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How music therapy provides real clinical results

By John Murphy, MDLinx
Published August 19, 2019

Key Takeaways

Music has been linked with medicine for centuries, but only recently have researchers made demonstrable progress in using music to improve medical outcomes in various conditions, such as stroke, coronary heart disease, pain, Alzheimer disease, and others.

Take note that music therapy isn’t the equivalent of smooth jazz playing in the background at the dentist’s office (although that may certainly induce a positive effect). Like physical, occupational, and speech therapy, music therapy is a discipline unto itself.

Established as a profession in the United States in 1950, music therapy is the “clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program,” according to the American Music Therapy Association.

In music therapy, a patient can be actively involved (through singing, playing an instrument, or even dancing) or be a receptive listener (paying direct attention to the music). The music therapist creates a music playlist that can be chosen by the therapist or individualized to the patient (and sometimes chosen by the patient).

Much more research, in the form of clinical trials, needs to be done to better validate the effects of music therapy. But in the meantime, here are just a few conditions in which music therapy has been shown to provide specific benefits.

Stroke

Rhythmic auditory stimulation (RAS) involves synchronizing a patient’s movement—eg, hitting the ground with the foot during walking—to an external auditory cue, such as the ticking of a metronome or the sound of the drumbeat in music. The rhythm of this synchronization can facilitate physical rehabilitation.

After a person has a stroke, an essential part of rehabilitation focuses on mobility. In numerous studies, researchers have shown that music therapy, in the form of RAS, can improve a range of mobility parameters, including gait velocity, stride length, general gait, and possibly gait cadence. RAS with music (eg, a song with a strong, consistent beat) appears to have a greater effect than RAS without music (ie, the ticking of a metronome).

Playing musical instruments may also help patients regain functional motor skills. In one study, stroke patients who were trained to play on an electronic keyboard or electronic drums showed significant increases in speed, precision, and smoothness of movements. Their motor control in everyday activities also improved significantly compared with control patients.

Pain

It’s now well known that music has an analgesic effect. The granddaddy of this research was a 1960 study of 5,000 patients undergoing dental surgery. The researchers found that listening to a combination of music and noise reduced pain in 90% of cases.

More recently, authors of a systematic review and meta-analysis concluded that listening to music reduced postoperative pain, anxiety, and analgesia use in patients undergoing surgical procedures. Music also increased patient satisfaction. It was even effective when patients were under general anesthesia.

“Music is a simple and cheap intervention, which reduces transient discomforts for many patients undergoing surgery. A drug with similar effects might generate substantial marketing,” wrote Paul Glasziou, PhD, professor of evidence-based medicine, Bond University, Queensland, Australia, in a related commentary.

Heart attack

In a randomized clinical trial, patients hospitalized after a heart attack were evaluated for music therapy’s effect on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and double product (DP, which is SBP x HR). A notable difference in this trial is that patients were randomized to different musical “interventions”—some listened to classical music (Mozart), some listened to rock and roll (the Beatles), and some to news on the radio.

Interestingly, the researchers found that patients who listened to Mozart had a significant reduction in SBP compared with those who listened to the Beatles. Those in the Mozart group also had significantly reduced DP compared with the news group. But, in all groups, DBP and HR values did not significantly differ after the intervention than before.

“The absence of effects on the HR is quite plausible, given that all patients evaluated were hospitalized for treatment of MI and were receiving beta blockers,” the authors wrote. “It is noteworthy, however, that despite the full treatment of different variables within a hospital setting, patients still showed benefit from music therapy.”

Alzheimer disease and dementia

In behavioral studies, researchers have shown that music therapy can improve some cognitive functions in people with Alzheimer disease. In particular, active music therapy that uses individualized music playlists can provide cognitive improvements in orientation, language, and memory, as well as improvements in anxiety and depression.

How does music actually affect the brains of those with dementia?

“It has been postulated that music’s ability to induce arousal and evoke positive emotional responses can activate the parasympathetic or sympathetic nervous system, depending on the type of music and rhythm, to in turn alleviate neuropsychological symptoms and enhance encoding efforts,” wrote the authors of recent literature review.

They emphasized that music therapy that uses individualized music playlists and focuses on relaxation techniques tends to produce greater benefits in people with Alzheimer disease. “We hypothesize this is due to the enhancement of autobiographical memory, autonomy, and parasympathetic modulation which in turn has positive effects on cognition and behavior.”

The research described above is only a sample of the evidence of music therapy. Other studies have shown that music therapy:

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