Effects of vibroacoustic stimulation in music therapy for palliative care patients: a feasibility study

Background: The present study aimed at examining whether methodological strategies from a previously implemented study design could be transferred to the evaluation of the psychological and physiological effects of a music therapy intervention working with vibroacoustic stimulation in palliative care. Method: Nine participants suffering from advanced cancer took part in single-sessions of music therapy, lasting for 30 min. The live music therapy intervention utilized singing chair sounds and vocal improvisation. Visual analogue scales (VAS) were used to assess self-ratings of pain, relaxation, and well-being before and after each session. During the intervention, we continuously recorded heart rate variability (HRV) as a measure of autonomic functioning. Data collection was complemented by a semi-structured interview to explore subjective experiences in more detail. Feasibility was defined as the ability to complete 80 % of the sessions in accordance with the study protocol. Results: In 5 out of 9 sessions (55 %) it was possible to deliver the intervention and obtain all data as intended. VAS assessment was feasible, although graphical and statistical examination revealed only marginal mean changes between pre and post. HRV recordings were subject to artifacts. While HRV parameters differed between individuals, mean changes over time remained relatively constant. Interview data confirmed that the individual perception was very heterogeneous, ranging from “calming” to “overwhelming”. Conclusion: The criterion of feasibility was not met in this study. Physiological data showed high attrition rates, most likely due to movement artifacts and reduced peripheral blood flow in some participants’ extremities. Examination of individual-level trajectories revealed that vibroacoustic stimulation may have an impact on the autonomic response. However, the direction and mechanisms of effects needs to be further explored in future studies. Trial registration: German Clinical Trials Register – DRKS00006137 (July 4th, 2014)

Relaxation Effects of Musially Guided Resonance Breathing: A Randomized Controlled Pilot Study

Music therapy and resonance breathing (breathing at about 0.1 Hz) may be effective in treating stress-related symptoms and promoting relaxation. However, no identified study has explicitly explored the potential of integrating the working mechanisms into a combined approach using live played music to guide respiration. Therefore, the objective of the present pilot study was to evaluate the psychophysiological effects of a combined intervention. A total of 60 healthy adults were randomized to either the experimental group or the control group (where participants listened to prerecorded relaxation music). Heart rate and heart rate variability were extracted for the following 5-minute segments: Resting baseline, stress task, intervention, resting post-intervention. Additionally, self-evaluation scores for relaxation and general well-being were assessed with visual analogue scales. Significant time × group interaction effects were found for general well-being (p = .028) and heart rate variability as measured by RMSSD (p \u3c .001), indicative of increased parasympathetic outflow in the experimental group. In conclusion, the combination of music therapy and resonance breathing seems to be a well-received and effective way to induce relaxation and well-being in healthy adults. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Short-term music therapy treatment for adolescents with depression-A pilot study

Music therapy holds promising potential to support adolescents with depression mastering developmental tasks as well as improving emotion regulation. The objective of the present pilot study was to assess the feasibility, acceptance and potential effectiveness of a theory driven music therapy treatment plan for youth with depression. The treatment aimed to reduce severity of depression and to improve emotion regulation and health related quality of life. Hair cortisol concentration served as an additional biological marker for bodily stress. In an outpatient center, adolescents with depression received 12 single sessions of music therapy. A prospective, single-arm repeated-measures design (pre-, post-, follow-up) was used to examine acceptance, feasibility, and outcome measures. Nine adolescents were included in analyses. The music therapy treatment plan seems to be feasible and well accepted by adolescents. The results of analyses indicate improvements regarding depressive symptoms, positive coping with difficult emotions and health-related quality of life in included patients. The beneficial effects were not shown to be fully sustained in the follow-up. The results suggest that music therapy caused no harm and might have contributed to the improvement of clinical outcomes in the mildly to moderately adolescents with depression. Several recommendations for future trials in this field are reported

Trajectories of Terminally Ill Patients\u27 Cardiovascular Response to Receptive Music Therapy in Palliative Care

Context: Relaxation interventions are frequently used to promote symptom relief in palliative care settings, but little is known about the underlying mechanisms. Objectives: The present analysis aimed at examining the psychophysiological pathways of terminally ill patients\u27 cardiovascular response to a live music therapy vs. prerecorded mindfulness exercise. Methods: Eighty-four patients of a palliative care unit were randomly assigned to either of the two interventions. Multilevel modeling was used to analyze trajectories of physiological change. Vagally mediated heart rate variability (VM-HRV) and blood volume pulse amplitude (BVP-A) served as indices of autonomic nervous system response. Participants\u27 gender, age, baseline scores, self-rated pain, and assignment to treatment were entered to the models as predictors. Results: Both VM-HRV and BVP-A showed significant linear and quadratic trends over time, as well as substantial heterogeneity among individuals\u27 trajectories. Baseline scores, pain, and treatment significantly accounted for random variation in VM-HRV intercepts. BVP-A levels were significantly higher in women than in men. Moreover, assignment to treatment significantly accounted for differences in the linear slopes of peripheral blood flow. Conclusion: Higher levels of VM-HRV in the music therapy group highlight the importance of a therapeutic relationship for the effectiveness of relaxation interventions in end-of-life care settings. Music therapy caused significantly stronger reductions of vascular sympathetic tone and, therefore, may be indicated in the treatment of pain and stress-related symptoms in palliative care. Initial self-ratings of pain moderated patients\u27 physiological response and need to be taken into account in clinical practice and future theory building. (PsycINFO Database Record (c) 2018 APA, all rights reserved

