Objective: The aim of the single case experimental study [1] was to examine the treatment of PD under a more holistic systemic perspective similar to the 4-level model by Shiavio & Altenmüller [2]. The approach refers to an adequate view on viable systems like humans in contrast to formerly more traditional linear thinking and acting.

Background: With the focus on self-management and neuroprotection in PD, dancing and music-related activities such as singing are gaining importance [2]. Integrative approaches in the rehabilitation aim to reduce the impairments between the self as “agent” and its body system. Barnish et al. [3] reported some benefits of singing on clinical outcomes of people with PD. Main criticism to get more proof on these outcomes is the lack of theoretical foundation for singing activities and substantial methodological limitations of the studies. As we show, the findings of the Polyvagal theory by Porges [4] and the Theory of Personality Interaction Systems by Kuhl [5] can serve for a praxeology of singing in the context with PD. Insights into the somato-psychological function loops of the cited theories provide an explanatory model of how singing can counteract the vicious circle of functional deficits, vegetative dysfunction, embodied rigidity and loss of self-regulation and self-management in PD.

Method: According to the theoretical approaches, a baseline assessment including Development-oriented personality scanning [6], Body Perception Questionnaire [7], measurement of heart rate variability, and FOG was designed to produce a data figure on the basis of which patients of PD progress across singing could be measured and accounted for. Sixteen patients with PD were included in a singing group (6x1hour per week). Pre-post-measurements were done to explore the psycho-vegetative effects of singing.

Results: Agglutination of the single cases showed predicted correlations between stress-regulation, a specific pattern of coping according to the Theory of Kuhl and symptoms. Singing was useful to get out of stress-regulation and to get access to individual resources for social engagement and adaptive behavior.

Conclusion: Existing theoretical approaches can be referred for an explanatory model and are useful to foster a personal development competence in PD. Singing is a promising music-based rehabilitation for Parkinsonism through the eyes of an embodied cognitive science.

References: [1] Pospeschill, M. & Siegel, R. (2018) Methoden für die klinische Forschung und diagnostische Praxis. Heidelberg: Springer-Verlag. [2] Schiavio, A. & Altenmüller, E. (2015). Exploring music-based rehabilitation for Parkinsonism through embodied cognitive science. Frontiers in Neurology. https://doi.org/10.3389/fneur.2015.00217 [3] Barnish, J., Atkinson, R. Barran, S., Barnish, M. (2016). A potential benefit of singing for people with Parkinson’s disease: A systematic review. Journal of Parkinson’s Disease, Vol 6(3), 2016. pp. 473-484. http://dx.doi.org/10.3233/JPD-160837 [4] Porges, S.W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A Polyvagal Theory. Psychophysiology, 32(4):301-1 Porges, S.W. (2007). A phylogenetic journey through the vague and ambiguous Xth cranial nerve: a commentary on contemporary heart rate variability research. Biol. Psychol.;74(2):301-7. DOI:10.1016/j.biopsycho.2006.08.007. [5] Kuhl, J. (2001). Motivation und Persönlichkeit. Interaktion psychischer Systeme. Göttingen: Hogrefe. [6] Kuhl, J., & Henseler, W. (2004). Entwicklungsorientiertes Scanning (EOS) [Developmentoriented personality scanning]. In L. v. Rosenstiel & J. Erpenbeck (Eds.). Handbuch der Kompetenzmessung (pp. 428-453). Heidelberg: Spektrum Akademischer Verlag. [7] Cabrera, A., Kolacz, J. Pailhez, G., Bulbena-Cabre, A., Bulbena, A.& Porges S.W (2017). Assessing body awareness and autonomic reactivity: Factor structure and psychometric properties of the Body Perception Questionnaire-Short Form (BPQ-SF) DOI: 10.1002/mpr.1596

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MDS Abstracts - https://www.mdsabstracts.org/abstract/singing-tune-into-self-regulation-a-holistic-system-perspective/