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      Vocal Music Therapy for Chronic Pain: A Mixed Methods Feasibility Study

      , MA, MT-BC 1 , , MA, MT-BC 1 , , PhD 2 , , MA, MT-BC, LPC 3 , , PhD, MT-BC 1

      Journal of Alternative and Complementary Medicine

      Mary Ann Liebert, Inc., publishers

      music therapy, pain management, clinical trials

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          Abstract

          Objective: The purpose of this study was to determine the feasibility and preliminary effects of a vocal music therapy (VMT) program on chronic pain management.

          Design: A mixed methods intervention design was used in which qualitative data were embedded within a randomized controlled trial.

          Setting: An urban nurse-management health center on the East Coast of the United States.

          Subjects: Participants ( N = 43) were predominantly Black (79%) and female (76.7%) with an average pain duration of 10 years.

          Intervention: Participants were randomly allocated to a 12-week VMT program or a waitlist control.

          Outcome measures: We tracked consent rate (percentage of participants enrolled out of total number screened), attrition rate, and treatment adherence. We used PROMIS ® (Patient Reported Outcomes Measurement Information System) tools to measure pain interference, pain-related self-efficacy, pain intensity, depression, anxiety, positive effect, and well-being, ability to participate in social activities, and satisfaction with social roles at baseline and week 12. VMT participants also completed the Patient Global Impression of Change Scale. We conducted semistructured interviews to better understand participants' experience of the intervention.

          Results: The consent rate was 56%. The attrition rate was 23%. Large treatment effects (partial eta squared) were obtained for self-efficacy (0.20), depression (0.26), and ability to participate in social activities (0.24). Medium effects were found for pain intensity (0.10), anxiety (0.06), positive effect, and well-being (0.06), and small effects for pain interference (0.03) and satisfaction with social roles (0.03). On average, participants felt moderately better after completion of the VMT program ( M = 4.93, standard deviation = 1.98). Qualitative findings suggest that VMT resulted in better self-management of pain, enhanced psychological well-being, and stronger social and spiritual connections.

          Conclusions: Recruitment into the 12-week program was challenging, but quantitative and qualitative findings suggest significant benefits of VMT for chronic pain management.

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          Most cited references 28

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          Eta-Squared and Partial Eta-Squared in Fixed Factor Anova Designs

           J J Cohen (1973)
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            Towards a neural basis of music-evoked emotions.

            Music is capable of evoking exceptionally strong emotions and of reliably affecting the mood of individuals. Functional neuroimaging and lesion studies show that music-evoked emotions can modulate activity in virtually all limbic and paralimbic brain structures. These structures are crucially involved in the initiation, generation, detection, maintenance, regulation and termination of emotions that have survival value for the individual and the species. Therefore, at least some music-evoked emotions involve the very core of evolutionarily adaptive neuroaffective mechanisms. Because dysfunctions in these structures are related to emotional disorders, a better understanding of music-evoked emotions and their neural correlates can lead to a more systematic and effective use of music in therapy. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Reward and motivation in pain and pain relief.

              Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain.
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                Author and article information

                Journal
                J Altern Complement Med
                J Altern Complement Med
                acm
                Journal of Alternative and Complementary Medicine
                Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                1075-5535
                1557-7708
                February 2020
                04 February 2020
                04 February 2020
                : 26
                : 2
                : 113-122
                Affiliations
                [ 1 ]Department of Creative Arts Therapies, Drexel University, Philadelphia, PA.
                [ 2 ]Department of Psychology, Drexel University, Philadelphia, PA.
                [ 3 ]Stephen and Sandra Sheller 11th Street Family Health Services, Drexel University, Philadelphia, PA.
                Author notes
                Address correspondence to: Ming Yuan Low, MA, MT-BC, Department of Creative Arts Therapies, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 ml3337@ 123456drexel.edu
                Article
                10.1089/acm.2019.0249
                10.1089/acm.2019.0249
                7044781
                31750726
                © Ming Yuan Low, et al. 2019; Published by Mary Ann Liebert, Inc.

                This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are cited.

                Page count
                Figures: 1, Tables: 6, References: 35, Pages: 10
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                Categories
                Original Articles

                clinical trials, music therapy, pain management

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