segment Three, music enables players to elaborate their social play successfully. Overall, music contributes to the ritualization of the play format, which allows developmentally delayed players to relax because their knowledge of when and how to participate becomes automatic. The familiar beat of the music allows these players to place new variations within the context of the original play format.

Thaut, M.H.; McIntosh, G.C.; Prassas, S.G.; and Rice, R.R. Effect of rhythmic auditory cuing on temporal stride parameters and EMG patterns in hemiparetic gait of stroke patients. Journal of Neurologic Rehabilitation, 1993, 7, 9-16.

           Abstract: This study investigated the effect of musical rhythm on temporal parameters of the stride cycle and muscle activity in gait of stroke patients. Ten subjects were studied over three trials. Each trial consisted of a baseline walk without rhythm and a walk with rhythm as pacemaker, matched to the step cadence of the baseline walk. Results showed significant (p < .05) changes: weight-bearing stance time on the paretic side and stride symmetry improved with rhythmic cuing magnitude of muscle activation increased on the affected side. Specificity of changes in muscle activation and improvement in temporal gait parameters suggest a strong entrainment effect of auditory rhythmic cues on temporal gait control in stroke patients.

(B) Indicates a book, which can be obtained from the publisher or through a library. Other publications are from journals and should be available through a public or college library for nominal cost.

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