Implementation of virtual music therapy in the practice of Czech music therapists: a best practice implementation project.

INTRODUCTION AND AIMS: Czech music therapists lacked the skills and knowledge to adapt their practice to virtual music therapy (VMT) at the beginning of the COVID-19 pandemic, when physical contact was restricted. The aims of this project were to implement the best evidence-based recommendations concerning VMT in the practice of Czech music therapists and increase the number of therapists using VMT. METHODS: The project used the JBI Evidence Implementation Framework to promote change in the practice of participants. A baseline audit of 26 practitioners was conducted using questionnaires and interviews. The audit criteria consisted of 8 best practice recommendations, followed by the implementation of targeted strategies and a follow-up audit. RESULTS: Of the 26 music therapists, 18 began practicing VMT following the rollout of the implementation strategies. Strategies included educational workshops, instructional materials, technological support, individual counseling, and interactive training sessions. There was an increase in compliance with all audit criteria. The most critical barriers were lack of knowledge about VMT and lack of technical skills; lack of resources; technological challenges; low confidence of music therapists to provide VMT; and reduced need for VMT after the lockdown restrictions were relaxed. CONCLUSIONS: The implementation project helped to overcome temporary pandemic restrictions, increase the quality of VMT practice, develop strategies for VMT training, and identify reasons for using VMT during the pandemic and beyond.

Experience of having a sibling with autism spectrum disorder: a systematic review protocol.

OBJECTIVE: This qualitative systematic review aims to understand the experiences of neurotypical siblings of a person with autism spectrum disorder. INTRODUCTION: Autism spectrum disorder influences communication and social interaction with other people and has a significant impact on family relationships. The experiences of siblings range from the positive, such as development of increased empathy and ability to cope with challenges, to experiences that are more negative, such as a higher risk of bullying. In many countries, neurotypical siblings are marginalized and don't receive adequate support to cope with the increased challenges. INCLUSION CRITERIA: This review will consider qualitative studies exploring the experiences of siblings of a person with autism spectrum disorder. There will be no limitations regarding age, gender, sex, or length of relationship with the sibling. We will consider studies from all countries and contexts. METHODS: This study will be conducted according to the JBI methodology for qualitative reviews. A 3-step search strategy will be used to find published and unpublished studies from the following sources: MEDLINE, CINAHL, APA PsycINFO, Scopus, SocINDEX, Web of Science, Embase, ERIC, ProQuest Dissertations and Theses, Open Dissertations, and Google Scholar (first 100 records). There will be no search limitations on the publication period or language, but only studies with an English-language abstract/title will be considered for inclusion. Screening, data extraction, and data synthesis will be conducted by 2 independent reviewers.

Impact of educational and psychological interventions compared with standard care in college/university students with autism spectrum disorder: a systematic review protocol.

OBJECTIVE: This review will explore the impact of educational and psychological interventions on educational, social, behavioral, and mental health outcomes in students with autism spectrum disorder in tertiary education. INTRODUCTION: This systematic review will inform a new guideline on support for students with autism spectrum disorder in the tertiary education environment. These students face multiple educational, behavioral, social, and health-related problems that require effective interventions. INCLUSION CRITERIA: Participants are students with autism spectrum disorder in a tertiary education study program. Educational and psychological interventions will be included, such as accommodations, meta-cognitive and self-regulation training, psychological counseling, social skills training, and peer-mentoring/academic coaching. The comparator will be standard care. The study outcomes will include academic drop-out rates and evaluations, learning skills, social skills and social engagement, behavior, mental health (including anxiety, stress, and depression), and employment after graduation. This review will consider quantitative studies only. METHODS: A 3-step search strategy will be used to find both published and unpublished studies in MEDLINE, CINAHL, APA PsycINFO, SocINDEX, Web of Science, Clinical Trials, ProQuest Dissertations and Theses, Open Dissertations, ERIC, WHO ICRTP, and Google Scholar. There will be no date or language limitations. All stages of article screening, critical appraisal, and data extraction will be conducted by 2 independent reviewers with the resolution of any disagreements done via consensus or through a senior reviewer. If possible, the included studies will be pooled using meta-analysis. The degree of certainty of the evidence will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022323554.

