Feasibility of therapeutic music listening in fibromyalgia: a randomised controlled pilot study.

BACKGROUND: Fibromyalgia patients can benefit from music approaches as complementary treatments. In the literature, it was shown that these interventions managed pain conditions as well as reduced complaints, increased relaxation, and improved moods. OBJECTIVE: This study aimed at evaluating music therapy, in the form of therapeutic music listening, specifically for patients with fibromyalgia, to treat chronic pain by reducing pain perception, increasing well-being, and improving quality of life. METHODS: Twenty-four patients with fibromyalgia were recruited to take part in this feasibility pilot study that adopted a between-subject and within-subject design. Participants were randomised into three groups: (1) standard care, (2) standard care plus preferred music listening, (3) standard care plus Melomics-Health music listening, composed by an algorithm. Participants in experimental groups listened to 30 min of music at home, twice a day for a month. Patients' perceptions of changes following the listening, the intensity of pain and its interference in their lives, physical and mental well-being, and reported attitudes towards listening to music were evaluated respectively through the patients' global impression of change, the brief pain inventory, the Short Form Healthy Survey-12, and the cognitive behavioural assessment-outcome evaluation. RESULTS: The study showed that music listening can significantly affect mental well-being compared to no music. Moreover, the effects in the Melomics-Health group are maintained at follow-up. No significant effect on pain perception was noted. CONCLUSIONS: The study provides information supporting a possible role of music listening in improving well-being of patients with fibromyalgia.

Background Music in elderly nursing home: a feasibility explorative study.

SUMMARY: Introduction. This study explores how a background music-listening program within residential facilities for the elderly can influence the general environment and be effective on psychological and behavioral aspects. The feasibility of this type of intervention was explored. Methods and Materials. Twenty-nine residents involved in the experiment were observed for 4 weeks in absence of a music intervention and for the same period during the experimental condition. The intervention consisted in music listening programs, designed by trained music therapists for specific objectives according to the different times of the day. Experimental and control condition effects were compared through the administration of clinical scales and observational grids. Results. The results of clinical scales showed that music listening programs reduced behavioral symptoms in 7 out of 8 people with the most severe neuropsychiatric symptoms. The observational scheme completion showed a clear improvement in all outcomes considered, with the exceptions of agitation (in the morning) and irritability (in the afternoon). Discussion. The study brings several points to attention, including the need to establish a set of criteria in music listening programs selection and administration (e.g. identification of music characteristics related to objectives and outcomes, assessment strategies, involvement of a team of professionals). Implementing evidence-based clinical practice is crucial and the highlighted results encourage the introduction of music-listening approaches as part of therapeutic interventions in elderly nursing homes.

Music listening for people living with dementia: a systematic review.

SUMMARY: This review aimed at exploring how music listening-based approach can be effective on physiological, cognitive and behavioural aspects, with specific reference to the domain of dementias. Music listening can be considered one of the most common approaches in dementia care, frequently in combination with other non-pharmacological treatments. This type of intervention may allow persons with dementia to work on the organization and regulation of their emotions thanks to the mediation of the sonorous-musical element. Methods. Two independent researchers performed literature search by consulting the PUBMED database and the Cochrane Register of randomized controlled trials (articles written in English and published from January 1st 2000 to February 28th 2022 were considered as eligible). Results. Twelve articles met the inclusion criteria and were included in this review. The selected studies highlighted some effects of music listening in people with moderate to severe dementia. Assuming a clinical point of view, the results showed how music listening intervention could bring benefits on the behavioural and psychological symptoms of dementia, also if not always statistically significant. Discussion/Conclusion. The study focused on the need to define clear criteria of music listening programs selection and administration, but also on the involvement of trained music therapists in planning and managing the music listening-based interventions. Music listening interventions should be developed by implementing evidence-based practice and integrating research in the field. The identification of specific musical elements connected with the therapeutic outcome is a key point for the music therapy future.

Communication improvement reduces BPSD: a music therapy study based on artificial neural networks.

