Brains on Beethoven, a Feasibility Study of Music Therapy in the Neuro Icu

Journal

Neurocritical care

Year

2014

Abstract

Introduction This study is to determine the feasibility of evaluating the effect of music therapy, specifically Beethoven's Ninth Symphony on brain-injured patients in the neurointensive care unit. A secondary aim of this study is to evaluate the feasibility of commercially available wrist accelerometers (Fitbit ) as non-invasive neurologic monitors. Methods Patients with a GCS score 5- 12 admitted > 24 hours and < 7 days were recruited from the Neuro ICU. The study design is a 3-part randomized cross-over study consisting of daily 67-minute sessions: Beethoven's Ninth Symphony via MP3 player with noise cancelling ear-buds, noise cancelation only, or control group with ear-buds and music turned off. Outcome measurements included sedation and pain medication requirements, FOUR score, NIHSS and activity with Fitbits placed on each wrist. Results Seven patients were identified and met study criteria. Three patients were excluded after consent was obtained: 2 due to an improvement in GCS after extubation and one due to incorrect date of onset. Four patients completed the study protocol. Neurologic exam changed during the intervention for 75% patients (3/4). Anecdotal observations during suggest patients appear to be more restful during the music session compared to other sessions. Analysis of the Fitbit data failed to show any lateral differences even when the patient had a hemiplegic exam. There were no observed complications from this study. Conclusions Studying the effects of music on brain injured patients is feasible. Anecdotal evidence during the intervention periods suggests music may be a safe and effective method of inducing restfulness in this patient population. Future studies are needed to determine significance. This study was not powered to do so. Due to medical necessity, all patients were restrained during the study period, which likely affected the results of Fitbit. Fitbits do not appear to be useful neurologic monitors.

Music and Health Institute Terms

Hospital Setting; Intensive Care Unit (ICU); Medication Use; Music Therapy; Observational Measures; Pain; Physiological Measures; Sedative Intake; Stroke

Indexed Terms

brain; feasibility study; society; accelerometer; control group; crossover procedure; drug therapy; ear; EMBASE keywords; extubation; hemiplegia; human; monitor; National Institutes of Health Stroke Scale; noise; outcome assessment; pain; patient; population; sedation; study design; wrist

Study Type

Randomized Controlled; Trial; Quantitative Methods

Document Type

Article

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