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Music Therapy in Medical Treatment

Currently, there are many studies regarding the benefits of music therapy in medical treatment, especially to treat neurological and mental disorders such as depression, dementia, and schizophrenia. However, many doctors do not know about this music therapy and its medical effectiveness.

Music Therapy in Medical Treatment
Source Picture: https://www.ucsfbenioffchildrens.org/services/music_program/

What is Music Therapy?

Based on the World Federation of Music Therapy, the definition of music therapy is the use of music or musical instruments (sound, rhythm, melody, or harmony) by a qualified music therapist intended for a client or a group, in the process to facilitate and promote communication, relationships, learning, mobilization, expression, organization, and other therapeutic objective objectives, to meet physical, emotional, mental, social, and cognitive needs.

Music therapy also aims to restore function or develop one's potential to be able to achieve a better quality of life.

Music therapy techniques currently used:

Production technique

  • Structured improvisation techniques
  • Thematic Improvisation
  • Communicative improvisation
  • Free improvisation
Reproduction technique

  • Sing or play the music that has been composed
  • Learn or practice musical ability
Acceptance technique

  • Listen to music directly (therapist plays music)
  • Listen to recorded music
  • Listen to music and body perception
  • Listen to music and dance or move.

The therapy sessions are given, focussing on the client (client-centered). Clients can be one group or one person (one to one). Each music therapy session has a specific purpose, such as practicing socialization, emotions, motor skills, and other aspects.

There are various techniques and forms of music therapy available today. One example is listening to old music or playing violin in dementia patients. One popular type of music therapy is playing drums. This therapy is often applied to patients with motor disorders, such as Parkinson's. 

How effective is music therapy?

Functional MRI examination proves that music can affect waves in the brain, as evidenced by activity in the nucleus accumbens and auditory cortex. This activity turns out to be related to whether someone likes it or not to the music they hear. Also, the superior temporal gyrus is involved in making decisions about the type of music the patient wants to listen to.

The healing effects of music therapy are associated with the process of neuroplasticity in the brain. 

Music therapy effects:

Listening to music can activate the dopaminergic region. This region is related to motivation, prizes/rewards, and learning. The dopamine neurotransmitters produced in this region play a role in the regulation of neuroplasticity.

The Hebbian Theory in 1949 states the repeated and persistent stimulation to an A axon cell can trigger the growth and changes in B cell metabolism that near to cell A.   Therefore, music stimulation excites not only the music area neurons, but also the movement, vowels, breathing, and pulse. This theory explains the association between music and non-musical activities/behaviors such as walking, socializing, etc.

Based on the hypothesis that music can trigger neuroplasticity, therapists try to apply music therapy for the following purposes:


  • Improve social skills so that they can interact with friends. For example, teach children to share toys by using music.
  • Improve the ability to express emotions that are appropriate to the situation.
  • Improve cognitive abilities. One way is to create a song whose lyrics are a process of an activity.
  • Assist patient movement. It has been proven that ten sessions of music therapy can extend stride length by up to 25% in patients who have difficulty walking.

What are some diseases that music therapy can help treat?

Psychiatric disorders are a group of diseases that most often use music therapy. Music therapy is also used for lung disease or for pain relief, especially in cases of cancer and other terminal diseases.

A. Psychiatric disorders
Schizophrenia and psychosis
A 2017 meta-analysis compared the combination of standard therapy and music with only standard treatment in schizophrenic patients and psychosis. As it turns out, this combination further enhances global status, mental status, quality of life. In addition, the higher the number of sessions, the greater the therapeutic effect.

Depression
A 2016 meta-analysis involving 19 studies stated that music therapy could reduce symptoms of depression significantly. However, variations in forms of music therapy between studies make it difficult for clinicians to intervene. Further studies are needed to find out which form of music therapy is most effective in treating depression.

Autism
The effects of music therapy for children with autism have been widely studied. Most research states that music therapy has a positive impact. Unfortunately, each study has different positive effects. For example, a 2017 study in Norway reported that there was an improvement in the quality of life of patients, but there was no improvement in social skills. Meanwhile, other research stated that there was an increase in social skills. This difference is due to variations in method, music therapy type, and duration of follow-up.

The following are the positive effects of music therapy for children with autism that have been studied:

  • Increase social interaction.
  • Improve non-verbal communication skills.
  • Increase initiating behavior (behavior to start social interactions, such as asking questions).
  • Increase social emotions.
  • Improve reciprocity.
  • Improve the quality of relationships with parents.
  • Improve the quality of life and happiness of patients.
Dementia
A 2017 meta-analysis involving 6 studies stated that active music therapy improves global cognition. Other parameters (attention, memory, learning, language, motor-perception function) did not increase significantly after being analyzed globally.


Music Therapy as a Palliative therapy for some Illness

Various studies use music as palliative therapy, for example, the use of music therapy for cancer cases. A review of 52 studies stated that music therapy could reduce anxiety, pulse frequency, breathing frequency, blood pressure, and pain in cancer patients. However, no substantial evidence was found regarding the improvement of physical function.

Music therapy is often used to reduce pain. A 2013 study showed that the addition of music therapy to relaxation exercises is more effective than relaxation exercises alone.

Patients with a terminal illness often show psychiatric symptoms, such as psychosis and depression. Research in 2004 showed that music therapy could reduce psychiatric symptoms in breast cancer patients.

