Music as medicine: It doesn’t have to be Mozart


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Stop for a moment. What do you hear? Dogs barking, cats meowing, people talking and telephones ringing? How do these sounds make you feel? Happy? Sad? Stressed? Relaxed? Do you hear music? 

Put yourself in your patients’ position. They are stuck in a cage, for hours, days or weeks at a time, unsure why they’re there or when they’ll go home. They may be hungry and anxious, unfed before surgery and upset by the heavy metal music the kennel staff prefers.1

Could this negatively affect their physiologic state prior to surgery? Yes. Are there alternatives? Yes.
You can, today, shift the acoustic stimuli to which you expose your patients from stressful to supportive with safe and inexpensive, though carefully selected, music.

Music is medicine. A 2013 Cochrane review determined that “music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.”2 This follows the findings of “three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients.”

Why not modify our clinic soundscapes to keep stress and anxiety to a minimum and reduce over-reliance on sedatives and other psychoactive agents?

The Impact of Sounds

The more science unveils about the effects of sound, both “good” and “bad,” on the nervous system, the more we recognize our responsibility to attend to our collective acoustic atmosphere. The music or noise in our clinics may either help alleviate or actually worsen pain control.

A systematic review of music as an adjuvant analgesic in hospitalized humans found a positive effect of music on pain.3 Furthermore, music reduced anxiety, reliance on opioid medication, muscle tension and heart rate.

How many clinics and hospitals, whether human or veterinary, miss out on this well-researched opportunity to significantly benefit patients and staff, despite the impressive, positive evidence of the value of music in medicine?  

Nonhuman animals respond to music and sound in many ways that resemble effects on humans. A compelling compilation of music’s effects on animal physiology, behavior and welfare appeared in the February 2013 issue of Lab Animal.4 This review paper explored the wide-ranging effects of music on the brain and behavior, learning and development, reward centers in the brain, psychoneuroimmunologic parameters, growth, productiveness, play and conditioning. 

Sound, as an environmental enrichment or stressful stimulus, introduces a variable that could confound outcomes.

Music Therapy without Mozart

Music does not have to be Mozart. That said, however, many researchers have relied on Mozart’s works to examine how his compositions alter brain physiology. 

Mozart’s piano sonata K.448 accelerated learning in rats exposed to music at 2 weeks of age. Calming music played for rat pups prior to birth increased neurogenesis in the hippocampus and improved spatial learning capacity. 

Music played to chicks before they hatched raised the synaptic density of neurons within the hippocampus, benefiting spatial learning after hatching.

In contrast, exposure to loud noise had opposite effects.

Musical Neuromodulation

Instituting healing sounds does not require a background in music or even an innate affinity for classical. Even simple rhythms strongly impact the nervous system. The process of synchronizing physiologic processes to external rhythms is called “entrainment.” 

We respond to the tempo and rhythm of sounds around us through changes in heart rate, respiratory rate, brain activity and spinal cord activation.5-7

Sound stimulates hard-wired circuits throughout the brain and spinal cord, emphasizing the important role of rhythm for rehabilitation. 

Rhythmic auditory stimulation has been shown to improve gait velocity, cadence, stride length and gait symmetry in human patients with acquired brain injury such as stroke.8

Music affects more central and autonomic nervous system pathways and in more complex ways than most other types of input. Its impact extends to the hypothalamic-pituitary-adrenal axis and the neuroendocrine-immune network, where it modulates metabolism, gastrointestinal motility, metabolism and more.9

Massage for the Mind

Can you think of the last time you received a relaxing massage when music wasn’t playing in the background? 

In many ways, music therapy acts as massage for the mind. Both rely on rhythmic inputs designed to elicit certain outcomes. Pre-event sports massage, for example, involves rapid, invigorating hand movements that correspond to upbeat, lively, rhythm-driven music. Post-event recovery calls for slower music and longer, slower treatment techniques. 