Music-based interventions to reduce internalizing symptoms in children and adolescents: A meta-analysis

Background: Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach. Methods: Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysisusing standardized mean differences (SMD) was conducted. Results: Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g=−0.73; 95%CI [−1.42;−0.04], Z= 2.08, p= 0.04, k= 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n= 100) compared to different control group interventions (n= 95). Limitations: The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design. Conclusions: Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed

The Quick Inventory of Pain Symptoms (QIPS)

The article presents the Quick Inventory of Pain Symptoms (QIPS) to assess the frequency and intensity of pain experienced within the last week in non-clinical samples. The first evaluation of the inventory administered to 100 undergraduate and graduate students revealed a concurrent validity of the QIPS with the four pain-related items of the symptom checklist (SCL-90r). Furthermore, this preliminary analysis showed that the QIPS is capable of revealing sex differences. Further studies are needed to validate the inventory and its psychometric properties to evaluate its use in different populations

Evaluating a Treatment Manual for Music Therapy in Adult Outpatient Oncology Care

Music therapy is a prevalent treatment for people with a life-threatening illness, with inpatient oncology care being one of the most common fields of application. A recently published review on this topic shows that studies examining the effects of active music therapy treatments in an outpatient setting are still rare. Based on the Phase Model of Psychotherapy Outcome, a treatment manual has been developed for outpatient music therapy cancer care, consisting of 20 individual sessions. The aim of this study was to evaluate the effectiveness of the procedures of this manual by comparing prescores and postscores of 20 patients’ self-reported general therapy outcome, quality of life, and subjective pain intensity ratings. Results show that the intervention led to a significant improvement on all 3 dependent measures. Effect sizes ranged from medium to large. The authors conclude that it is necessary to further expand outpatient cancer care in Germany and to integrate music therapy as an effective treatment into these areas. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Body mass index and parasympathetic nervous system reactivity and recovery following graded exercise

OBJECTIVES: The present study sought to expand upon prior investigations examining patterns of vagally mediated heart rate variability (vmHRV) and perceived exertion as a function of body mass index (BMI) in response to and recovery from exercise. METHODS: Participants underwent a resting (baseline) period, followed by a graded exercise protocol on an ergometer with ascending difficulty stages, and finally another resting (recovery) period. Individuals were stratified into three BMI groups: low, moderate, and high. RESULTS: Individuals in the high BMI group exhibited a significantly greater decrease in vmHRV from baseline to graded exercise in comparison to the moderate BMI group. Individuals in the high BMI group also showed significantly lower vmHRV at recovery compared with baseline than individuals with moderate BMI; indicating that the high BMI group's vmHRV did not recover to the degree of those in the moderate BMI group. No significant results regarding vmHRV were found in the low BMI group. Of note, BMI and perceived exertion during the recovery period were positively associated. Results also showed a significant negative association between vmHRV and perceived exertion at each grade of exercise. There was no significant association between vmHRV and perceived exertion during baseline or recovery. CONCLUSIONS: This report extends prior research studying BMI and patterns of vmHRV reactivity in the domain of physical exercise. Our data contribute to previous reports suggesting that high BMI can lead to maladaptive patterns of vmHRV reactivity to and recovery from physical exercise

I Need to Hear Some Sounds That Recognize the Pain in Me: An Integrative Review of a Decade of Research in the Development of Active Music Therapy Outpatient Treatment in Patients With Recurrent or Chronic Pain

Music is widely used to reduce pain in a broad variety of clients and settings. Most studies focus on the pain-reducing effect of music-listening interventions on patients with acute pain, whereas studies investigating the effect of active therapy (ie, music making) on pain perception in patients with recurrent or chronic pain are rare. This article reviews the findings of a series of previously published studies by our work group, conducted during the past 10 years, using defined music therapy plans in the treatment of outpatients with conditions of recurrent or chronic pain. This review provides evidence that a specific music therapy concept tailored to the demands of the patient might be able to substantially reduce pain frequency and pain intensity in patients with recurrent or chronic pain. However, further studies need to investigate the nature of those beneficial effects and their specificity. [PUBLICATION ABSTRACT