A 2014 systematic review involving 14 studies discussed the effects of music therapy on ventilated terminal disease patients. The result, listening to music could reduce the anxiety that was measured subjectively. Objectively, a decrease in pulse frequency, breath frequency, and systolic blood pressure are found. The positive effects of music therapy for reducing anxiety in patients with ventilators have proven to be consistent with three previous systematic reviews.

A clinical trial proves that music therapy 15-20 minutes before procedure procedures (endoscopy, colposcopy, surgery, etc.) can reduce anxiety. Other observational tests prove that music therapy can reduce the anxiety and pulse frequency of patients who will undergo surgery.

A systematic review in 2016 stated that singing could have a positive effect on patients with chronic obstructive pulmonary disease (COPD). Positive outcomes that had been investigated were improving the quality of life and decreasing anxiety. Although the results of inter-studies consistently mention that singing has a positive impact on COPD patients, it still needs other studies to assess the long-term effects of singing therapy.

Music therapy can also benefit patients with motor disorders, such as Parkinson's and stroke cases. A 2013 study stated that music therapy improved the gait and arm-swing disorders of Parkinson's patients. Uniquely, this study uses applications as a medium for music therapy. Other studies in 2016 made use of percussion music to improve the motor function of stroke patients.


References
1. M. S. Solanki, M. Zafar, R. Rastogi. Asian J Psychiatr. 2013; 6(3): 193-199. https://www.ncbi.nlm.nih.gov/pubmed/23642975
2. K. Mossler, J. Assmus, T. O. Heldal, K. Fuchs, C. Gold. Arts in Psychotherapy. 2012; 39($): 333-341. http://vbn.aau.dk/en/publications/music-therapy-techniques-as-predictors-of-change-in-mental-health-care(8051f536-f0f9-4aa8-8507-e1a99f792141)/export.html
3. P. Anderson. Music therapy may strike the right note for schizophrenia. https://www.medscape.com/viewarticle/881730, 2017
4. Medscape. Music as Medicine: Ancient Wisdom, Modern Science. https://www.medscape.com/slideshow/music-as-medicine-6009039#4, 2017
5. D. Brauser. Music therapy brings dementia patients ‘back to life’. https://www.medscape.com/viewarticle/769657#vp_2, 2012
6. B. S. Stetika. The therapeutic potential of drumming and rhythm. https://www.medscape.com/viewarticle/886726#vp_5, 2017
7. E. L. Stegemoller. J Music Ther. 2014; 51(3): 211-227. https://www.ncbi.nlm.nih.gov/pubmed/25316915
8. K. Zhao, Z. G. Bai, A. Bo, I. Chi. Int J. Geriatr Psychiatry. 2016; 31(11): 1188-1198. http://onlinelibrary.wiley.com/doi/10.1002/gps.4494/full
9. L. Weisman, C. Bridgemohan. Autism spectrum disorder in children and adolescents: complementary and alternatives therapy. https://www.uptodate.com/contents/autism-spectrum-disorder-in-children-and-adolescents-complementary-and-alternative-therapies?source=search_result&search=music%20therapy&selectedTitle=2~26#H33, 2017
10. W. T. Basco. Music therapy and autism spectrum disorder: any lasting benefit? https://www.medscape.com/viewarticle/887034, 2017
11. L. F. Poli, L. Bieleninik, N. Brondino, X. J. Chen, C. Gold. Aging Ment Health. 2017; 13(14). http://www.tandfonline.com/doi/abs/10.1080/13607863.2017.1348474
12. J. Bradt, C. Dileu, L. Magil, A. Teague. Cochrane database of systematic review. 2016; 8. https://www.ncbi.nlm.nih.gov/pubmed/27524661
13. J. Bradt, C. Dileo, D. Grocke, L. Magil. Cochrane Database Syst Rev. 2016; 10(8). https://www.ncbi.nlm.nih.gov/pubmed?term=21833957&myncbishare=helsebiblioteket
14. L. Scudder. Music in managing pain. https://www.medscape.com/viewarticle/805604_4, 2013
15. J. Bradt, C. Dileo. Cochrane Database Syst Rev. 2014; (12). https://www.ncbi.nlm.nih.gov/pubmed?term=25490233&myncbishare=helsebiblioteket
16. Y. Choi. Treatment of acute procedural anxiety in adults. https://www.uptodate.com/contents/treatment-of-acute-procedural-anxiety-in-adults?source=search_result&search=music%20therapy&selectedTitle=1~26#H1822698, 2017
17. A. Lewis, et al. Nature partner journal. 2016; 16. https://www.nature.com/articles/npjpcrm201680
18. K. Johnson. Mosic-motion app helps PD Patients walk better, worry less. https://www.medscape.com/viewarticle/812491,2013
19. D. M. Keller. Enriched music therapy benefits stroke patients long term. https://www.medscape.com/viewarticle/871396#vp_1, 2016

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2 Comments


  1. Selamat sore Dr Tubagus ? Maaf mahu tanya metode di atas bisa diterapkan buat sakit kepala menahun seperti yang saya alami selama 6 tahun kah? Mohon di jawab dokter ? Terima kasih.

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    Replies
    1. Selamat sore Mbak Tari. terima kasih sudah berkunjung kesini.

      Metode Music Therapy bisa diaplikasikan untuk pada kasus nyeri atau kasus Neuro (syaraf). Meskipun yang saya sebutkan di artikel sebagai contoh adalah kasus-kasus psikologis.

      Oh ya Mbak Tari bisa konsultasi lebih lanjut melalui email saya
      doktertubagus@gmail.com.

      Monggo.

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