Effect of low frequency sound vibration on acute stress response in university students-Pilot randomized controlled trial.

Background: Low frequency sound (LFS, combined with music listening) is applied by practitioners in vibroacoustic therapy who report a positive effect of this intervention on acute stress response. However, there is a lack of research on this topic and studies with mainly objective measurements are scarce. Materials and methods: In this pilot double-blinded Randomized Controlled Trial we used a multimodal approach to measurement of acute stress response in 54 international university students attending a university summer school in Olomouc, the Czech Republic who were individually randomized into a group receiving LFS vibration and a control group. In both groups, the acute stress response was measured by heart rate variability (HRV), visual analogue scales (VAS) for stress and muscle relaxation. Results: Differences were found in pre-test post-test measures, however, between groups differences occurred only for HRV, with statistically significant improvement in the experimental group (parameter LF/HF and pNN50). Conclusion: Vibroacoustic therapy has the potential to contribute to the stress management of university students. Further research is needed to explore the effect of LFS on stress response, especially when applied without additional music listening.

Corrigendum: Tactile low frequency vibration in dementia management: A scoping review.

[This corrects the article DOI: 10.3389/fpsyg.2022.854794.].

Social support and family quality of life in Chinese families of children with autism spectrum disorder: the mediating role of family cohesion and adaptability.

Background: The current study examined the interrelations among social support, family quality of life (FQOL), and family cohesion and adaptability in Chinese families of children with autism spectrum disorder (ASD). Methods: A sample of 163 caregivers of children with ASD in China were surveyed with the Social Support Rating Scale, Beach Center Family Quality of Life Scale, and Chinese version of Family Adaptability and Cohesion Scale II, respectively. We used structural equation modeling to examine the mediating role of family cohesion and adaptability on the relationship between social support and FQOL. Results: The results indicated that social support had a positive impact on FQOL and that family cohesion and adaptability completely mediated the relationship between social support and caregivers' satisfaction on FQOL. Conclusions: Facilitating family cohesion and adaptability by providing social support may be beneficial to help families of children with ASD improve their FQOL. The findings identified the need for developing targeted interventions for this population.

Why Music Therapists Choose to Work with a Clinical Population: An International Pilot Survey.

(1) Background: Throughout their career, music therapists make decisions regarding the clinical population they choose to work with. Though such decisions can have broad implications on the professional development of the music therapist, not much is known about the reasons for making these decisions and whether they are affected by demographic or professional factors. (2) Methods: In this pilot study, we surveyed 439 music therapists from six countries (i.e., Austria, the Czech Republic, Germany, Israel, Spain, and Switzerland) using an online questionnaire. We asked the respondents to explain why they chose to work with their main clienteles, and we examined whether their reasons were connected to demographic factors such as country of origin, gender, and seniority, and professional factors such as experience as a music therapist and population one works with. (3) Results: The category analysis of these responses pointed at nine distinct reasons that could be grouped into "practical reasons", "reasons of connection", and "innovation". There were differences in reasoning between music therapists from different countries, and with different degrees of seniority, but not between male and female music therapists. (4) Discussion: The implications on training programs and on policy makers are discussed as well as the importance of this subject to the development of music therapists' professional identity.

Tactile Low Frequency Vibration in Dementia Management: A Scoping Review.

