MUSIC
‐
PD
: A Delphi‐Derived, Culturally Adaptable Music Therapy Protocol for Parkinson's Disease Rehabilitation
Mythili Udupa, Sobana R., Cristian Falup‐Precurariu, Baishali Banerjee Mukherjee, Jenita Caren Rajakumari J., Bhuvaneswari Chandrasekar, Nicolas Matia Phielipp, Rajeev Ojha, Chan Hiu Fai Germaine, Jacky Ganguly, Divyani Garg, Prakash Kumar Manharlal, Harish Kulkarni, Manjula Caldera, Nagaraja Sarangamat, Rajeev K. Gupta, Syamal Bhushan Ghosh Dastidar, Rajagopalan Venkatapathy, Sathyapal Hegde, Bradley W. Vines, Annie Heidersceit, Tiago Mestre, Kallol Ray Chaudhuri, Prashanth Lingappa Kukkle Abstract
Background
Music‐based interventions have shown promise in Parkinson's disease (PD) rehabilitation. However, variability in intervention design, delivery, dose, and documentation limits clinical translation.
Objective
The aim of the study was to develop a consensus‐based music therapy protocol for PD, designed to permit cultural and linguistic adaptation.
Methods
A PRISMA‐informed evidence‐mapping review identified music‐based and rhythm‐based interventions relevant to PD rehabilitation. Findings informed a modified Delphi process involving a multidisciplinary expert panel of movement disorder neurologists, qualified music therapists, and people with PD. Round 1 generated qualitative inputs on therapeutic domains, safety, feasibility, and cultural adaptation. These were synthesized into 36 structured statements and rated in Round 2 using a 5‐point Likert scale. Consensus was predefined as ≥80% agreement.
Results
The evidence map included 32 studies and identified 3 therapeutic clusters: motor/gait rehabilitation, voice‐respiratory communication, and nonmotor cognitive‐affective engagement. Of the 36 Delphi statements, 33 reached consensus. High‐convergence domains included patient‐preferred familiar music, cultural adaptation, rhythmic auditory stimulation for gait rehabilitation, multidomain symptom targeting, and vocal rehabilitation. The final framework was organized into LAYA—Locomotor Auditory Yielding Activation Module, NADA—Neurocognitive and Affective Domain Activation Module, and RAGA—Respiratory Aerodynamic Glottal Activation Module. The protocol incorporated session‐selection rules, safety screening, difficulty levels, active and/or receptive therapy components, flexible pragmatic session guidance, caregiver‐supported practice, and a proposed session‐planning/documentation resource.
Conclusion
MUSIC‐PD provides a structured, Delphi‐derived, and panel‐approved framework for integrating music‐based interventions into multidisciplinary PD rehabilitation. It translates evidence and multidisciplinary consensus into a protocol intended for prospective feasibility, fidelity, safety, and efficacy evaluation.