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Baylan S, Haig C, MacDonald M, Stiles C, Easto J, Thomson M, Cullen B, Quinn TJ, Stott D, Mercer SW, Broomfield NM, Murray H, Evans JJ. Measuring the effects of listening for leisure on outcome after stroke (MELLO): A pilot randomized controlled trial of mindful music listening. Int J Stroke 2019; 15:149-158. [PMID: 30940047 PMCID: PMC7045280 DOI: 10.1177/1747493019841250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Cognitive deficits and low mood are common post-stroke. Music listening is
suggested to have beneficial effects on cognition, while mindfulness may
improve mood. Combining these approaches may enhance cognitive recovery and
improve mood early post-stroke. Aims To assess the feasibility and acceptability of a novel mindful music
listening intervention. Methods A parallel group randomized controlled feasibility trial with ischemic stroke
patients, comparing three groups; mindful music listening, music listening
and audiobook listening (control group), eight weeks intervention.
Feasibility was measured using adherence to protocol and questionnaires.
Cognition (including measures of verbal memory and attention) and mood
(Hospital Anxiety and Depression Scale) were assessed at baseline, end of
intervention and at six-months post-stroke. Results Seventy-two participants were randomized to mindful music listening
(n = 23), music listening (n = 24), or
audiobook listening (n = 25). Feasibility and acceptability
measures were encouraging: 94% fully consistent with protocol; 68.1%
completing ≥6/8 treatment visits; 80–107% listening adherence; 83% retention
to six-month endpoint. Treatment effect sizes for cognition at six month
follow-up ranged from d = 0.00 ([−0.64,0.64], music alone), d = 0.31,
([0.36,0.97], mindful music) for list learning; to d = 0.58 ([0.06,1.11],
music alone), d = 0.51 ([−0.07,1.09], mindful music) for immediate story
recall; and d = 0.67 ([0.12,1.22], music alone), d = 0.77
([0.16,1.38]mindful music) for attentional switching compared to audiobooks.
No signal of change was seen for mood. A definitive study would require 306
participants to detect a clinically substantial difference in improvement
(z-score difference = 0.66, p = 0.017, 80% power) in verbal
memory (delayed story recall). Conclusions Mindful music listening is feasible and acceptable post-stroke. Music
listening interventions appear to be a promising approach to improving
recovery from stroke.
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Affiliation(s)
- Satu Baylan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Caroline Haig
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Maxine MacDonald
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ciara Stiles
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Jake Easto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Meigan Thomson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Breda Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - David Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stewart W Mercer
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Usher institute of population health sciences and informatics, University of Edinburgh, Edinburgh, UK
| | - Niall M Broomfield
- Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, UK.,Norwich Medical School, University of East Anglia, England, UK
| | - Heather Murray
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Jonathan J Evans
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Baylan S, McGinlay M, MacDonald M, Easto J, Cullen B, Haig C, Mercer SW, Murray H, Quinn TJ, Stott D, Broomfield NM, Stiles C, Evans JJ. Participants' experiences of music, mindful music, and audiobook listening interventions for people recovering from stroke. Ann N Y Acad Sci 2018; 1423:349-359. [PMID: 29727009 DOI: 10.1111/nyas.13618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/20/2017] [Accepted: 12/31/2017] [Indexed: 12/01/2022]
Abstract
Existing research evidence suggests that both music listening and mindfulness interventions may have beneficial effects on mood and cognition poststroke. This mixed-methods study, nested within a pilot randomized controlled trial investigating the feasibility and acceptability of combining music listening and brief mindfulness training poststroke, explored study participants' experiences of engaging in the interventions. Fifty-six stroke survivors who were randomized to receive an 8-week intervention of mindful music listening (n = 15), music listening (n = 21), or audiobook listening (n = 20, control) using self-selected material participated in a postintervention individual semistructured interview with a researcher not involved in their intervention delivery. Interview questions focused on affective, cognitive, and physical experiences. Data were coded and analyzed using thematic analysis. Across groups, listening was associated with positive distraction from thoughts and worries. Mindful music listening was most strongly associated with relaxation and concentration, improved attentional control, and emotion regulation, as well as enjoyment. Music listening was most strongly associated with increased activity, memory reminiscence, and improved mood. In addition, participants provided valuable feedback on intervention feasibility and acceptability. The findings suggest that the interventions were feasible and enjoyable for people recovering from stroke.
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Affiliation(s)
- Satu Baylan
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Meigan McGinlay
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Maxine MacDonald
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jake Easto
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Breda Cullen
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Caroline Haig
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Heather Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - David Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Niall M Broomfield
- Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Ciara Stiles
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Stroke Psychology Service, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Jonathan J Evans
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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