BACKGROUND: Literature showed the effects of music therapy on behavioral disturbances, cognitive functions, and on quality of life in people with dementia. Especially, relational active music therapy approach is oriented to reduce behavioral disturbances increasing communication, especially non-verbal communication. OBJECTIVE: This study aimed at exploring the connection between the baseline characteristics of responders and the positive outcome of the intervention, but also the close relationship between the behavioral disturbances and the core of the therapeutic intervention (the relationship/communication improvement). METHOD: Linear correlation index between input variables and the presence of a critical improvement of behavioral symptoms according Neuropsychiatric Inventory and a semantic connectivity map were used to determine, respectively, variables predictive of the response and complex connections between clinical variables and the relational nature of active music therapy intervention. The dataset was composed of 27 variables and 70 patients with a moderate-severe stage of dementia and behavioral disturbances. RESULTS: The main predictive factor is the Barthel Index, followed by NPI and some of its sub-items (mainly, Disinhibition, Depression, Hallucinations, Irritability, Aberrant Motor Activity, and Agitation). Moreover, the semantic map underlines how the improvement in communication/relationship is directly linked to "responder" variable. "Responder" variable is also connected to "age," "Mini Mental State Examination," and sex ("female"). CONCLUSIONS: The study confirms the appropriateness of active music therapy in the reduction of behavioral disturbances and also highlights how unsupervised artificial neural networks models can support clinical practice in defining predictive factors and exploring the correlation between characteristics of therapeutic-rehabilitative interventions and related outcomes.

[What happens if algorithmic music meets medicine]. / Cosa succede se la musica algoritmica incontra la medicina.

SUMMARY: Since ancient times there has been recognition of music's therapeutic powers, inherent in the properties of sound and its effects on human beings at a psychophysical level. Literature showed the development of therapeutic applications of music in numerous clinical settings. Music-listening itself can qualify as an effective therapeutic means within clinical contexts. Numerous studies document the potentialities of this practice. Whilst, it appears to be difficult to study the phenomenon of music from a scientific point of view, it may be possible to attempt moving music closer to science. Algorithms are of help in this process. Only recently has algorithmic music been used within the context of composing music with therapeutic aims helping to create songs for precise therapeutic aims: music characteristics can be altered and re-modelled and, above all, simplified. It was exactly this intent that recently brought into being an algorithm, Melomics-Health, which composes music with a "therapeutic" logic. Melomics-Health allows us to study the effect of specific musical parameters and structures on individuals (including neuro-scientific aspects) with the possibility to correlate effectiveness and efficiency to those precise musical aspects and to re-model the latter based on these findings. The use of algorithms applied to music as therapy constitutes a new starting point, an attempt to bring art and science closer together, to increase awareness and effectiveness in the use of music in therapeutic contexts; a new perspective integrating art, science and technology in the service of medicine, in clinical work and research.

Music as support to Occupational Therapy.

SUMMARY: Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages from interdisciplinary approach, implying that classic rehabilitative models are constantly enhanced by updated evidences in rehabilitation literature and enriched with competences from different fields. Recent literature has showed how music interventions can improve clinical and rehabilitative outcomes at different levels. Physical or occupational therapists, caregivers and care staffs are frequently involved in providing music interventions with or without the support of a music therapist. In particular, occupational therapists can use music as support to the rehabilitation of daily living activities and, in general, as a complementary tool of their work. This paper wants to stress the implementation of music and music therapy techniques and related specific training programs in the field of occupational therapy, pointing and summarizing main workable evidence-based approaches with music in occupational therapy settings.

Active music therapy approach for stroke patients in the post-acute rehabilitation.

Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study.

The Music Therapy Session Assessment Scale (MT-SAS): Validation of a new tool for music therapy process evaluation.

BACKGROUND: Music therapy (MT) interventions are aimed at creating and developing a relationship between patient and therapist. However, there is a lack of validated observational instruments to consistently evaluate the MT process. AIM: The purpose of this study was the validation of Music Therapy Session Assessment Scale (MT-SAS), designed to assess the relationship between therapist and patient during active MT sessions. METHODS: Videotapes of a single 30-min session per patient were considered. A pilot study on the videotapes of 10 patients was carried out to help refine the items, define the scoring system and improve inter-rater reliability among the five raters. Then, a validation study on 100 patients with different clinical conditions was carried out. The Italian MT-SAS was used throughout the process, although we also provide an English translation. RESULTS: The final scale consisted of 7 binary items accounting for eye contact, countenance, and nonverbal and sound-music communication. In the pilot study, raters were found to share an acceptable level of agreement in their assessments. Explorative factorial analysis disclosed a single homogeneous factor including 6 items (thus supporting an ordinal total score), with only the item about eye contact being unrelated to the others. Moreover, the existence of 2 different archetypal profiles of attuned and disattuned behaviours was highlighted through multiple correspondence analysis. CONCLUSIONS: As suggested by the consistent results of 2 different analyses, MT-SAS is a reliable tool that globally evaluates sonorous-musical and nonverbal behaviours related to emotional attunement and empathetic relationship between patient and therapist during active MT sessions.

