A-Z List


Coma

Problem Areas for Clients

  1. Coma rating scores using the Glasgow Coma Scale may be very confusing because composite scores are used. Two patients could have the same score yet be very different. For example, one patient might exhibit good physical responses but poor cognitive understanding and score the same as a patient with good comprehension who was not able to respond physically.
  2. Each patient is different and will therefore respond differently to different stimuli.
  3. Try to determine if the behavior elicited is a true response to a stimulus.
  4. The music stimulation program should be presented for only brief periods of time during the patient’s alert stage unless a lengthy warm-up produces a better quality of or more different types of responses.
  5. Consider what kinds of stimulation you’re using and for how long.
  6. There may be a difference in the patient’s care as to who’s in charge- a rehab specialist or a neuro surgeon. The rehab specialists often have a more positive outlook because they see more patients with potential for recovery. The neuro surgeons may have a more negative outlook because they see the patients who are in need of surgery.
  7. Research may be biased because the studies include individuals with different circumstances. Different types of stimulation and visits from significant others both could have an effect on the patient’s outcome.
  8. Consider the intrusion quality of the music.
Music therapy goals for targeting these problem areas

  1. To provide music to elicit relaxation
  2. To provide music for stimulation purposes to elicit responses
  3. To use music to alter breathing patterns
  4. To assist recovery as quickly and efficiently as possible
  5. To help people regain the most independent level of functioning possible
Music Therapy methods used for treatment

  1. Use a wide variety of instruments- pitched, non-pitched, high, low, and different sounds.
  2. Use intrusive stimuli- cymbals in ears, rhythmic patterns on chest, high pitched flute, flexitone.
  3. Use non musical stimuli including sounds of previous importance to patient.
  4. Use your voice.
  5. Use gongs, drum heads, tone bars, tambourine, jingle stick and bell bracelet.
  6. Use combinations of guitar and voice or other instruments.
  7. Play songs that are familiar to the patient using varied tempo and volume.