Effects of Music on Anxiety and Pain in Children With Cerebral Palsy Receiving Acupuncture: A Randomized Controlled Trial
Abstract
OBJECTIVES: To study the effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture daily in a clinical setting. DESIGN: A randomized controlled trial. SETTING: Acupuncture Unit at Shenzhen Hospital of Traditional Chinese Medicine in Shenzhen City of China. PARTICIPANTS: Sixty children with cerebral palsy undergoing acupuncture. METHODS: INTERVENTION: Children listened to their favorite music or a blank disc for 30 min. MEASUREMENTS: (1) the modified Yale preoperative anxiety scale for children's anxiety (mYPAS); (2) children's hospital of eastern Ontario pain scale (CHEOPS) and Wong-Baker faces pain rating scale (FACES) for pain intensity; (3) vital signs including mean arterial blood pressure (MAP), heart rate (HR) and respiratory rate (RR). RESULTS: An independent sample t-test showed significantly lower mYPAS scores in the music group 30 min after the intervention compared with the control group (t=4.72, P=0.00). Significant differences between groups were found in mYPAS scores (F=4.270, d.f.=1, P=0.043, Partial eta(2)=0.069) and over treatment duration (F=143.421, d.f.=1.521, P=0.000, Partial eta(2)=0.712). A significant interaction was also found (F=4.298, d.f.=1.521, P=0.025, Partial eta(2)=0.069). LSD's post hoc testing confirmed that the mYPAS scores significantly increased from the baseline to 1 min (P=0.000, 95% CI 14.913, 20.257) and then gradually decreased from 1 to 30min (P=0.000, 95% CI -18.952, -13.714). For pain intensity scores, a highly significant time effect was found in both the CHEOPS (F=87.347, d.f.=2, P=0.000, Partial eta(2)=0.601) and FACES (F=225.871, d.f.=1.822, P=0.000, Partial eta(2)=0.796), and a significant interaction effect was found as well (F=4.369, d.f.=2, P=0.015, Partial eta(2)=0.070; F=5.859, d.f.=1.822, P=0.005, Partial eta(2)=0.092). However, no significant difference between groups was present (F=2.343, d.f.=1, P=0.131, Partial eta(2)=0.039; F=3.738, d.f.=1, P=0.058, Partial eta(2)=0.061). Significant differences between groups were found in MAP and HR (P<0.05) and over time (P<0.05), but no significant effects in RR were apparent (P>0.05). A significant interaction effect was found in HR (P<0.05), but not in MAP or RR (P>0.05). CONCLUSIONS: This study demonstrates that listening to music while receiving acupuncture can relieve anxiety among children with cerebral palsy; however, no effect was observed in terms of pain reduction. Further research is needed to explore the types of music which best impact an individual's treatment. Whether music results in fewer accidents and side effects of acupuncture should be investigated. Music can be considered as adjunctive therapy in clinical situations that may be anxiety-provoking for children.