Few people appreciate music like Annamarie Engelhard. You could say she was born for it.
After all, her great uncle was Woody Guthrie, one of America's most significant folk musicians (e.g. "This Land is Your Land"). Music defined her family. As a child, Annamarie took piano and violin lessons and dabbled in other instruments, like guitar. It’s no surprise she made music her career.
"Music is powerful. It transports you to another place and creates connection and peace," says Annamarie, Craig's neurologic music therapist.
In high school, Annamarie worked with children who had learning disabilities. One day, she put music to sign language to help a boy learn.
"It worked so well I thought I could invent a new field of study that used music for therapy," she says. "Then I discovered it already existed."
Annamarie was so inspired that she chose to pursue music therapy, attending the birthplace of neurologic music therapy at Colorado State University. There, she earned a degree and accreditation and became a board-certified music therapist and neurologic music therapist. She was thrilled to combine her two loves — music and science — into a meaningful career. Today, she runs the neurologic music therapy program at Craig Hospital. You could say it was meant to be.
At Craig, music therapy is used in several ways to help people heal. For example, when the part of the brain that controls language is damaged, as with stroke or brain injury, some people are left with aphasia — the inability to speak, read, write or understand language. Since the brain processes music in multiple areas rather than a focal area like with language, people with aphasia can often sing even if they can’t speak.
“Being there when an individual with a brain injury finds their voice and sings again is a powerful moment for both patients and families,” Annamarie says.
Music can give patients the capacity to begin functional communication. When music therapy partners with speech therapy, patients start communicating their needs through singing, like putting a tune to “I’m thirsty” or “I need to use the restroom” or saying “I love you.” Once patients graduate from Craig, they can continue to improve their communication with music therapy in the CHAT Program, an intensive Craig outpatient speech therapy program for individuals with aphasia that partners with Annamarie.
Music therapy also helps people with acquired brain injuries walk again. When a brain is injured, it sometimes loses the ability to send signals to the limbs telling them to make the movements that result in walking. A technique called Rhythmic Auditory Stimulus (RAS) trains the motor system to synchronize with a musical beat and move more accurately.
“Do you ever notice when someone is walking in front of you wearing high heels, you hear that ‘click, click, click,’ and you automatically start walking to that rhythm? That’s called entrainment. We use that same neurologic pathway to make walking smooth and automatic again after a brain injury,” Annamarie says.
In collaboration with physical therapy and occupational therapy, Annamarie joins in Power Hour, a group therapy class combining physical exercise with live music interventions. The class retrains muscles and nerves to move better and stronger, helping individuals improve during their hospital stay. She also works with people individually and can be found in the gym co-treating with occupational therapists as patients improve their arm coordination, or she can be seen walking down the halls, guitar in hand, helping patients learn to walk again alongside their physical therapists.
“It’s remarkable how quickly music can help some individuals improve. I had one patient go from walking very unevenly at the beginning of our first session to having perfect cadence by the end of that session,” Annamarie says.
As an additional service at Craig Hospital, she also helps musicians regain the ability to play music again after a spinal cord injury by coordinating with occupational therapy and rehab engineering to create tools or adapt instruments so they can play again. To celebrate, Annamarie will partner with the Therapeutic Recreation Department to give patients the opportunity to put on a concert or play music for patients, family or staff at Craig.
“Music is like a special power people can tap into. They are always surprised by how music can activate their brains and help them heal,” Annamarie says.
One of the first things Annamarie asks in music therapy is about the genre of music people like or their favorite artists. Then she uses that music during their sessions together.
“Many patients and families tell me they think neurologic music therapy was the catalyst for getting their brain working again. That’s incredibly satisfying,” she shares.
Craig Hospital is one of a handful of places in the nation to offer an in-house music therapy program to people with stroke, traumatic brain injuries and spinal cord injuries. When asked what is the greatest challenge for the neurologic music therapy program Annamarie says “Being able to meet all the needs within the hospital.” In 2020, Annamarie was busy. She provided approximately 1,070 neurologic music therapy sessions and helped more than 100 patients. She hopes that the program can grow to meet the needs of all Craig patients and has visions for expansion in outpatient and group programs.