The prevalence of dementia is increasing with the ever-growing population of older adults. Non-pharmacological, music-based interventions, including sensory stimulation, were reported by the Lancet Commission in 2020 to be the first-choice approach for managing the behavioural and psychological symptoms of dementia. Low frequency sinusoidal vibration interventions, related to music interventions through their core characteristics, may offer relief for these symptoms. Despite increasing attention on the effectiveness of auditory music interventions and music therapy for managing dementia, this has not included low frequency vibration. This scoping review, following the JBI methodology guidelines, was conducted to investigate participants' responses to both sound and mechanical vibration, the characteristics of the delivered interventions, methodological challenges, and the specifics of the research experiments reported. An extensive search was conducted in BMC, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, ERIC, MEDLINE (OvidSP), Pedro, ProQuest Central, PsycINFO, Scopus, and Web of Science. Current Controlled Trials, Clinical Trials, and Google Scholar were also searched as well as a hand search in relevant journals. Studies on adults with all types of dementia, investigating tactile low frequency sound or mechanical vibration in any context were considered. Data from eight full-length studies (three RCTs, two quasi-experimental, two case reports, and one qualitative) were extracted using the data extraction table developed by the authors and were included in the analysis and critical appraisal. Issues in quality related to, for example, control groups and blinding. Few studies addressed participants' subjective responses to the interventions. Reporting on the intervention characteristics was unclear. It appeared more frequent sessions led to better outcomes and home-based interventions potentially addressing the issue of access and feasibility. Future research should include neuroimaging to measure and confirm the hypothesised mechanism of cerebral coherence. Standardised reporting of intervention characteristics is also needed to ensure replicability of the experiments. Higher quality research is needed to investigate the impact and effect of low frequency vibration for the symptoms of dementia and compare outcomes in meta-syntheses.

The Effect of Low Frequency Sound on Heart Rate Variability and Subjective Perception: A Randomized Crossover Study.

BACKGROUND: Vibroacoustic therapy (VAT) uses low-frequency sound, often combined with listening to music, for therapeutic purposes. However, the impact of low-frequency vibration (LFV) on physiological functions and subjective perception is relatively unknown. METHODS: We conducted a randomized cross-over study with the aim of comparing the effect of constant LFV of 40 Hz, its amplitude modulation, and the placebo condition on heart rate variability (HRV), stress perception (measured by visual analogue scales for stress) and mood (measured by UWIST Mood Adjective Check List). RESULTS: Research experiments with various interventions (constant LFV with sound of nature (river in forest), amplitude modulation of the same LFV with sounds of nature and sounds of nature without LFV) were realised involving 24 participants. It was found there was an effect on HRV, stress perception and mood after the interventions. However, there were only seldomly experienced, and mostly nonsignificant, differences between the intervention conditions, so the effects may be attributed to factors other than LFV. CONCLUSIONS: Large scale experimental studies are needed to verify the preliminary findings and to explore various coinciding factors that may have influenced the results of this study, e.g., type of autonomic nervous system. We propose that the effect of LFV exposure may differ when combined with listening to music, and this hypothesis should be investigated in future studies.

The Effects of Ayres Sensory Integration and Related Sensory Based Interventions in Children with Cerebral Palsy: A Scoping Review.

The theory of Ayres Sensory Integration® was formulated in the 1960s, and is also known as sensory integration (SI). It has been used in people with cerebral palsy (CP), though the research evidence for its effects in this population is contradictory and inconclusive. To fill in this knowledge gap, we conducted a scoping review of the body of literature on the topic, including any type of quantitative or qualitative research of SI in people with CP without any restrictions of age, language, geography, professionals involved, etc. In September 2020, we searched Scopus, ProQuest Central, MEDLINE (via PubMed), CINAHL Plus and the Academic Search Ultimate and Web of Science, as well as the grey literature sources OpenGrey and MedNar. Two reviewers independently screened the texts and the references lists of the included papers. We finally included seven relevant papers (four randomized controlled trials, two quasi-experimental studies and one case series), though not all fidelity measures required for Ayres SI were reported in the papers. The age of participants ranged from 3 months to 15 years; no studies were identified on adults. There is some evidence that SI or related sensory-based interventions (SBI) may be useful for movement development and other outcomes (attention span, therapy of sensory processing disorders, body perception and therapy of strabismus), but there is only scarce and low-quality evidence comparing interventions. We recommend to conduct well-designed randomized controlled trials (RCTs) with an optimal sample size on the effectiveness of formal Ayres SI for the motor development or other outcomes (as attention span or self-care abilities) using standardized measurement tools.

