Are We Doing More Than We Know? Possible Mechanisms of Response to Music Therapy

Due to advances in medical knowledge the population of older adults struggling with issues of aging like Alzheimer's disease (AD), Parkinson's disease (PD), and stroke is growing. There is a need for therapeutic interventions to provide adaptive strategies to sustain quality of life, decrease neurologic impairment, and maintain or slow cognitive decline and function due to degenerative neurologic diseases. Musical interventions with adults with cognitive impairments have received increased attention over the past few years, such as the value of personalized music listening in the iPod project for AD (1); music as a tool to decrease agitation and anxiety in dementia (2); and music to aid in episodic memory (3); Rhythmic Auditory Stimulation as rehabilitation for PD (4); and recently the potential of 40 Hz sensory brain stimulation with AD and PD (5, 6). These approaches indicate the expanding scope and efficacy of music therapy and the potential mechanisms involved. This paper explicates a four-level model of mechanisms of music response (7, 8) that may help understand current music therapy approaches and treatments and help focus future research. Each level will be illustrated with research and suggestions for research directions

Music Therapy in the Treatment of Depression: Implications for Individuals Recovering from Non-degenerative, Acquired Brain Injury (ABI)

Stroke is a prevalent disease, and the leading cause of disability from neurological disorder worldwide. The emotional impact a stroke may have on a person and occurrence of depression can affect their readiness to engage in rehabilitation, their functional outcomes, and their ability to reintegrate socially. Depression often goes undiagnosed and untreated. Music and music therapy have the potential to access and effect change concurrently in multiple domains, making it a valued method for facilitating non-pharmacological, therapeutic change while supporting a person’s emotional needs. Music therapy interventions may provide motivation for participation in rehabilitation, as well as facilitate goal acquisition in physical, psychosocial, emotional, communicative and cognitive domains. This paper explores the role of motivation, evidence of music-induced affective responding, therapeutic effects of music interventions on mood, physiological and neural correlates, social interaction, music therapy implications for individuals recovering from acquired brain injury, and future directions

Long-Term Multi-Sensory Gamma Stimulation of Dementia Patients: A Case Series Report

Dementia prevalence is increasing globally, and symptom management and treatment strategies require further investigation. Music-based interventions have demonstrated some efficacy with respect to quality of life and symptom reduction, though limited with respect to cognition. This study reports on three case studies where the use of gamma stimulation over one year contributed to maintenance of cognition and increases in mood for participants with Alzheimer’s disease or mild cognitive impairment. Auditory stimulation with isochronous sound at 40 Hz was delivered to participants via a commercially available vibroacoustic chair device five times per week for 30 min with assistance from caregivers. Further research is needed to assess the integration of this therapy in the overall care for persons with dementia

Are We Doing More Than We Know? Possible Mechanisms of Response to Music Therapy

Due to advances in medical knowledge the population of older adults struggling with issues of aging like Alzheimer’s disease (AD), Parkinson’s disease (PD), and stroke is growing. There is a need for therapeutic interventions to provide adaptive strategies to sustain quality of life, decrease neurologic impairment, and maintain or slow cognitive decline and function due to degenerative neurologic diseases. Musical interventions with adults with cognitive impairments have received increased attention over the past few years, such as the value of personalized music listening in the iPod project for AD; music as a tool to decrease agitation and anxiety in dementia; and music to aid in episodic memory; Rhythmic Auditory Stimulation as rehabilitation for PD; and recently the potential of 40Hz sensory brain stimulation with AD and PD. These approaches indicate the expanding scope and efficacy of music therapy and the potential mechanisms involved. This paper explicates a four-level model of mechanisms of music response that may help understand current music therapy approaches and treatments and help focus future research. Each level will be illustrated with research and suggestions for research directions

Short-Term Effects of Rhythmic Sensory Stimulation in Alzheimer’s Disease: An Exploratory Pilot Study

