Music therapy in the treatment of multiple sclerosis: a comprehensive literature review

Tango classes in people with Multiple Sclerosis (PwMS): Impact on motor and non-motor functions

BACKGROUND

While music-based therapy (MBT) has been shown to improve motor and non-motor features in multiple sclerosis (MS), benefits of tango have never been assessed.

OBJECTIVE

To evaluate the benefits of tango classes on quality of life (QoL), mood, fatigue, gait, balance, perception of cognitive disorder and sexuality in people with MS.

METHODS

7 participants (age 41.14 ± 14.27 years, disease duration 14.14 ± 7.6 years) and respective partners undertook one-hour weekly classes for 20 weeks. Participants had early-stage MS (EDSS<3.5). They were assessed for mood (ZUNG rating scale; Beck Depression Inventory -II); balance (Berg Balance Test; Tinetti scale), cognition (MS Neuropsychological Screening Questionnaire), SD (Multiple Sclerosis Intimacy and Sexuality Questionnaire), fatigue (Fatigue Severity Scale) and QoL (36-Item Short Form Survey).

RESULTS

Group comparison of pre-post change scores showed a general improvement in all the outcome measures, which was significant in mood, SD, cognition and QoL.

DISCUSSIONS AND CONCLUSION

Tango classes provides benefits to pwMS, especially on non-motor symptoms. Follow-up assessment is required to confirm the durability of these effects.

Effects of music therapy intervention on gait disorders in persons with multiple sclerosis: A systematic review of clinical trials

BACKGROUND

Music Therapy (MT) is a unique treatment method for Persons with Multiple Sclerosis (PwMS) that can accelerate their functional recovery. MT has been proven to adjust the gait performance of PwMS in a short period. Its therapeutic effects in gait disorders of PwMS for long-term intervention are also starting to draw interest, but it has yet to be investigated.

AIM

This review aimed to systematically examine the outcomes of PwMS with gait disorders after receiving MT intervention.

METHODS

A systematic review has been performed using several academic databases with keywords such as music therapy, multiple sclerosis, and gait. The study protocol was registered on PROSPERO (CRD42022365668).

RESULTS

A total of 405 studies were initially identified. After applying the inclusion and exclusion criteria, twelve studies were finally included. The results showed that all PwMS received MT intervention with different strategies, and ten studies confirmed that gait disorders of PwMS were effectively improved by MT intervention.

CONCLUSION

Most previous studies focused on the transient effects of MT on the gait performance of PwMS. This review bridges gaps in the long-term intervention of MT on gait disorders of PwMS and offers references for therapists to design treatment plans. According to this review, MT intervention has positive therapeutic effects on gait disorders in PwMS.

Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis

INTRODUCTION AND AIM

Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model.

METHOD

Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed.

RESULTS

Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients.

CONCLUSION

Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.

A Systematic Review and Meta-analysis of the Effects of Music Therapy on Postpartum Anxiety and Pain Levels

Introduction: Postpartum anxiety may be associated with depression, postpartum blues, and maternal mood disorders. This systematic review investigated the effects of music therapy on postpartum anxiety and pain levels.

Methods: English databases including Cochrane, Medline, Embase, Web of Science, Scopus, and PubMed and Persian databases including Scientific Information Database (SID) and the Iranian Registry of Clinical Trials (IRCT) were searched. The data were analyzed in RevMan 5.3 and reported as forest plots. The present study was conducted on postpartum women (i.e., the participants). All randomized controlled trials comparing the effects of music (i.e., the intervention) and placebo or routine care (i.e., the control) on postpartum anxiety and pain (i.e., the outcome) were included in the study.

Results: Out of a total of 60 retrieved articles, four eligible articles were selected and entered the meta-analysis process. According to the results, anxiety (MD=-0.68, 95% CI=-1.90 to -0.54, P < 0.001) and pain (MD=-1.85, 95% CI=-3.96 to 0.26, P < 0.001) levels of patients in the music therapy group were reduced more significantly than those in the control group.

Conclusion: The results showed that music therapy can significantly reduce both postpartum anxiety and pain scores. However, due to the high heterogeneity of the studies, more randomized trials using a standard tool such as the Consolidated Standards of Reporting Trials (CONSORT) statement are needed.

Music-based therapy in rehabilitation of people with multiple sclerosis: a systematic review of clinical trials

BACKGROUND

Multiple sclerosis (MS) is a major cause of chronic neurological disability in young adults. An increasing number of controlled studies have assessed the potential rehabilitative effects of new drug-free treatments, complementary to the standard care, including music-based therapy (MBT).

