Effects of Integrated Music and Occupational Therapy on Motor and Autonomic Function in Children with Neurogenic...

Neurogenic scoliosis (NS) is a frequent complication in children with neurological disorders (ND), often associated with impaired postural control, reduced functional mobility, and autonomic nervous system (ANS) dysregulation, negatively affecting rehabilitation outcomes. Occupational therapy (OT) is a core component of conservative management, while music therapy (MT) has been proposed as an adjunct intervention with neuromodulatory and autonomic regulatory effects. This study investigated whether integrating MT into OT enhances motor function and autonomic regulation in children with ND, focusing on NS.

Eighteen children aged 5-12 years with non-degenerative neurological disorders participated in this non-randomized controlled study. Six children (33.3%) presented with neurogenic scoliosis. Participants were allocated into three groups: Group 1 (NS receiving OT+MT, n=6), Group 2 (OT only, n=6), and Group 3 (OT+MT without scoliosis, n=6). The intervention lasted six weeks. Motor outcomes included the 10-Meter Walk Test (10MWT) and Pediatric Balance Scale (PBS). Autonomic regulation was assessed using heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation. Due to small sample size and non-normal distribution statistical analyses were applied (Kruskal-Wallis, Dunn's post-hoc tests with Bonferroni correction, and Wilcoxon signed-rank tests). Effect sizes were calculated using r.

Baseline characteristics were similar across groups (p > 0.05), except pulse rate (p = 0.019).Post-treatment analyses demonstrated significant between-group differences in systolic blood pressure (H(2)=13.675, p = 0.001), diastolic blood pressure (H(2)=12.129, p = 0.002), heart rate (H(2)=9.013, p = 0.011), and oxygen saturation (H(2)=12.283, p = 0.002). Group 1 showed the greatest reductions in systolic (20.06 ± 7.16 mmHg) and diastolic blood pressure (11.72 ± 3.79 mmHg), heart rate (14.06 ± 6.24 bpm), and the largest increase in oxygen saturation (+2.19 ± 0.36%). Significant differences between Groups 1 and 2 were found for all autonomic measures (p ≤ 0.03). Within-group analyses demonstrated significant improvements in Group 1 for PBS (z = 2.201, p = 0.031, r = 0.635) and all autonomic measures (p = 0.031, r ≥ 0.63). Group 3 was the only group to demonstrate significant improvement in walking speed (z = 2.201, p = 0.031, r = 0.635).

Integrating MT into OT showed clinically promising improvements in autonomic regulation and postural control, particularly in children with neurogenic scoliosis. Large effect sizes indicate a robust MT effect, supporting its inclusion in pediatric neurorehabilitation.