Effects of Patient-Directed Interactive Music Therapy on Sleep Quality in Postoperative Elderly Patients: A Randomized-Controlled Trial.

PURPOSE: This study aimed to investigate the effects of patient-directed interactive music on saliva melatonin levels and sleep quality among postoperative elderly patients in the intensive care unit (ICU). PATIENTS AND METHODS: A total of 133 elderly patients were randomized into three groups: interactive music therapy (IMT), passive listening (PL), and the control group. The control group (n = 45) received routine medical care, while IMT and PL groups received music therapy on ICU day 1. The IMT group received up to 20 mins of interactive music sessions, including relaxation techniques. The PL group received only pre-selected relaxing music-listening for 30 mins. Saliva melatonin and cortisol levels were measured three times at 11 p.m. (preoperative, operation day, and postoperative day [POD] 1). The Richards-Campbell Sleep Questionnaire (RCSQ) and Quality of Recovery-40 questionnaire (QoR40) were administered on the preoperative day, as well as PODs 1 and 2. RESULTS: The RCSQ showed a significant improvement in the IMT group compared to the control group on POD2 (71.50 vs 56.89, p=0.012), but the QoR40 did not show any difference between groups. The quality control of the saliva sample was not available due to the immediate postoperative patient's condition, resulting in a higher dropout rate. Saliva melatonin levels on POD 1 were elevated in the IMT group compared to the control group (1.45 vs 0.04, p=0.0068). The cortisol level did not show a significant difference between groups. CONCLUSION: Single IMT intervention improved subjectively assessed short-term sleep quality in postoperative elderly patients. It is difficult to conclude whether music therapy intervention affects the level of melatonin and cortisol. TRIAL REGISTRATION: The study was registered at ClinicalTrials.Gov (number NCT03156205).

Gait training for adults with cerebral palsy following harmonic modification in rhythmic auditory stimulation.

This study aimed to investigate the differences in gait outcomes of young adults with cerebral palsy (CP) following rhythmic auditory stimulation (RAS) with different types of cueing. A total of 13 ambulatory adults with CP were recruited. The participants were assigned to receive either RAS with simple chords or RAS with complex chords. Each participant received 30-min individual sessions three times per week for 4 weeks. In the simple RAS group, basic chords were used for cueing. In the complex RAS group, the diversified chords were adopted from patients' preferred music. At pre- and posttest, spatiotemporal and kinematic parameters and the range of motion (ROM) for each joint during a gait cycle were collected. After RAS, cadence, velocity, and stride length significantly increased, but no significant group effect was found. Meanwhile, regarding kinematic parameters, a significant interaction effect between time and group was observed with the angle of plantar flexion in the preswing phase and ROM in the ankle. The complex RAS group showed increased maximal ankle plantar flexion in the preswing phase. These results demonstrated that the primary agent for gait control is rhythm, while perception of music facilitates patient engagement in walking differently depending on the level of musical elements.

Dyadic Drum Playing and Social Skills: Implications for Rhythm-Mediated Intervention for Children with Autism Spectrum Disorder.

Current perspectives on social skills development of individuals with autism spectrum disorder (ASD) emphasize the interplay between motor and social skills. Given the evidence supporting this relationship, studies are needed to explore the potential benefit of rhythmic behaviors to improve social skills in children with ASD. The purpose of this two-part study was to confirm the relationship between dyadic drum playing and social skills and to further develop a rhythm-mediated music therapy intervention for improving the social skills of children with ASD. In Study 1, we conducted a factor analysis to examine whether dyadic drum playing was related to social skills in 42 children with typical development and 10 children with high-functioning ASD. In Study 2, we conducted a preliminary pilot of a rhythm-mediated music therapy intervention with eight children with ASD and measured changes in social skills (e.g., imitation and engagement in joint action with others) and dyadic drum playing behaviors. Study 1 findings included identification of four factors related to dyadic drum playing. The presence of rhythmic cueing and tempo adjustment correlated with social skills, providing a strong rationale for the use of dyadic drum playing to address social skills. In Study 2, participants showed decreased asynchrony when tapping with a partner at adjusted tempi after the rhythm-mediated intervention. Furthermore, participants showed greater engagement in joint action following the intervention. This study supports potential benefit of the rhythm-mediated intervention using dyadic drum playing and provides preliminary evidence strengthening its use in the social domain for individuals with ASD.