Even Cell Cultures Respond

New research shows that even cells in culture respond to music.10 

After finding that cells from a human breast cancer cell line change their activity in response to music, researchers asserted, “[O]ur results suggest for the first time that music can directly interfere with hormone binding to their targets, suggesting that music or audible sounds could modulate physiological and pathophysiological processes.”

Begin Today

Incorporating music into your practice can start today.
 
If you don’t have access to a professionally trained music therapist who can tailor musical inputs to patients’ specific needs, at least begin attending to the sounds of your clinic or academic facility.
 
Think of ways in which music might be introduced into exam rooms, surgical suites and critical care units. Relaxing sounds serve as supportive measures during times of prolonged medical treatment, such as chemotherapy and dialysis.11 

Clients could calm their cats on the way to the clinic with music psychoacoustically designed with felines in mind.12 

We’ve Come a Long Way

Before the phonograph, doctors needed live musicians to play for patients.13 Now, humans have iPods and dogs have iPawds.14 

Stop allowing auditory stress to make you and your staff miserable. Your next Rx? Satie’s Gymnopedie No. 3.15  

Dr. Robinson, Dipl. ABMA, FAAMA, oversees complementary veterinary education at Colorado State University.

FOOTNOTES
Roque AL, Valenti VE, Guida HL, et al.  The effects of different styles of musical auditory stimulation on cardiac autonomic regulation in healthy women.  Noise Health.  2013;15(65):281-287.
2 Bradt J, Dileo C, and Shim M.  Music interventions for preoperative anxiety (Review).  2013 Jun 6;6:CD006908. doi: 10.1002/14651858.CD006908.pub2
3 Cole LC and LoBiondo-Wood G.  Music as an adjuvant therapy in control of pain and symptoms in hospitalized adults:  a systematic review.  Pain Management Nursing. 2012 Oct 26. pii: S1524-9042(12)00144-0. doi: 10.1016/j.pmn.2012.08.010. [Epub ahead of print]
4 Alworth LC and Buerkle SC.  The effects of music on animal physiology, behavior and welfare.  Lab Animal.  2013;42(2):54-61.
5 Thaut MH, Stephan KM, Wunderlich G, et al.  Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization.  Cortex.  2009;45(1):44-53.
6 Thaut MH, Demartin M, and Sanes JN.  Brain networks for integrative rhythm formation.  PLoS One.2008;3(5):e2312.
7 Molinari M, Leggio MG, De Martin M, et al.  Neurobiology of rhythmic motor entrainment.  Ann NY Acad Sci.  2003;999:313-321.
8 Bradt J, Magee WL, Dileo C, et al.  Music therapy for acquired brain injury.  Cochrane Databased Syst Rev.  2010 Jul 7;(7):CD006787. doi: 10.1002/14651858.CD006787.pub2.
9 Yamasaki A, Booker A, Kapur V, et al.  The impact of music on metabolism.  Nutrition.   2012;28(11-12):1075-1080.
10 Lestard Ndos R, Valente RC, Lopes AG, et al.  Direct effects of music in non-auditory cells in culture.  Noise Health.  2013;15(66):307-314.
11 Solanki MS, Zafar M, and Rastogi R.  Music as a therapy:  role in psychiatry.  Asian Journal of Psychiatry.  2013;6:193-199.
12 Leeds J and Spector L.  Through a Cat’s Ear, Volume 1:  Music for Calming.  Accessed at http://throughadogsear.com/tace/on 11-18-13.
13 Moris DN and Linos D.  Music meets surgery:  two sides to the art of “healing”.  Surg Endosc.  2013;27:719-723.
14 Spector L.  Top 8 reasons your dog needs an iPawd.  Accessed at http://throughadogsear.com/top-8-reasons-your-dog-needs-an-ipawd/on 11-18-13.
15 Throughadogsear.com .  Music to calm your canine companion (Vol. 3).  Accessed at http://throughadogsear.com/samples/.

 

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