Efficacy, Treatment Characteristics, and Biopsychological Mechanisms of Music-Listening Interventions in Reducing Pain (MINTREP): Study Protocol of a Three-Armed Pilot Randomized Controlled Trial

Reporting Guidelines for Music-based Interventions checklist: explanation and elaboration guide

Background

Detailed intervention reporting is essential to interpretation, replication, and eventual translation of Music-based Interventions (MBIs) into practice. Despite availability of Reporting Guidelines for Music-based Interventions (RG-MBI, published 2011), multiple reviews reveal sustained problems with reporting quality and consistency. To address this, we convened an interdisciplinary expert panel to update and improve the utility and validity of the existing guidelines using a rigorous Delphi approach. The resulting updated checklist includes 12-items across eight areas considered essential to ensure transparent reporting of MBIs.

Objective

The purpose of this explanation and elaboration document is to facilitate consistent understanding, use, and dissemination of the revised RG-MBI.

Methods

Members of the interdisciplinary expert panel collaborated to create the resulting guidance statement.

Results

This guidance statement offers: (1) the scope and intended use of the RG-MBI, (2) an explanation for each checklist item, with examples from published studies, and (3) two published studies with annotations indicating where the authors reported each checklist item.

Conclusion

Broader uptake of the RG-MBIs by study authors, editors, and peer reviewers will lead to better reporting of MBI trials, and in turn facilitate greater replication of research, improve cross-study comparisons and meta-analyses, and increase implementation of findings.

A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes

BACKGROUND

Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.

OBJECTIVE

The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.

METHODS

This systematic review was directed by a protocol based on the Methodological Expectations of Cochrane Intervention Reviews. Quality of studies was assessed with the Cochrane risk of bias assessment tool. Searches were performed in the following databases: MEDLINE, Embase, APA PsycInfo, CINAHL Plus with Full Text, Academic Search Complete, RILM Abstracts of Music Literature, Web of Science, and Scopus.

RESULTS

We identified 59 articles meeting the inclusion criteria, 37 involving music and 22 involving nonmusic sound interventions, with one study comparing music and sound. The identified studies were representative of a general ICU population, regardless of patients' ability to communicate. Our review demonstrated that both slow-tempo music and sound interventions can significantly (i) decrease pain; (ii) improve sleep; (iii) regulate cortisol levels; (iv) reduce sedative and analgesic need; and (v) reduce stress/anxiety and improve relaxation when compared with standard care and noise reduction. Moreover, compared to nonmusic sound interventions, there is more evidence that music interventions have an effect on stress biomarkers, vital signs, and haemodynamic measures.

CONCLUSION

These results raise the possibility that different auditory interventions may have varying degrees of effectiveness for specific patient outcomes in the ICU. More investigation is needed to clarify if nonmusic sound interventions may be equivalent or not to music interventions for the management of discrete symptoms in ICU patients.

REGISTRATION OF REVIEWS

The protocol was registered on Open Science Framework in November 6 2023 (https://doi.org/10.17605/OSF.IO/45F6E).

A between-subjects investigation of whether distraction is the main mechanism behind music-induced analgesia

Music- and distraction-induced pain reduction have been investigated extensively, yet the main mechanism underlying music-induced analgesia remains unknown. In this study, to assess whether music-induced analgesia primarily operates through cognitive modulation, we used the cold pressor task and objectively compared the pain tolerances of participants in a four-group between-subjects design: a music group that listened to a music piece in the absence of any tasks, a music-and-attention-to-music group that listened to the same piece while also rating the arousal levels in the music, a music-and-attention-to-pain group that rated their pain levels while listening to the same piece, and a silence group as control. The group passively exposed to music playback did not show significantly higher pain tolerance compared to the silence group. However, pain tolerances in the music group negatively correlated with participants' self-reported arousal ratings of the music at the end of the experiment. The groups that engaged in an active task - whether evaluating the arousal levels in the music or reporting their experienced pain levels - demonstrated similarly higher pain tolerances compared to the silence group. These findings suggest that engaging in a task, regardless of whether it involves exteroceptive or interoceptive attention, can enhance pain tolerance.

The effect of preferred music versus disliked music on pain thresholds in healthy volunteers. An observational study

Pain is a prevalent and debilitating healthcare problem. Since pharmacological treatments have numerous side-effects, additional treatment could be beneficial. Music has been shown to affect the pain perception and the pain threshold. The objective of this observational study was to evaluate the effect of preferred music as opposed to disliked music on pain (tolerance) thresholds and perceived pain intensity in healthy volunteers. Pain thresholds were measured via quantitative sensory testing. The volunteers were randomly assigned to either handheld pressure algometry to assess the pressure pain threshold to or electrical measurements to assess the electrical pain tolerance threshold while listening to preferred and disliked music. The pain thresholds were administered on the dorsal side of the forearm. The perceived pain intensity was assessed via a numerical rating scale, ranging from 0 (no pain) to 10 (worst pain imaginable). In total 415 volunteers were included in this study. The pressure pain threshold was assessed in 277 volunteers and in the electrical pain tolerance threshold test 138 volunteers were entered. In both groups, preferred music yielded higher pain thresholds than disliked music (P<0.001) and lower perceived pain intensity during the stimulus (P = 0.003). Moreover, the highest pain thresholds of both pressure pain and electrical pain tolerance thresholds were obtained when the preferred music was preceded by disliked music. Listening to preferred music when receiving noxious stimuli leads to higher pain thresholds and lower perceived pain scores in comparison with disliked music. Preferred music could be beneficial for patients with pain or undergoing painful procedures.

Does art reduce pain and stress? A registered report protocol of investigating autonomic and endocrine markers of music, visual art, and multimodal aesthetic experience

The pain- and stress-reducing effects of music are well-known, but the effects of visual art, and the combination of these two, are much less investigated. We aim to (1) investigate the pain- and (2) stress-reducing effects of multimodal (music + visual art) aesthetic experience as we expect this to have stronger effects than a single modal aesthetic experience (music/ visual art), and in an exploratory manner, (3) investigate the underlying mechanisms of aesthetic experience, and the (4) individual differences. In a repeated-measures design (music, visual art, multimodal aesthetic experience, control) participants bring self-selected “movingly beautiful” visual artworks and pieces of music to the lab, where pain and stress are induced by the cold pressor test. Activity of the pain and stress responsive systems are measured by subjective reports, autonomic (electrocardiography, electrodermal activity, salivary alpha-amylase) and endocrine markers (salivary cortisol).