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National
Institutes Of Health Report
Effects
of Vibroacoustic Music on Symptom Reduction In Hospitalized
Patients
Visual Analog
Pre-Post Percentage Difference
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Mean
% of symptom
reduction
|
Count
No of patients
in each study
|
| Total |
53.04 |
267 |
| Depression |
45.33 |
18 |
| Tension
& Anxiety |
54.59 |
74 |
| Fatigue
& Tired |
49.06 |
60 |
| Pain |
51.18 |
46 |
| Headache |
59.79 |
24 |
| Nausea |
59.13 |
16 |
| Other |
56.11 |
29 |
September 1997
Program Evaluation
Vibroacoustic Network
Respondents:
"Our program evaluation at the Clinical Center of
the National Institutes of Health has given us enough data to
suggest a series of research protocols that we (four of us who
use the acoustic recliners daily with our wide variety of patients)
will be laying out in the next few months. So far, with
N=190, we have seen statistically significant and clinically
significant results in both tension-anxiety reduction as well
as symptom reduction. We have revised our simple patient
reported session evaluation form as attached. The data
has been broken down into diagnostic groups (all chronic disease
processes: cancer, AIDS, heart and lung, blood, and psychiatric
disorders are the main groups), with no noticeable drop
off in reported effectiveness by group. The results are
not publishable since we did not do a randomized clinical trial,
only simple program evaluation project. But we are VERY
encouraged by the data."
November, 1997
Effects of Vibroacoustic Music on Symptom Reduction in
Hospitalized Patients
Brief description:
Patients experiencing a variant of symptoms were offered vibroacoustic
music. Patient report of both state of relaxation and
symptom intensity were collected before and after the 40 minute
session. This program evaluation has provided information
with which to develop a research plan.
Abstract
The need for hospitalized patients o experience the relaxation
response as an antidote to the stress of treatment and adjustment
to the possibility of chronic or life threatening conditions
is clear. The systematic application of music to promote
positive changes in behavior has been used successfully in a
variety of hospital settings. The effectiveness of music
interventions has been measured physiologically and behaviorally.
In order to provide patients
with assistance in achieving a relaxation response, recreation
therapists at a major research hospital created several relaxation
opportunities for patients and their family members.
Among them are a weekly class, "The Art of Relaxation."
This class is both didactic and experiential. Held in
a patient lounge, it can accommodate up to nine individuals.
The content includes a short introduction, an explanation of
four components of relaxation (from Benson), and examples of
short form relaxation techniques (i.e. eye roll-sigh).
This is followed by a 15-20 minute experiential session using
one of the following techniques: progressive relaxation,
guided imagery, rhythmic breathing, body scan, or autogenic
training.
The recreation therapists
also created a relaxation room with four Somatrons, a commercially
available vibroacoustic recliner. The Somatrons deliver
ear level stereo auditory and tactile vibrations that allow
the body to feel the music that is normally only heard.
Patients can access an initial session in the relaxation room
using Therasound music titled "Balance" designed or
its anxiolytic properties. Subsequent uses of the relaxation
room have used either "Balance" or music from "The
Musical Body" (Therasound). In all cases, this is
a therapist guided session with about 10 minutes of debriefing
after the music.
This presentation of the
program evaluation data from the use of the vibroacoustic recliners
with anxiolytic music gathered from 268 adult patients with
varying diagnoses over the last 17 months. The measures
were patient self-report instruments completed immediately pre
and post to assess symptom intensity and relaxation. Symptoms,
up to three, were identified by the patients. Symptom
intensity was measured on a visual analogue scale. Relaxation
was measured seven item Self-Report Rating Scale for Tension
and Relaxation (Poppen, 1988, p.126).
The results follow. The
most frequently identified symptoms were tension-anxiety (73),
pain (67), fatigue (62), nausea (27), headache (23), and depression
(15) which comprised 92% of the first symptoms mentioned.
(Note: patients could state up to three symptoms and rate each,
But this report analyzed only the first mentioned symptom.)
Each of these symptoms showed reduction in intensity based on
pre-post mean scores. Cumulatively, the pre rating mean
was 67.20 (of 100) and the post rating mean was 31.55, a 53%
reduction of symptoms. The most frequently self-reported
symptoms that were reduced included tension-anxiety (p <.001),
pain (p <.0001), fatigue (p <.0001), nausea (p <.0005),
headache (p <.0001), and depressed mood (p<.0004).
The intensity of symptoms was reduced from pre to post by following
percentages: tension-anxiety, 54.65%; pain, 58.31%; fatigue,
46.63%; nausea, 56.44%; headache, 51.64%; and depressed mood,
46.63%.
To measure the state of
relaxation, the seven point Self-Report Rating Scale for Tension
and Relaxation was used. With an N=272, the pre rating
was 5.12(5 is "Feeling Some Tension in Some Parts of My
Body") while the post rating was 2.77 (3 is "Feeling
More Relaxed Than Usual"), a statistically significant
difference (p<.0001). Although this scale is nominal,
tests of fit allow for estimation of effective improvement of
33.4% in state of relaxation.
Clinical impressions of
the group of five recreation therapists were commensurate with
the statistical significance levels indicated. Most patients
were buoyed by having a perceived effect on their symptom burden.
We used this positive outcome to point out that patients
could clearly benefit by regular practice of an effective relaxation
technique. They were given additional training in the
"Art of Relaxation" class, through individual instruction,
or by readings.
This program evaluation
data was not a research study. It did not use random assignment,
control group, or a comparison group. Nonetheless, it
did generate enough data to suggest the worthiness of writing
a research plan for several sequential research protocols.
Our group of recreation therapists have decided to continue
focus on symptom reduction. We will measure the duration
of the symptom intensity reduction beyond the vibroacoustic
session. Furthermore, we will be comparing subsequent
sessions to see whether the treatment effect is as robust with
additional treatment. We have done preliminary analyses
by diagnosis and see a different set of symptoms per diagnosis
so we will continue to collect data based on diagnosis.
We are considering what could constitute an adequate control
group (e.g., no treatment, music with no tactile input, different
kinds of music, music of choice vs. prescribed music).
How does vibroacoustic music compare with the other relaxation
techniques, such as progressive relaxation, autogenic training,
mindfulness meditation, and guided imagery? In addition,
what should be the research participant inclusion criteria?
Should there be a minimum baseline of perceived tension-relaxation
or symptom intensity? And finally,which study should come first
and what is a proper sequencing so that a cluster of studies
could be done in such a way as to build a body of knowledge
around vibroacoustic music as a developing technology?
The recliners
referred to in this study are four Somatron Professional Power
Models. NIH also has Somatron mats in daily use.
Byron Eakin,
Somatron Vibroacoustic Products
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