[Music therapy and Occupational medicine]. / Musicoterapia e Medicina del Lavoro.

OBJECTIVES: This review focuses on randomized and clinical controlled trials regarding the use of music in workplaces. METHODS: The paper represents a possible starting point to introduce a scientific approach in the use of music techniques in the occupational medicine, improving psychological and work performance outcomes. RESULTS: Some key points about the definition of music approaches and their aims were reported in the article.

Improvement of spontaneous language in stroke patients with chronic aphasia treated with music therapy: a randomized controlled trial.

AIM OF THE STUDY: The aim of this research is to evaluate the effects of active music therapy (MT) based on free-improvisation (relational approach) in addition to speech language therapy (SLT) compared with SLT alone (communicative-pragmatic approach: Promoting Aphasic's Communicative Effectiveness) in stroke patients with chronic aphasia. MATERIALS AND METHODS: The experimental group (n = 10) was randomized to 30 MT individual sessions over 15 weeks in addition to 30 SLT individual sessions while the control group (n = 10) was randomized to only 30 SLT sessions during the same period. Psychological and speech language assessment were made before (T0) and after (T1) the treatments. RESULTS: The study shows a significant improvement in spontaneous speech in the experimental group (Aachener Aphasie subtest: p = 0.020; Cohen's d = 0.35); the 50% of the experimental group showed also an improvement in vitality scores of Short Form Health Survey (chi-square test = 4.114; p = 0.043). CONCLUSIONS: The current trial highlights the possibility that the combined use of MT and SLT can lead to a better result in the rehabilitation of patients with aphasia than SLT alone.

A novel music-based therapeutic approach: the Therapeutic Music Listening.

The therapeutic use of music is frequently based on active interventions that directly involve the patient through a sonorous-music interaction with the music therapist. In contrast, approaches based on musical listening are characterized by a relationship aimed at promoting an introspective work and processing of one's emotional experiences. Increasingly, the scientific literature has shown how even listening to music related to the patient's personal tastes (preferred music listening) and by-passing the direct relationship with the patient, can produce therapeutic effects in different clinical settings. However, in many cases, a clear therapeutic rationale and specific application protocols are still lacking. The paper introduces a novel approach based on music listening: the Therapeutic Music Listening. This approach integrates the subjective component of listening (patient's musical tastes) and structural and parametric characteristics of the music in relation to the therapeutic aims. The article defines theoretical-applicative bases as well as therapeutic and research perspectives of this music listening-based intervention.

Movement Sonification Techniques to Improve Balance in Parkinson's Disease: A Pilot Randomized Controlled Trial.

BACKGROUND: Movement sonification has been recently introduced into the field of neuromotor rehabilitation alongside Neurologic Music Therapy and music-based interventions. This study introduces the use of musical auditory cues encompassing the melodic-harmonic aspect of music. METHODS: Nineteen patients with Parkinson's disease were randomly assigned to the experimental (n = 10) and control (n = 9) groups and underwent thrice-weekly sessions of the same gait training program, with or without sonification. Functional and motor parameters, as well as fatigue, quality of life, and the impact of intervention on patients' well-being, were assessed at baseline (PRE), the end of treatment (POST), and at follow-up (FU). Between-group differences were assessed for each outcome measure using linear mixed-effects models. The outcome measure was entered as the dependent variable, group and time as fixed effects, and time by group as the interaction effect. RESULTS: Mini BESTest and Dynamic Gait Index scores significantly improved in the experimental group (p = 0.01 and p = 0.03, respectively) from PRE to FU, demonstrating a significant impact of the sonification treatment on balance. No other significant differences were observed in the outcome measures. CONCLUSIONS: Larger sample sizes are needed to confirm the effectiveness of sonification approaches in Parkinson's disease, as well as in other neurological disorders.