Changes in gait patterns induced by rhythmic auditory stimulation for adolescents with acquired brain injury.

The effects of rhythmic auditory stimulation (RAS) on gait in adolescents with acquired brain injury (ABI) were investigated. A total of 14 adolescents with ABI were initially recruited, and 12 were included in the final analysis (n = 6 each). They were randomly assigned to the experimental (RAS) or the control (conventional gait training) groups. The experimental group received gait training with RAS three times a week for 4 weeks. For both groups, spatiotemporal parameters and kinematic data, such as dynamic motions of joints on three-dimensional planes during a gait cycle and the range of motion in each joint, were collected. Significant group differences in pre-post changes were observed in cadence, walking velocity, and step time, indicating that there were greater improvements in those parameters in the RAS group compared with the control group. Significant increases in hip and knee motions in the sagittal plane were also observed in the RAS group. The changes in kinematic data significantly differed between groups, particularly from terminal stance to mid-swing phase. An increase of both spatiotemporal parameters and corresponding kinematic changes of hip and knee joints after RAS protocol indicates that the use of rhythmic cueing may change gait patterns in adolescents with ABI.

Rhythmic Auditory Cueing in Motor Rehabilitation for Stroke Patients: Systematic Review and Meta-Analysis.

BACKGROUND: Given the increasing evidence demonstrating the effects of rhythmic auditory cueing for motor rehabilitation of stroke patients, this synthesized analysis is needed in order to improve rehabilitative practice and maximize clinical effectiveness. OBJECTIVE: This study aimed to systematically analyze the literature on rhythmic auditory cueing for motor rehabilitation of stroke patients by highlighting the outcome variables, type of cueing, and stage of stroke. METHODS: A systematic review with meta-analysis of randomized controlled or clinically controlled trials was conducted. Electronic databases and music therapy journals were searched for studies including stroke, the use of rhythmic auditory cueing, and motor outcomes, such as gait and upper-extremity function. RESULTS: A total of 10 studies (RCT or CCT) with 356 individuals were included for meta-analysis. There were large effect sizes (Hedges's g = 0.984 for walking velocity; Hedges's g = 0.840 for cadence; Hedges's g = 0.760 for stride length; and Hedges's g = 0.456 for Fugl-Meyer test scores) in the use of rhythmic auditory cueing. Additional subgroup analysis demonstrated that although the type of rhythmic cueing and stage of stroke did not lead to statistically substantial group differences, the effect sizes and heterogeneity values in each subgroup implied possible differences in treatment effect. CONCLUSIONS: This study corroborates the beneficial effects of rhythmic auditory cueing, supporting its expanded application to broadened areas of rehabilitation for stroke patients. Also, it suggests the future investigation of the differential outcomes depending on how rhythmic auditory cueing is provided in terms of type and intensity implemented.

Can young adolescents with cochlear implants perceive different timbral cues?

OBJECTIVE: This study aimed to compare the timbre recognition and preferences of young adolescents with cochlear implants (CIs) to that of adolescents with normal hearing (NH). METHODS: Nine Korean adolescents with CIs and 25 adolescents with NH participated in this study. After listening to each of four Western instruments and five traditional Korean instruments, participants were asked to identify presented instruments and rate how much they liked the timbres. RESULTS: The results showed that the CI group recognized instruments significantly less often than the NH group. They also tended to show a relatively higher recognition of the instruments bearing a rapid and strong attack time. With regard to timbre preferences, no significant differences were found between the groups. DISCUSSION: Young adolescents with CIs show potential for detecting salient features in sound information, especially instrumental timbre. This study indicates what can be considered to incorporate more sounds with varying origins and tone qualities into music perception and education for this population.