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.

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.

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.

Effects of music therapy on psychological symptoms and heart rate variability in patients with dementia. A pilot study.

We assessed the effects of music therapy (MT) on behavioral and psychological symptoms (BPSD) in dementia associated with changes in physiological parameters, as heart rate (HR) and heart rate variability (HRV). Twenty subjects were randomly assigned to MT treatment or standard care; all patients underwent neuropsychological assessment and ECG Holter recordings before and after the 15-week treatment. The treatment included 30 MT sessions. Depression significantly decreased (p=0.021) in the MT group. PNN50 improved in 50% patients of the MT group, but in none of the control group (p=0.013). MT may improve symptoms of depression and increase HRV in demented patients.