[The efficacy of music and music therapy in the neuromotor rehabilitation]. / L'efficacia della musica e della musicoterapia nella riabilitazione neuromotoria.

This article review includes the controlled and randomized controlled trials about the use of music and music therapy techniques in the neuromotor rehabilitation. The paper defines the music therapy and delineates the neuroscientific bases and rehabilitative potential of music and music therapy interventions. Significant results are present in the stroke and Parkinson's disease rehabilitation. The Author's conclusions suggest the need of more rigorous studies based on clear procedures and strong methodological research criteria.

Music therapy, emotions and the heart: a pilot study.

BACKGROUND: The autonomic nervous system plays an important role in the control of cardiac function. It has been suggested that sound and music may have effects on the autonomic control of the heart inducing emotions, concomitantly with the activation of specific brain areas, i.e. the limbic area, and they may exert potential beneficial effects. OBJECTIVE: This study is a prerequisite and defines a methodology to assess the relation between changes in cardiac physiological parameters such as heart rate, QT interval and their variability and the psychological responses to music therapy sessions. METHODS: We assessed the cardiac physiological parameters and psychological responses to a music therapy session. ECG Holter recordings were performed before, during and after a music therapy session in 8 healthy individuals. The different behaviors of the music therapist and of the subjects have been analyzed with a specific music therapy assessment (Music Therapy Checklist). RESULTS: After the session mean heart rate decreased (p = 0.05), high frequency of heart rate variability tended to be higher and QTc variability tended to be lower. During music therapy session "affect attunements" have been found in all subjects but one. A significant emotional activation was associated to a higher dynamicity and variations of sound-music interactions. CONCLUSION: Our results may represent the rational basis for larger studies in diferent clinical conditions.

Effect of Algorithmic Music Listening on Cardiac Autonomic Nervous System Activity: An Exploratory, Randomized Crossover Study.

It is proven that music listening can have a therapeutic impact in many clinical fields. However, to assume a curative value, musical stimuli should have a therapeutic logic. This study aimed at assessing short-term effects of algorithmic music on cardiac autonomic nervous system activity. Twenty-two healthy subjects underwent a crossover study including random listening to relaxing and activating algorithmic music. Electrocardiogram (ECG) and non-invasive arterial blood pressure were continuously recorded and were later analyzed to measure Heart Rate (HR) mean, HR variability and baroreflex sensitivity (BRS). Statistical analysis was performed using a general linear model, testing for carryover, period and treatment effects. Relaxing tracks decreased HR and increased root mean square of successive squared differences of normal-to-normal (NN) intervals, proportion of interval differences of successive NN intervals greater than 50 ms, low-frequency (LF) and high-frequency (HF) power and BRS. Activating tracks caused almost no change or an opposite effect in the same variables. The difference between the effects of the two stimuli was statistically significant in all these variables. No difference was found in the standard deviation of normal-to-normal RR intervals, LFpower in normalized units and LFpower/HFpower variables. The study suggests that algorithmic relaxing music increases cardiac vagal modulation and tone. These results open interesting perspectives in various clinical areas.

Effects of Algorithmic Music on the Cardiovascular Neural Control.

Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.

Conventional and Algorithmic Music Listening before Radiotherapy Treatment: A Randomized Controlled Pilot Study.

Music listening is a widespread approach in the field of music therapy. In this study, the effects of music listening on anxiety and stress in patients undergoing radiotherapy are investigated. Sixty patients with breast cancer who were candidates for postoperative curative radiotherapy were recruited and randomly assigned to three groups: Melomics-Health (MH) group (music listening algorithmically created, n = 20); individualized music listening (IML) group (playlist of preferred music, n = 20); no music group (n = 20). Music listening was administered for 15 min immediately before simulation and during the first five radiotherapy sessions. The State-Trait Anxiety Inventory (STAI) and the Psychological Distress Inventory (PDI) were administered before/after treatment. Cochran's Q test and McNemar test for paired proportions were performed to evaluate if the proportion of subjects having an outcome score below the critical value by treatment and over time was different, and if there was a change in that proportion. The MH group improved in STAI and PDI. The IML group worsened in STAI at T1 and improved STAI-Trait at T2. The IML group worsened in PDI at T2. The No music group generally improved in STAI and PDI. Clinical and music listening-related implications are discussed defining possible research perspectives in this field.