Usefulness of music therapy in clinical practice
Augustovski F, Pichon Riviere A, Alcaraz A, Bardach A, Ferrante D, Garcia Marti S, Glujovsky D, Lopez A, Regueiro A, Colantonio L
Record ID 32006000895
The aim of this report was to assess the usefulness of music therapy in clinical practice. Music therapy is aimed at developing potential functions and to restore the individual's functions. The use of music therapy has been proposed: - in subjects with physical, neurological, mental and sensorial disabilities - in mental health for children, adults and teenagers - in infertility, pregnancy and early attachment disorders - in special education, neurosis, addictions, coma patients, patients in intensive care unit, Down Syndrome and management of autism, among others.
Authors' results and conclusions:
Music therapy in patients with neurological diseases
One Cochrane systematic review, updated in 2004, assessed the effects of music therapy on the management of behavioral, social, cognitive and emotional disorders in demented elderly people. This review included 5 poor methodology studies whose results could not be conclusive as regards its efficacy. Only one RCT was found; it compared music therapy with physical therapy in 32 patients with Parkinson's disease. Both groups showed improvement in some of the evaluation scores while therapy was in progress, for example: bradykinesia, stiffness and tremor, but this effect could not be maintained when therapy was over.
Music therapy in patients with psychiatric disorders
One Cochrane meta-analysis, updated in 2004, assessed the effects of music therapy in the management of schizophrenia. This review included 4 studies and concluded that music therapy as complementary to common assistance helps patients with schizophrenia to improve their general condition in the short and medium term. There is also certain evidence on the effects it has on mental status, performance and mainly on its negative symptoms; however, its effects do not seem to depend on the number and length of sessions and there is not enough evidence about the dose-response relationship nor the length of its long term effects. Similar results were reported in other three RCTs with fewer patients.
Music therapy in inpatients or patients who undergo therapeutic or diagnostic procedures
One meta-analysis of 19 studies published in 2002 showed that music therapy reduces anxiety during regular management of inpatients, though this effect was not observed in patients who underwent therapeutic or diagnostic procedures. These patients presented a slight reduction in respiratory frequency and better mood and tolerance.
Patients who underwent colonoscopies
Findings similar to those reported in the metanalysis as regards diagnostic procedures were reported by Smolen et. al., in a study which included 32 patients who underwent colonoscopies and Lopez et. al, in a study which included 118 patients though in the first study, the group treated with music therapy required lower doses of anaesthetics. However, other studies showed decreased anxiety in patients who underwent gastrointestinal testing and who listened to music of their own choice or classical music selected by the investigators.
Patients who underwent surgery
Four studies evaluating the effect of music therapy on patients who underwent surgery were found. In general, decreased anxiety in patients exposed to music therapy prior, during and post surgery and lower requirements of anesthesia was observed though no differences were found in their clinical parameters or hospital stay. One study carried out in Chinese patients did not show differences with the use of music therapy in operated patients.
Female patients who underwent procedures
One study published in 2003 randomized 110 women in labor to listen to soft music during the first hours of their labor or to common management of delivery. Women exposed to music presented less pain during the first 3 hours of labor than those in the control group. Another study which randomized 220 women who underwent colonoscopies to listen to music or to habitual management. The patients who listened to music presented less pain and less anxiety that those in the control group.
Other groups of patients
Benefits were found in decreased anxiety in ventilated patients and in those patients who underwent bone marrow transplantation and decreased osteoarticular pain and better quality, length and effectiveness of sleeping in elderly patients exposed to music therapy. Coverage policies Music therapy is not included in the Argentina's Ministry of Health's Emergency Mandatory Medical Plan (PMOE). Health policies found, both in the U.S. health system, consider music therapy investigational and coverage is not provided.
There is certain evidence on the usefulness of music therapy in patients with some neurological diseases, in decreased anxiety in patients who underwent procedures or surgery, in ventilated patients and in the elderly with osteoarthritis or difficulties in sleeping. However, its effects seem to depend on the number and length of sessions and there is not enough evidence on its dose-response relationship nor the length of long-term effects, nor of an adequate standardization of the type of treatment to perform in each case. The use of music as relaxing agent in offices, hospital or during surgeries has not shown adverse effects and is almost inexpensive. Still to be determined is its cost-effectiveness and an adequate standardization of the treatments in those cases where specific music therapy sessions provided by an accredited music therapist are required.
English language abstract:
An English language summary is available
- Delivery, Obstetric
- Music Therapy
- Parkinson Disease
Institute for Clinical Effectiveness and Health Policy
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Institute for Clinical Effectiveness and Health Policy (IECS)