This study assessed the effect of stimulating the somatosensory system of Alzheimer’s disease (AD) patients at three stages of their illness with 40 Hz sound. In this AB cross-over study design, 18 participants (6 mild, 6 moderate, 6 severe) each participated in 13 sessions: one intake and 12 treatment. Treatment A consisted of 40 Hz sound stimulation and Treatment B consisted of visual stimulation using DVDs, each provided twice a week over 6 weeks for a total of 6 times per treatment. Outcome measures included: St. Louis University Mental Status Test (SLUMS), Observed Emotion Rating Scale, and behavioral observation by the researcher. Data were submitted to regression analysis for the series of 6 SLUMS scores in treatment A and 6 scores in B with comparison by group. The slopes for the full sample and subgroups in the 40 Hz treatment were all significant beyond alpha = 0.05, while those for the DVD were not. A thematic analysis of qualitative observations supported the statistical findings. 40 Hz treatment appeared to have the strongest impact on persons with mild and moderate AD. Results are promising in terms of a potential new treatment for persons with AD, and further research is needed

Participation in group music therapy: a preliminary study of the experiences and perceptions of adolescents who stammer

Music therapy and music-based interventions are increasingly used in the treatment of speech, language, and communication needs, and music therapy has been extensively applied to adolescent groups. To date, however, there has been no published work examining music therapy for adolescents who stammer. The aim of the current study was to explore adolescents’ experiences and perceptions of a group music therapy intervention. Four adolescents who stammer participated in semi-structured interviews examining their experience of group music therapy intervention. The music therapy group intervention consisted of five therapeutic sessions conducted at a summer camp for children and adolescents who stammer. Analysis of in-depth, semi-structured interviews revealed four main themes and several subthemes. Recurrent themes revealed a variety of psychosocial benefits related to the experience of group music therapy, such as developing new friendships and facilitating peer support, increasing self-confidence and self-expression. There was also an emphasis on fun and enjoyment. This paper highlights a number of key benefits of music therapy for adolescents who stammer. These preliminary results highlight the potential of music therapy for adolescents who stammer, and the role of addressing psychosocial aspects of stammering within this creative arts intervention

Therapist and individual experiences and perceptions of music therapy for adolescents who stutter: a qualitative exploration

Introduction: Affective reactions frequently reported by adolescents who stutter include embarrassment, frustration, and feelings of anxiety about further stuttering. It is possible that music therapy could enhance stuttering treatment outcomes; however, little is known about how individuals who stutter, and therapists working with this group, view such therapy. The purpose of this study was to explore individuals who stutter and therapist experiences with, and perceptions of, music and music therapy for stuttering. This work is part of a larger mixed-methods project to explore the effectiveness and potential benefit of music therapy with adolescents who stutter. Methods: Semi-structured interviews were conducted with six clinicians and three individuals who stutter. Interview data were analysed using qualitative content analysis. Results: Four themes emerged from participants’ accounts: (1) the experience of living with stuttering, (2) the importance of music in everyday life, (3) the application of music therapy in stuttering, and (4) recommendations for music therapy in the continuum of support services for individuals who stutter. Discussion: Participants in this study perceived music and music therapy to benefit individuals who experience stuttering, particularly within the context of mental health. There is agreement that song writing, improvisation and song singing are most useful when working with adolescents who experience stutterin

Practices and innovations in telehealth music therapy

Telehealth music therapy innovations from various theoretical approaches with individuals across the lifespan are shared from clinicians and researchers representing 4 global regions of the WFMT. Reflect and identify how to continue to advance work in this format based on the experience accumulated. Telehealth music therapy practice was not widely practiced until the onset of COVID-19 in 2020. Since that time, the field of music therapy experienced widespread adoption of this synchronous, remote approach to service delivery when in-person services were not possible. Now, many music therapists are sustaining telepractice innovations leading to improved access and services. Many service users have benefited from music therapy because of the increased access made possible through telepractice, and a 2021 Certification Board for Music Therapy position paper suggests that “telepractice is here to stay” (CBMT, 2021). Current applications of telepractice music therapy continue to grow across a wide range of practice areas including: persons with dementia, Parkinson’s, mental health diagnoses, military, pediatrics, and children with complex needs and their caregivers and many more. Continued work in providing telehealth needs to consider topics including: ethics, end of life care, technological advances, education and training, access, cultural humility, and applications in supporting those affected by global conflict

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit