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858 - Personalized Music Performance in Recreational Therapy Enhances Sense of Agency in Acute Rehab Patients with Functional Restrictions

Friday, February 28, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

JW

Jason Wang, BA

Medical Student
Rutgers Robert Wood Johnson Medical School
Bridgewater, New Jersey, United States

Co-Author(s)

TN

Tanjum Nusrat, CTRS

Recreational Therapist
Mount Sinai Health System
NY, New York, United States
Miguel X. Escalon, MD

Program Director
Icahn School of Medicine at Mount Sinai
NY, New York, United States

Case Diagnosis: Intradural extramedullary spinal and thoracic tumors; adjustment disorder with mixed anxiety and depressed mood

Case Description: A 42-year-old female with paraplegia secondary to intradural extramedullary spinal and thoracic tumors graded T10 AIS C presented to acute rehabilitation for robotic exoskeleton therapy. The patient reported feelings of depression and powerlessness due to her unfortunate situation. A member of the patient’s care team collaborated with recreational therapy to perform weekly violin concerts for the patient during group therapy sessions for one month. The concerts consisted of uplifting songs and dance music, including songs by Alicia Keys, the patient’s favorite motivational music. The patient reported improvements in mood and quality of life, and expressed renewed confidence that she could improve in therapy.

Discussions: Rehabilitation can be frustrating for patients with paraplegia. The sudden decline in their functional mobility can make them feel like they are trapped in a body they cannot control, and their corresponding decline in mood may negatively impact progress in daily therapy. One way to address this is to personalize patients’ daily activities in a way that connects with uplifting experiences they have had. Live music is one example of an enjoyable recreation that patients associate with meaningful experiences, and it can be integrated into existing recreational therapy workflows on acute rehabilitation units.

Conclusions: For patients with new-onset restrictions that significantly differ from their functional status prior to hospitalization, it is crucial to consider that their mood and motivation in therapy are directly linked to how much agency they feel like they have over their situation. As physiatrists, it is important to communicate with patients about what they find meaningful and purposeful as part of their social history on admission in order to understand how best to help them achieve their long-term functional goals.