Exploring vibroacoustic therapy in adults experiencing pain: a scoping review.

OBJECTIVE: To explore the characteristics and outcomes of vibroacoustic therapy (VAT) in adults experiencing pain. To give directions for future research and clinical applications of VAT in pain management for adults. DESIGN: Scoping review. DATA SOURCES: BMC, CINAHL Plus, Cochrane Library, EBSCOhost, EBM Reviews, EMBASE, Epistemonikos, ERIC, MEDLINE complete, Scopus, Web of Science, Google Scholar, ProQuest, hand search in unpublished sources. STUDY SELECTION: All quantitative and qualitative research studies and systematic reviews, without any date or language limit. DATA EXTRACTION: Two independent reviewers extracted data on the study design, location and setting, the causes of pain, participants, vibroacoustic intervention, measurement tools, and key findings related to pain. RESULTS: From 430 records, 20 were included for narrative synthesis. Fifteen studies researched chronic pain, two studies acute pain, two studies both types of pain and one study experimentally induced pain. The description of VAT applied in studies usually included the description of research experiments, vibroacoustic devices and frequencies of sinusoidal sound. There was high heterogeneity in study protocols, however, 40 Hz was predominantly used, most sessions ranged between 20 and 45 min, and the frequency of treatment was higher for acute pain (daily) compared with chronic pain (daily to once a week). Outcomes related to pain focused mainly on perceived pain; however, other surrogate measures were also considered, for example, an increased number of treatment days or pain medication usage. CONCLUSIONS: Research in this area is too sparse to identify properties of VAT that are beneficial for pain management. We suggest VAT researchers describe a minimum of four measurements-frequency, amplitude, pulsation and loudness. Randomised controlled trials are needed to establish reliable scientific proof of VAT effectiveness for both acute and chronic pain. Furthermore, clinical practice would benefit from researching patients' experiences and preferences of vibroacoustic treatment and its psychosocial components.

Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis.

This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013-2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines repository, GRADEpro Database, MAGICapp, NICE and WHO websites. Two reviewers will independently screen full texts of the documents identified. The following information will be extracted: methods used for identifying different stakeholders and incorporating their perspectives; methods for identification and prioritization of non-health outcomes; methods for determining thresholds for decision-making; methods for incorporating and grading evidence from non-randomized studies; methods for addressing concerns with conditional recommendations in public health; methods for reaching consensus; additional methodological concerns; and any modifications made to GRADE. A combination of directed content analysis and descriptive statistics will be used for data analysis, and the findings presented narratively in a tabular and graphical form. In this protocol, we present the pilot results from 13 identified eligible guidelines issued between January and August 2021. We will publish the full review results when they become available.

Visual transformation for guidelines presentation of the strength of recommendations and the certainty of evidence.

OBJECTIVE: The objective of this paper is to propose an approach to visual unification of adapted guidelines and transformation of classifications of certainty of evidence (CoE) and strength of recommendations (SoR) into the approach suggested by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group. STUDY DESIGN AND SETTING: We carried out a literature search in MEDLINE and Epistemonikos, an analysis of selected guidelines, and an iterative discussion to decide on a consistent visual presentation and CoE and SoR depictions. RESULTS: The results of the literature search suggested this issue had not been addressed yet. The analysis of the chosen eight guidelines showed significant heterogeneity in the visual presentation of recommendations. Recommendations were often worded similarly to whether or not they were strong or conditional. Many guidelines contained "statements," almost all of which did not fulfill the good practice statement (GPS) criteria. We proposed an approach for transforming recommendations that are being adapted and which use various classification systems for CoE and SoR into GRADE and a consistent visual style. CONCLUSION: Guideline developers should aim for unification in the formulation of recommendations to improve transferability.

