ven after months of physical therapy, Ileana Rodriguez’s walk showed no signs of improvement. She would take two steps and pause, then take another step and stop again—her steps devoid of momentum and that forward fluid motion most of us associate with the act of walking.

A former ballet dancer in Cuba, the 20-year-old had suffered an incomplete spinal cord injury on her tenth vertebra just three years before. Known as arterio venus malformation, or AVM, an abnormal collection of blood vessels essentially short circuited and caused a stroke on her spine, leaving her legs immobilized. By 2003 she regained partial use of her legs, relearning to walk with the help of a walker and then with braces. But her new style of start-stop walking was unsafe. Her physical thera- pist tried tirelessly to improve her gait pattern, but nothing seemed to work.

“Ileana is the epitome of fitness—she is an excellent walker with braces and with her walker, but she could not take two steps in a row,” recalls Ivan Ros, a physical therapist assistant with Miami Physical Therapy Associates, a clinic specializing in patients with spinal cord injuries. It was here that Gloria Estefan, A.B. ’78, received physical therapy after breaking her back in a 1990 bus accident. “Typically when you walk you create momentum, and you depend on that momentum to keep you going. But Ileana was wasting that, and it drove me nuts,” Ros recalls.

nter Shannon de l’Etoile, program director and assistant professor of music therapy at the University of Miami Phillip and Patricia Frost School of Music. Knowing that rhythm has helped patients with Parkinson’s disease and those recovering from a stroke increase the number of steps they take per minute and establish a more rhythmic walking pattern, de l’Etoile thought Rodriguez also might benefit. During the first of five sessions, which began in June 2003, de l’Etoile used an electric metronome and keyboard synthesizer to establish the rhythmic cue, known in the field as rhythmic auditory stimulation.

“What research now shows is that when people are following a rhythmic cue, they tend to take nice, even steps forward that are both fluent and symmetrical,” de l’Etoile explains.

Rodriguez took her first step on the accentuated beat and kept walking, matching her steps to the tempo rhythmically and without pausing. Her crutches were also in tempo, stepping to the second and fourth beats of the four-beat rhythmic cue. “I don’t know what happened,” recalls Rodriguez. “I guess I was concentrating more on keeping the rhythm that I forgot my bad habit and began walking without taking a pause in between. And I’ve been walking that way ever since.”

After the five sessions, Rodriguez’s cadence had increased by 17.5 percent. Even more remarkable, Rodriguez could walk to the beat even when the music had been turned off, known in the field as fading. She also showed better posture and an upright head position.

“It was exciting because I was looking for entrainment—if she could walk to the rhythm—which says a lot about the timing mechanisms in the brain and the spinal cord,” says de l’Etoile.

The connection between music and health dates back to prehistoric times, when societies used music to dispel evil spirits. Recent developments in technology enable scientists to examine exactly how the human brain and body create and respond to music. Using this knowledge, music therapists help individuals maintain, regain, and improve mental, physical, and emotional health, as well as develop important life skills ranging from speech intelligibility to attention and memory. Patients with Broca’s aphasia, for example, which is caused by damage to the brain’s left hemisphere following a type of stroke, can usually understand what words mean but have trouble speaking clearly. Often these individuals can still sing, since singing is largely a right-hemisphere task. A music therapist can use a program known as melodic intonation therapy to access the healthy pathways in the brain, gradually moving the individual from singing to speaking fluently.

Founded in 1969, the Music Therapy Program at the University of Miami—one of 70 programs nationwide and only two in Florida—offers both an undergraduate and master’s program. A Ph.D. program is presently being piloted. In addition to teaching the theory, research, and clinical techniques of music therapy, the program’s curriculum provides a solid foundation in musical skills, including music theory, history, conducting, applied instruction, and participation in ensembles. Students also must complete courses in the sciences, such as biology, anatomy, physiology, and psychology. The program’s focus on neurologic music therapy—the biological processing and production of music—makes it unique.

Through affiliations with several community agencies, including the University of Miami/Jackson Memorial Medical Center, music therapy students work with various populations in diverse clinical backgrounds. Upon completion of coursework, they enter a six-month, full-time clinical internship.

“Our connection with UM/Jackson and its many divisions is a tremendous advantage for us,” says William Hipp, dean of the Frost School of Music.

The master’s degree, which requires a thesis, gives students advanced clinical skills and research experience. One area of graduate research looks at the effect of different types of musical experiences (i.e., passive listening versus active participation through singing or instrument playing) on level of arousal and its effect on cognitive abilities. This information could help treat patients with arousal deficits, such as those stemming from traumatic brain injury or attention-deficit hyperactivity disorder (ADHD). Another project explores the ability of children in middle school to convey basic emotions through instrumental improvisation. These results may reveal whether or not music works to address emotional and behavioral disorders.

Teresa Lesiuk, who joined the music therapy faculty this fall, is studying the effects of music listening on work performance, especially in high-stress occupations such as computer information system designers and air traffic controllers. Her studies have shown that when music listening is encouraged in the workplace, employee productivity and mood improve. She serves as vice president of the Research Alliance for Institutes of Music Education and is bringing the international group’s biannual research conference to the Frost School in 2007.

Upon graduation, music therapists work in a variety of settings, such as hospitals, nursing homes, rehabilitation centers, hospices, correctional facilities, and private practice. As director and music therapist at Creative Children Therapy, a nonprofit clinic in Miami, Yani Rubio, B.M. ’97, M.M. ’02, treats children and teens of all ages with diagnoses such as cerebral palsy, autism, Down syndrome, learning disabilities, speech delays, communication disorders, sensory disorders, ADHD, and emotional disabilities. “My goal is to make my clients functional in life and active members of society,” she says.

When dealing with a child with autism, for instance, Rubio might test cognitive skills by asking the child to sing along or answer a question about a book he or she has just read. “I always ask myself, ‘How can I use the music to motivate them, to meet their goals, to improve those target behaviors?’ and that is what I will incorporate into a session,” she says.

What is unique is how Rubio weaves music throughout the session. Songs are repetitious, predictable, and rhythmic; they not only capture a child’s attention but, perhaps more importantly, keep him engaged. Today Rubio begins a gait training session and uses rhythmic auditory stimulation to help ten-year-old Jimarys Rodriguez, who has cerebral palsy, to walk. In the two years she has been coming to the clinic, mother Mariela says her daughter has improved tremendously.

“When she first came here, she would take some steps by herself with the walker, but it wasn’t consistent. Now she is much stronger and can stand, get her balance, and take 15 to 20 steps on her own. She loves the music, so the therapy is something fun for her.”

As research continues to prove the potency of music therapy techniques for treating ailments of mind and body, Frost School of Music graduates like Rubio are uniquely positioned to take on important roles in health care.

“The field of music therapy is a burgeoning one, and that point is really driven home every time we do a search for a faculty member,” says Dean Hipp. “It’s a very tight market for qualified people.”