Ever sit in a quiet room? Statistically, I would bet yes. We have all experienced that at one moment or another, whether it be for appointments, a less than exciting class, or maybe a sit down dinner with the in-laws. When that does happen, have you noticed a clock in the background? It is not phased by your boredom and keeps on ticking and ticking, its loudness taunting you as each second screams by. Here’s another question, ever notice when you’re walking with a partner and somehow your footsteps eventually synch up? I know these questions are superbly random, but as NMTs like to put it, they ARE functional.

Fun fact (!!!): Christian Huygens was a Dutch mathematician and scientist that invented the pendulum clock. In 1666 this smart fellow noticed that when two pendulum clocks were mounted on the same wall, they would eventually synchronize together (Thaut, 2013). Hold on to your seats folks because this entrainment train is full speed ahead!

If I didn’t give it away, the observation Huygens observed was entrainment. Two different forces (the pendulum of both clocks) transferred energy between their separate moving parts to create synchrony. A stronger and more overpowering force can influence a weaker force to be on its frequency until they are both moving in similar time intervals. This is similar in our brains. The rhythm, or time within beats, gives the brain something to think about. For example, the interval of time in which we move will entrain to the time interval of the rhythm you hear. Your movement is optimized because you are now matching and entraining to the rhythm template you hear. This is what can happen when walking with a partner. Soon enough, the footsteps of you and your partner will match and function within the same rhythm and frequency (Thaut, 2013).

As we know, the scientific research on entrainment has been the foundation for development of clinical NMT interventions. Individuals with a motor impairment or dysfunction due to a motor disorder or brain injury, benefit from these appropriate clinical interventions that use auditory rhythmic patterns to entrain movement. Sensorimotor NMT interventions, like Rhythmic Auditory Stimulation for gait training and Therapeutic Instrumental Music Performance for upper extremities, are based in rhythmic entrainment because they use an auditory stimulus to prime the brain’s motor system to anticipate rhythm. Because of this anticipation of rhythm, planning and executing motor movements become easier, more responsive, more precise, and more fluid with rhythmic cues (Thaut, 2013).

Patterned Sensory Enhancement (PSE) is the third intervention for sensorimotor rehabilitation. Some examples of PSE exercises include moving hands in a marching motion, bicep curls, or any upper body movement that works on extension/flexion and supination/pronation. When activities of daily living have been impaired, PSE aims to regain them and can include exercises like grasping an object and moving it to opening a door. PSE is a lot like TIMP, however unlike TIMP, instruments are not utilized during PSE interventions. Let’s take a closer look!

During a PSE intervention, a NMT will model the impaired movement of focus with the patient and will set a tempo. Using a metronome the NMT will then talk to patient through the movement that’s in time with the rhythm. The verbal cues are maintained when music following that tempo is brought in. The verbal cues are faded out to allow the music and ONLY the music to facilitate the movement. Hence, the patient entrains to the auditory rhythm of the music stimulus.  Entrainment also works to make these movements more neurologically efficient, meaning, that during entrainment it takes less effort for your brain to tell your body to move and can allow your body to produce MORE reps before becoming fatigued.

A study for children with gross motor dysfunction by Thaut (1985) considered how rhythmic aids and verbal cues affect motor and muscular control. His results showed that the auditory rhythm and verbal cues were successful in helping muscular control and motor timing of a specific movement sequence. More importantly, the group that had verbal cueing only did not maintain motor accuracy and control of the movement sequence like the group with both verbal cues and rhythm. Another study by Thaut, Schleiffers, & Davis (1991) looked at an upper gross motor task with biceps and triceps. They found that when subjects used just an internal rhythm to hit the targets, muscles were activated one at a time. But when an external rhythm was present, muscles were activated at the same time and duration of the activation was longer.

This is the scientific beauty and effectiveness of NMT. PSE can supply this kind of rhythmic entrainment and benefit to patients of stroke, traumatic brain injury, or those with motor disorders. More importantly, it’s fun! So maybe next time you are in a quiet room and that clock keeps ticking, you won’t be so bored with thinking about all the possibilities that ticking rhythm can provide. #NeurologicMusicTherapy #MusicItsScience

By: Steph Mathioudakis, MedRhythms Blogger


Thaut, M. H. (1985). The use of auditory rhythm and rhythmic speech to aid temporal muscular control in children with gross motor dysfunction. Journal of Music Therapy, 22(3), 108-126.

Thaut, M. H. (2013). Entrainment and the motor system. Music Therapy Perspectives, 31, 31-33.

Thaut, M.H., Schleiffers, S., & Davis, W. (1991). Analysis of EMG activity in biceps and triceps muscles in an upper extremity gross motor task under the influence of auditory rhythm. Journal of Music Therapy, 28(2), 64-88.