Quality assessment of clinical practice guidelines for perioperative care and use of GRADE: a systematic review protocol.

INTRODUCTION: Perioperative care is a broad field covering an array of elective and emergency procedures. Clinical practice guidelines (CPGs) for perioperative care exist with various degrees of methodological quality. We intend to critically appraise them using AGREE II instrument and investigate the use of Grading of Recommendations, Assessment, Development and Evaluations (GRADE). METHODS AND ANALYSIS: We searched MEDLINE (Ovid), Epistemonikos, Cochrane Database of Systematic Reviews and PROSPERO and did not identify any similar systematic review in this area. We will search databases, repositories and websites of guideline developers and medical societies, including MEDLINE (Ovid), Embase (Ovid), DynaMed, the GIN international guideline library and registry of guidelines in development, BIGG international database of GRADE guidelines, ECRI Guideline Trust or National Institute for Clinical Evidence to identify all CPGs for perioperative care in an adult population in a general clinical setting. We will include CPGs, expert guidance, position papers, guidance documents and consensus statements published in the last 5 years by experts or international organisations that provide guidance or recommendations in the available full text with no geographical or language limitation. Excluded will be those containing only good practice statements. Two independent reviewers will perform critical appraisal using the AGREE II tool. The data presented in a narrative and tabular form will include the results of the critical appraisal for all identified CPGs for all AGREE II domains and an assessment of the use of the GRADE approach. ETHICS AND DISSEMINATION: Ethics approval is not required. We will disseminate the findings through professional networks and conference presentations and will publish the results.

Adaptation of Music Therapists' Practice to the Outset of the COVID-19 Pandemic-Going Virtual: A Scoping Review.

Background: In the midst of a worldwide COVID-19 pandemic, music therapists previously not involved in telehealth had to develop effective remote forms of music therapy. The objective of this review was to systematically explore how music therapists previously working in-person adapted to the transfer to remote forms of therapy in the context of the coronavirus outbreak. Methods: We searched Scopus, Web of Science Core Collection, CINAHL, Medline, ProQuest Central, PubMed, EMBASE, PsycINFO and PsyARTICLES, grey literature (to October 2020), and websites of professional organizations. We followed the JBI methodology for scoping reviews. Results: Out of the 194 screened texts, we included ten very heterogeneous articles with an overall very low quality. Most texts described remote therapy in the form of synchronous video calls using the Internet, one paper described a concert in a patio of a residential home. We report the authors' experience with the adaptation and activities, challenges and benefits of remote forms of therapy, recommendations of organizations, and examples and tips for online therapies. Conclusions: Music therapists have adapted the musical instruments, the hours, the technology used, the therapeutic goals, the way they prepared their clients for sessions, and other aspects. They needed to be more flexible, consult with colleagues more often, and mind the client-therapist relationship's boundaries. It seems, when taken as a necessary short-term measure, online music therapy works sufficiently well. The majority of papers stated that benefits outweighed the challenges, although many benefits were directly linked with the pandemic context.

Social Support and Family Functioning in Chinese Families of Children with Autism Spectrum Disorder.

Families caring for children with autism spectrum disorder (ASD) have reported poorer family functioning. Social support might strengthen family functioning, but limited research to date has focused on this association in China. This study conducted a cross-sectional survey of Chinese families that have children with ASD to examine the relationship between social support and family functioning. Caregivers of children with ASD from Sichuan province in China (N = 167) were surveyed concerning their perceived social support and family functioning. The Social Support Rating Scale was used to investigate caregivers' perceived social support from three dimensions: subjective support, objective support, and the utilization of support. A Chinese version of the Family Adaptability and Cohesion Scale was used to investigate their perceptions of family cohesion and adaptability. The Pearson correlation coefficient and stepwise multiple regression were used for analyses. The results suggested that social support was positively related to family cohesion and adaptability. Of the three sub-domains of social support, both subjective support and the utilization of support were positively associated with family cohesion and adaptability. The study's findings evidenced the importance of different types of social support and could be used to develop a targeted support service for families that have children with ASD to improve their family functioning and sustain the family unit.

