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Definition of Music Therapy• Prescribed use of music and musical
interventions for the purpose of restoring, maintaining and improving health and well-being.
• Provides a means with which people can build connections with their inner selves and with others around them.
Background
• Can be one-to-one or in groups, live vs recorded, passive vs active participation.
• Has been used for centuries (eg David playing the harp for King Saul, Hipprocrates played music for his mental patients)
• There is now a BAMT established 2011• Increasing evidence showing effectiveness
Music Therapy for children
• Pain/Anxiety• Growth• Palliative care• Disability• Social ability• Happiness!
Music therapy +
• Several studies/reviews suggest music may reduce pain during procedures:
-venepuncture/immunisations-lumbar puncture-burn dressing changes-post operative management• Balan R, Bavdekar SB, Jadhav S. Can Indian classical instrumental music reduce pain felt during venepuncture?Indian J
Pediatr. 2009 May;76(5):469-73. Epub 2009 Apr 23.• Klassen JA et al. Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized
controlled trials. Ambul Pediatr. 2008 Mar-Apr;8(2):117-28.
Music therapy + Anxiety
• Music significantly (p=0.017) reduced anxiety in A+E
• Aromatherapy was not significantly effective (p=0.347)
• Live music reduced the time needed for MRI scans (decreased movements + break requests)
• Music helped with crying in premature infants• Holm L, Fitzmaurice L. Emergency department waiting room stress: can music or aromatherapy improve anxiety scores?
Paediatr Emerg Care. 2008 Dec;24(12):836-8.• Walworth DD. Effect of live music therapy for patients undergoing magnetic resonance imaging. J Music Ther. 2010
Winter;47(4):335-50.• Keith DR, Russell K, Weaver BS. The effects of music listening on inconsolable crying in premature infants. J Music Ther.
2009 Fall;46(3):191-203.
Music therapy + Growth• Energy expenditure is decreased (10%)• Live harp music led to reduced activity (p<0.01 – from 5000 to 490 movements per hour)- increased weight gain (p<0.01 – 19.1g/kg/d vs 13.3)• Lubetzky R et al. Effect of music by Mozart on energy expenditure in growing preterm infants. Pediatrics. 2010 Jan;125(1):e24-8.
Epub 2009 Dec 7.• Kemper KJ, Hamilton C. Live harp music reduces activity and increases weight gain in stable premature infants. J Altern
Complement Med. 2008 Dec;14(10):1185-6.
Music therapy + Palliative Care
• Beneficial for pain control, distress and mood, and quality of life
• Parents 23 times more likely to report satisfaction with the palliative care package (p<0.05)
Hanser S. Music therapy in adult oncology: research issues. A Review. J Soc Integr Oncol. 2006 Spring;4(2):62-6.
Lindenfelser KJ et al. Music therapy in pediatric palliatrive care: family-centered care to enhance quality of life. Am J Hosp Palliat Care 2012 May 29(3):219-26
Knapp et al. Music therapy in an integrated pediatric palliative care program. Am J Hosp Palliat Care. 2009 Dec-2010 Jan;26(6):449-55. Epub 2009 Aug 7.
Music therapy + Disability• Pitch perception improved in prelingually
deafened children with cochlear implants
• Synergistic effect with acupuncture to improve movement in cerebral palsy (p<0.05)
• Increases attentive behaviour in visually impaired children (p=0.02)
• Chen JK, Chuang AY, McMahon C, Hsieh JC, Tung TH, Li LP. Music training improves pitch perception in prelingually deafened children with cochlear implants. Pediatrics. 2010 Apr;125(4):e793-800. Epub 2010 Mar 8.
• Yu HB, Liu YF, Wu LX. Acupuncture combined with music therapy for treatment of 30 cases of cerebral palsy. J Tradit Chin Med. 2009 Dec;29(4):243-8.
• Robb SL. Music interventions and group participation skills of preschoolers with visual impairments: raising questions about music, arousal, and attention. J Music Ther. 2003 Winter;40(4):266-82.
Music therapy + Social
• May improve peer awareness
• Reduces aggression and improves self esteem
• May help children with autism / delayed speech development to communicate
-Sussman JE. The effect of music on peer awareness in preschool age children with developmental disabilities. J Music Ther. 2009 Spring;46(1):53-68.
-Choi AN, Lee MS, Lee JS. Group Music Intervention Reduces Aggression and Improves Self-esteem in Children with Highly Aggressive Behavior: A Pilot Controlled Trial. Evid Based Complement Alternat Med. 2010 Jun;7(2):213-7. Epub 2008 Jul 17.
-Gold C, Wigram T, Elefant C.Music therapy for autistic spectrum disorder. Cochrane Database Syst Review. 2006 Apr 19;(2):CD004381.-Gross et al. Effects of music therapy in the treatment of children with delayed speech development – results of a pilot study. BMC Complement Altern Med 2010 Jun 21;10-39
Music therapy + Happiness
• Music therapy leads to greater happiness than play therapy
• May promote positive parenting and child development
Hendon C, Bohon LM. Hospitalized children's mood differences during play and music therapy. Child Care Health Dev. 2008 Mar;34(2):141-4.
Nicholson JM et al. Impact of music therapy to promote positive parenting and child development. J Health Psychol. 2008 Mar;13(2):226-38.
Summary• Inexpensive• Non-pharmacological• Non-invasive • Potential benefit psychologically and physiologically.
• However studies are too heterogeneous• Larger/International multi-centre cooperation
requiredAustin D. The psychophysiological effects of music therapy in intensive care units. Paediatr Nurs. 2010 Apr;22(3):14-20.
Mrazova M, Celec P. A systematic review of randomized controlled trials using music therapy for children. J Altern Complement Med. 2010 Oct;16(10):1089-95. Epub 2010 Oct 9.
Possible suggestions ???
• Music in the waiting room in A+E• Music on the wards • Encourage music in each cubicle• Considering hiring a music therapist• Instruments in the play area• Mini concerts