When Music Has a Clinical Role to Play

Music Therapy in Rehabilitation: What the Evidence Shows

A study by Van der Wal-Huisman and colleagues, published through the University of Groningen, examined live bedside music in hospitalised older surgical patients — a cohort particularly vulnerable to post-operative complications, and one for whom reducing pharmacological load is a genuine clinical priority. Working with trained musicians who performed live at patients’ bedsides, researchers documented measurable reductions in pain perception alongside positive changes in autonomic nervous system function.

These are not peripheral outcomes. Pain management and autonomic regulation — which governs heart rate, breathing, and the body’s overall stress response — are precisely what rehabilitation teams spend the post-operative period trying to stabilise. The findings support what many clinicians have observed anecdotally for years: that live, therapeutic music achieves something pharmacological intervention alone does not.

It reaches a different door.

The Hierarchy Issue in Healthcare

Rehabilitation has long operated with an implicit hierarchy. Physiotherapy, occupational therapy, and speech therapy are regarded as the pillars. Music therapy, where it exists at all, is treated as supplementary — something pleasant to offer once the “real work” is done. It is scheduled around other sessions, funded as an optional extra, and rarely integrated into the core rehabilitation plan from the outset.

The evidence does not support this ordering.

Research in neurological rehabilitation — including stroke recovery — has repeatedly shown that music engages neural pathways that movement or language therapies do not reach by the same route. Rhythm supports motor relearning. Melody activates language networks even when verbal pathways are damaged. Structured listening and active music-making reduce cortisol, lower blood pressure, and improve sleep quality — all of which directly affect the pace and completeness of recovery.

Early-stage rehabilitation is precisely when these mechanisms matter most. The window of heightened neuroplasticity following injury or surgery is not the moment to withhold an evidence-backed modality on the grounds that it feels secondary. That reasoning has more to do with convention than with science.

What a Music Therapist Actually Does

Music therapy is not background music. It is not a hospital radio station or a well-meaning volunteer with a guitar. A trained music therapist holds a clinical qualification, works within a multidisciplinary rehabilitation team, and sets measurable goals: improving upper limb rehabilitation through instrument-based tasks, supporting breath control relevant to post-stroke communication, building sustained attention in patients with acquired brain injury, and reducing the anxiety that frequently undermines engagement with demanding physical therapy sessions.

Receptive techniques — structured, intentional listening — can be introduced when a patient is still largely immobile. Active techniques, which involve the patient in producing sound, progress alongside physical and cognitive capacity. The therapist meets the patient where they are today, not where they were before.

This adaptability also makes music therapy particularly suited to home-based delivery — an area that matters as rehabilitation shifts progressively out of the hospital and into daily life, where home therapy services allow patients to continue structured care in their own environment.

An Appeal to Insurance Underwriters

Insurance underwriters — we are talking to you.

Music therapy delivered by a trained and credentialed therapist, working within a structured rehabilitation programme, is not a lifestyle perk. It is a clinical intervention with a growing evidence base for pain reduction, neurological recovery, anxiety management, and improved rehabilitation engagement. The Van der Wal-Huisman study is one of a widening body of peer-reviewed findings making precisely this case.

Post-hospitalisation outpatient coverage under Integrated Shield Plans already recognises physiotherapy, occupational therapy, and speech therapy as reimbursable. The evidence now asks — plainly — why music and art therapy is not on that list.

Patients who would benefit from early music therapy integration are currently paying out of pocket for sessions their clinicians recommend and the research supports. That gap is not clinical. It is administrative. It can be changed, and it should be.

Frequently Asked Questions

What conditions can music therapy support in rehabilitation? Music therapy has demonstrated clinical benefit across neurological conditions including stroke and acquired brain injury, post-surgical recovery in older adults, chronic pain, anxiety and mood disturbances associated with serious illness, and conditions affecting communication and swallowing. It is increasingly used alongside physiotherapy and occupational therapy as part of integrated rehabilitation programmes.

Is music therapy appropriate from the early stages of recovery? Yes — and this is where current clinical thinking is shifting most meaningfully. Receptive techniques can begin when a patient is still largely immobile. Given that the neuroplasticity window is most active early in recovery, that is precisely when music therapy’s effects on neural engagement, pain regulation, and mood support are most valuable.

Do I need prior musical experience to benefit? None whatsoever. A music therapist designs sessions around what the patient can engage with — starting from wherever they are, including complete beginners and those with no musical background at all.

How is this different from simply playing calming music in a room? A trained music therapist assesses clinical needs, establishes measurable rehabilitation goals, and structures sessions — using both listening-based and active music-making techniques — to work towards those goals. It is evidence-informed, clinically responsive, and categorically different from ambient sound or informal listening.

Can music therapy sessions be delivered at home? Yes. Music therapy lends itself readily to home-based delivery, which is particularly relevant as rehabilitation increasingly moves into the community setting. A therapist can work in a patient’s home environment using portable instruments and structured session frameworks, maintaining clinical continuity without requiring the patient to travel.