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Spaccavento S, Carraturo G, Brattico E, Matarrelli B, Rivolta D, Montenegro F, Picciola E, Haumann NT, Jespersen KV, Vuust P, Losavio E. Musical and electrical stimulation as intervention in disorder of consciousness (DOC) patients: A randomised cross-over trial. PLoS One 2024; 19:e0304642. [PMID: 38820520 PMCID: PMC11142721 DOI: 10.1371/journal.pone.0304642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Disorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity. OBJECTIVE We here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress. METHODS This is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo. DISCUSSION This study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023.
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Affiliation(s)
- Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Giulio Carraturo
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Elvira Brattico
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Benedetta Matarrelli
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Davide Rivolta
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Fabiana Montenegro
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Emilia Picciola
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Niels Trusbak Haumann
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Kira Vibe Jespersen
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Ernesto Losavio
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
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Rosenbach M, Dassa A, Gilboa A. Home-based music therapy for persons with dementia and their spouses as primary caregivers. Front Public Health 2023; 11:1250689. [PMID: 37854247 PMCID: PMC10579886 DOI: 10.3389/fpubh.2023.1250689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Music therapy has been found to be an effective intervention for persons with dementia (PWD) and their primary caregivers (PC), yet the implementation of musical strategies to improve daily care in the home environment requires further exploration. This study developed and examined a home-based music therapy (HBMT) work model that offers weekly joint music therapy sessions, and additional bi-weekly phone-counseling sessions with the PC. This was followed by an additional 12-week support period that included 3 therapy sessions and 3 phone counseling sessions once every other fortnight, so that the same type of session occurred at a frequency of once a month. Participants were five couples (PWD + spouse as PC) who live in their home. Findings based on the qualitative multiple case study research method showed the importance of the music therapist's (MT) continuous support. The MT's presence made it possible to address the needs of both spouses, separately and together, while maintaining the required balance. Moreover, the MT's presence enabled better implementation of the musical strategies independently and this was maintained during the intervention and the support period.
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McMahon K, McFerran K, Clark IN, Odell-Miller H, Stensæth K, Tamplin J, Baker FA. Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study. Front Med (Lausanne) 2023; 10:1205784. [PMID: 37275362 PMCID: PMC10232877 DOI: 10.3389/fmed.2023.1205784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Katrina McFerran
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N. Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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Colloby S, Whiting S, Warren A. Supporting the couple relationship following dementia diagnosis: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3643-e3655. [PMID: 36124618 PMCID: PMC10087355 DOI: 10.1111/hsc.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
There is now a significant body of research demonstrating the importance of supporting the couple's relationship for people living with dementia. Maintaining a strong relationship has been demonstrated to slow cognitive decline in dementia, reduce the caregiver's sense of burden and may delay the need for transfer into residential care. However, the potential for healthcare practitioners to deliver interventions to support the couple's relationship in the community remains largely unexplored. This scoping review aimed to locate interventions that support couples to maintain their relationship satisfaction when living with dementia. This review mapped studies across a broad range of disciplines and research methods, following the Joanna Brigg's Institute (JBI) framework. Following screening, 44 studies were identified. The approach of these programmes can be broadly grouped into three categories; Adaptation and use of shared activities to enhance the couple's relationship; Developing caregiver skills and reducing perceived burden to improve interaction and relationship quality; Connecting and strengthening the couple's relationship through sharing feelings and memories. Further research is required to explore the possibility and appropriateness of adaptation of these interventions for use by community healthcare practitioners. There is a need to identify interventions that can meet the needs of couples as dementia progresses into the moderate-severe stages. Heterogeneity and inconsistency in outcomes measurement for the couple's relationship, suggests the need to consider further how outcomes for couple's relationship quality may best be captured. It is also suggested that other existing programmes, outside of the scoping review results, but aimed at reducing dementia caregiver burden may have currently unexplored and developed outcomes for couple's relationship quality.