Tactile Low Frequency Vibration in Dementia Management: A Scoping Review Protocol.

Dementia is a growing issue in modern society. Non-pharmacological interventions such as music are suggested as the primary methods for symptom management. Therapeutic potential may also be found in sound/mechanical low frequency vibrations (LFV) that share the core characteristics of music, but these are lesser understood. The aim of the proposed scoping review is to explore the responses of persons with dementia to LFV, e.g., vibroacoustic therapy or whole-body vibration. The scoping review will follow the Joanna Briggs Institute methodology guidelines. An extensive search in BMC, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, ERIC, MEDLINE (OvidSP), Pedro, ProQuest Central, PsycINFO, Scopus, Web of Science, and grey literature sources in Clinical Trials, Current Controlled Trials, Google Scholar, and manual search of relevant journals is planned to find all relevant research papers. The paper selection, full-text assessment, and data extraction will be performed by two independent reviewers. Participants' responses to the interventions and the experiment designs, including methodological challenges, will be analysed and compared. Results may highlight potential gaps in reporting and comparing sound and mechanical vibration approaches and promote better understanding of their potential for managing the symptoms of dementia. Furthermore, the possible relationships between LFV and music-based interventions may become clearer.

Arts Therapies Interventions and Their Outcomes in the Treatment of Eating Disorders: Scoping Review Protocol.

Arts therapies (AsTs) are considered a valuable intervention for people with eating disorders, however the range of research studies and the comparison between the types of arts therapies are unknown. The goal of the future scoping review is to explore the therapeutic outcomes addressed by arts therapists in research studies on people with eating disorders and compare the different types of arts-based interventions. This scoping review will be conducted in accordance with the Joanna Briggs Institute methodology. Included will be research studies and sources oriented towards people with eating disorders of all ages and AsTs of any type (art therapy, drama therapy, music therapy, dance/movement therapy, and expressive therapies). There is no language/publication period limitation. The following databases will be searched: CINAHL Plus, EMBASE, MEDLINE (OvidSP), ProQuest Central, PsycINFO, PubMed, Scopus, and Web of Science. Sources of unpublished studies and grey literature will include Google Scholar, MedNar, clinical trials, and current controlled trials. Titles/abstracts and full texts of studies will be assessed against the inclusion criteria, and the data extracted by two independent reviewers. Based on the results, we will compare the types of AsTs according to the research designs, country/settings, intervention methods/materials, adverse effects reported, and therapeutic outcomes related to AsTs.

Potential of Vibroacoustic Therapy in Persons with Cerebral Palsy: An Advanced Narrative Review.

Vibroacoustic therapy (VAT) is a treatment method that uses sinusoidal low-frequency sound and music. The purpose of this narrative review is to describe the effects of VAT on motor function in people with spastic cerebral palsy (CP) according to study design as well as providing information about the age of the participants, measurement tools, and sound frequencies that were used. The systematic search strategy based on the first two steps of a standard evidence-based approach were used: (1) formulation of a search question and (2) structured documented search including assessment of the relevance of abstracts and full texts to the search question and inclusion criteria. Out of 823 results of the search in 13 scholarly databases and 2 grey literature sources, 7 papers were relevant. Most of the relevant studies in children and adults presented significant improvement of motor function. According to the study design, only five experimental studies and two randomized controlled trial (RCT) studies were available. In the discussion, findings of this review are compared to other related methods that use mechanical vibrations without music. The authors recommend continuing to research the effects of VAT on motor function and spasticity in adolescents and young adults with spastic CP.