OBJECTIVE

To analyze the evidence for the effectiveness of MBT within the therapeutic approaches to individuals diagnosed with MS.

METHODS

A systematic review of clinical trials was performed with searches in the following databases: BIOSIS, CINAHL, Cochrane, EBSCO, ERIC, Google Scholar, IBECS, LILACS, LISA (ProQuest), Medline, PEDro, PsycINFO (APA), Psychological & Behavioral, PubMed, SciELO, Scopus, SPORTDiscus and Web of Science. Clinical trials comparing MBT versus conventional therapy/no intervention were included.

RESULTS

From the 282 studies identified, 10 trials were selected. Among these, the total sample consisted of 429 individuals: 253 were allocated to the experimental group (MBT) and 176 to the control group (conventional therapies or no intervention). All the studies presented high methodological quality. Modalities of MBT were clustered into four groups: (1) Rhythmic auditory; (2) Playing musical instruments; (3) Dance strategy; and (4) Neurological music therapy. Overall, the studies consistently showed that MBT was better than conventional therapy or no intervention, with regard to gait parameters (double support time and walking speed), fatigue level, fatigability, coordination, dexterity, balance, walking endurance, lower extremity functional strength, emotional status and pain. Regarding mental fatigability and memory, the data were conflicting and the evidence was unclear.

CONCLUSION

MBT is a safe and effective approach for clinical rehabilitation of MS patients that leads to positive results regarding both motor and non-motor functions.

[The possibility of using music therapy in neurology on the example of multiple sclerosis]

Currently music therapy plays an important role in the drug-free treatment and rehabilitation of children and adults with acute and chronic neurological and somatic diseases including demyelinating diseases. Existing studies show the effectiveness of music therapy in the improvement of social skills, cognitive function and sleep as well as in the reduction in the severity of depression, anxiety and pain in patients with multiple sclerosis.

Effectiveness of music therapy: a summary of systematic reviews based on randomized controlled trials of music interventions

OBJECTIVE

The objective of this review was to summarize evidence for the effectiveness of music therapy (MT) and to assess the quality of systematic reviews (SRs) based on randomized controlled trials (RCTs).

STUDY DESIGN

An SR of SRs based on RCTs.

METHODS

Studies were eligible if they were RCTs. Studies included were those with at least one treatment group in which MT was applied. We searched the following databases from 1995 to October 1, 2012: MEDLINE via PubMed, CINAHL (Cumulative Index of Nursing and Allied Health Literature), Web of Science, Global Health Library, and Ichushi-Web. We also searched all Cochrane Database and Campbell Systematic Reviews up to October 1, 2012. Based on the International Classification of Diseases, 10th revision, we identified a disease targeted for each article.

RESULTS

Twenty-one studies met all inclusion criteria. This study included 16 Cochrane reviews. As a whole, the quality of the articles was very good. Eight studies were about "Mental and behavioural disorders (F00-99)"; there were two studies on "Diseases of the nervous system (G00-99)" and "Diseases of the respiratory system (J00-99)"; and there was one study each for "Endocrine, nutritional and metabolic diseases (E00-90)", "Diseases of the circulatory system (I00-99)", and "Pregnancy, childbirth and the puerperium (O60)". MT treatment improved the following: global and social functioning in schizophrenia and/or serious mental disorders, gait and related activities in Parkinson's disease, depressive symptoms, and sleep quality.

CONCLUSION

THIS COMPREHENSIVE SUMMARY OF SRS DEMONSTRATED THAT MT TREATMENT IMPROVED THE FOLLOWING: global and social functioning in schizophrenia and/or serious mental disorders, gait and related activities in Parkinson's disease, depressive symptoms, and sleep quality. MT may have the potential for improving other diseases, but there is not enough evidence at present. Most importantly, no specific adverse effect or harmful phenomenon occurred in any of the studies, and MT was well tolerated by almost all patients.

Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare

BACKGROUND

Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time.

METHODS

The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated.

RESULTS

A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints.

CONCLUSIONS

We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their families HBMT is also interesting as a blueprint for home based care for other groups of caregivers.

Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

Background

Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development.

Methods

A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children.

Results

Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication.

Conclusions

This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for children with delayed speech development. Further studies should be conducted to investigate the mechanisms of these interactions in greater depth.

Trial registration

The trial is registered in the German clinical trials register; Trial-No.: DRKS00000343