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Affiliation(s)
- Sarah Colloby
- Livewell SouthwestWest Therapy Team, Cumberland CentrePlymouthUK
- Faculty of Health, School of Health ProfessionsUniversity of Plymouth, Peninsula Allied Health CentrePlymouthUK
| | - Samantha Whiting
- Faculty of Health, School of Health ProfessionsUniversity of Plymouth, Peninsula Allied Health CentrePlymouthUK
| | - Alison Warren
- Faculty of Health, School of Health ProfessionsUniversity of Plymouth, Peninsula Allied Health CentrePlymouthUK
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Grady M, Melhuish R. Mindsong - music therapy for dementia: music therapy during the Covid-19 pandemic. Perspect Public Health 2022; 142:66-67. [PMID: 35274560 PMCID: PMC8918872 DOI: 10.1177/17579139211072377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M Grady
- Director of Music Therapy, Mindsong, Gloucestershire, UK
| | - R Melhuish
- Deputy Director of Music Therapy, Mindsong, Gloucestershire, UK
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Lee S, Allison T, O’Neill D, Punch P, Helitzer E, Moss H. OUP accepted manuscript. Health Promot Int 2022; 37:i49-i61. [PMID: 35417003 PMCID: PMC9162174 DOI: 10.1093/heapro/daac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The majority of people living with dementia are cared for by their families. Family carers play a vital role in upholding the formal care system. Caring for a family member with dementia can be fulfilling. However, this role can have a considerable negative impact on family carers’ mental and physical health and quality of life. Several empirical research studies have recently been conducted that explore the potential benefits of music interventions for family carers of people living with dementia. Singing has been the primary musical medium employed. This article presents the first review of this literature to date. It investigates the impact of music interventions on the health and well-being of family carers of people living with dementia, and how they experience and perceive these interventions. Whittemore and Knafl’s five-stage integrative review framework was utilized: (i) problem identification; (ii) literature search; (iii) data evaluation; (iv) data analysis and synthesis; and (v) presentation of the findings. A total of 33 studies met the inclusion criteria. Analysis and synthesis resulted in three overarching themes: impact on family carers, carer perceptions of music interventions and null quantitative findings in small studies. The review found that singing and music interventions may improve family carers’ social and emotional well-being, enhance their ability to cope and care and ameliorate the caring relationship, contributing to experiences of flourishing. However, it highlighted that this area is under-researched and pointed to the need for larger, more rigorous studies.
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Affiliation(s)
- Sophie Lee
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
- Corresponding author. E-mail:
| | - Theresa Allison
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA 94143, USA
| | - Desmond O’Neill
- Centre for Ageing, Neurosciences and the Humanities, Trinity College Dublin, D02 PN40, Ireland
| | - Pattie Punch
- Glucksman Library, University of Limerick, Limerick V94 T9PX, Ireland
| | - Elizabeth Helitzer
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
| | - Hilary Moss
- Health Research Institute, Ageing Research Centre, Irish World Academy of Music and Dance, University of Limerick, Limerick V94 T9PX, Ireland
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In the moment with music: an exploration of the embodied and sensory experiences of people living with dementia during improvised music-making. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000210] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The term ‘in the moment’ has received growing interest in the context of music programmes for people living with dementia, with music therapists, family carers, health-care professionals and people living with dementia themselves reporting the value of framing musical experiences in the ‘here and now’. Although this term is being used more frequently within the literature, there has yet to be a formal examination of such ‘in the moment’ musical experiences and how they might benefit a person living with dementia. We used a multiple-case study approach to develop a thematic framework of ‘in the moment’ musical experiences within the context of a music-making programme for people living with dementia. The research followed six people living with dementia and four family carers, and used video-observation and video-elicitation interviews to capture and analyse ‘in the moment’ experiences. Four thematic observations were developed which captured ‘in the moment’ musical experiences: Sharing a life story through music, Musical agency ‘in the moment’, Feeling connected ‘in the moment’ and Musical ripples into everyday life. These findings showcase the creativity and musical abilities of people living with dementia whilst affirming music as a medium to connect people living with dementia with their own life story, other people and the environments in which music-making takes place.
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Dassa A, Rosenbach M, Gilboa A. Towards sustainable implementation of music in daily care of people with dementia and their spouses. ARTS IN PSYCHOTHERAPY 2020; 71:101713. [PMID: 32952253 PMCID: PMC7485451 DOI: 10.1016/j.aip.2020.101713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/23/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022]
Abstract
Primary caregivers (PCs) of people with dementia deal with stressful daily living, especially spouses whose care recipient is at home. Several programs have been developed to aid caregiving by providing musical strategies, yet successful sustainable implementation of music in the daily lives of the couples awaits further research and development. To promote this, in this pilot study we proposed a music therapy program that included 12 weekly sessions with the couple in their home environment. In addition, there were bi-weekly phone counseling sessions with the PC, to reflect on the joint sessions and to help implement music in daily life. Findings based on the description, analysis, and interpretation of two cases showed that the proposed program provided a strong foundation upon which the treatment could succeed; it relied on natural forces such as the use of songs, which can empower each of the spouses individually, as well as together as a couple; and it included elements of ongoing support that enabled preservation of the accomplishments that were achieved during the sessions. Future research is required to examine whether this program is appropriate for couples in other housing contexts, and in different stages of dementia.
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Affiliation(s)
- Ayelet Dassa
- Music Department, Bar-Ilan University, Ramat-Gan, Israel
| | | | - Avi Gilboa
- Music Department, Bar-Ilan University, Ramat-Gan, Israel
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