Bernatzky-MeetTheExpertMusicTherapy

8/12/2019 Bernatzky-MeetTheExpertMusicTherapy

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11th Congress of the EAPC/Meet the Expert

Gnther Bernatzky, Michaela PreschUniversity of Salzburg, Faculty of Natural Sciences, Departm. of Organism Biology

The Contribution of Music Therapy

to Quality of Life in Older People Music as a Pharmacon?

Vienna, May 2009


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Enhance the

Quality of Life !

Content

IntroductionPhysiological Effects of Music

Research Studies

Summary


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Enhance the

Quality of Life !

Content


Research Studies

Summary


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Enhance the

Quality of Life !

physiological,

psychological,social,

spiritual,

Improving comfort

QUALITY OF LIFE.... alleviate ... stress


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INTEGRATEDINTERDISCIPLINARY

APPROACH!

QUALITY OF LIFE


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Most Common Symptoms

in Patients with Cancer

Pain 70 - 84%

Shortness of breath (Dyspnea) 25 - 50%

Nausea and Vomiting 25 - 30%

Depression/Anxiety ~ 30%Weakness/Cachexy 45 - 100%

Fatigue ~ 75%

(Lymphatic) Oedema ~ 30%

Agitation/Confusion 20 - 80%

Walsh, Donnelly, Mercadante 2000; David Cella: Jahrestagung der Gesellschaft fr Hmatoonkologie 10/2003

?

?

yes


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Multimodal Therapy

for Treatment of Fatigue

Elements of the therapy:

Relaxation techniques

cognitive stress management group therapies

medical training therapy

Onkologie 2003;26:607-608 und Cancer 2001; 92 (Suppl.6)


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Complementary Therapies

300 randomly selected hospices

Most popular methods:

Massage and Music Therapy

Demmer C. (2004): A survey of complementary therapy services provided by hospices,J Palliat Med: 7:510-516


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History of Music Therapy

Roger Bacon (c. 1214-1294 ) called attention to the

"delay of aging's symptoms" through music, anddemanded that all doctors have a thorough knowledgeof music.

Music as a fountain of youth.Paracelsus (1493-1541) practiced musical medicine -

he introduced a vibration method into medical

practice, a method that used art, music in particular,as a remedy.


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Abbildung: Verffentlichungen zur Musiktherapie in Fachzeitschriften pro Jahr berblick(Quellen: Psyndex, PsychInfo, MedLine 1950 -2005)

Scientific Publications on Music Therapy

Number

ofpapers

Year


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Enhance the

Quality of Life !

Content


Research Studies

Summary


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further literatur for figures:

www.biologie.de, www.auric.de

signal

Acoustic signals are

translated into neuronal

activity in thecochlea and progressively

transformed in the

auditory brainstem

How Music Affects the Brain


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thalamus

primaryauditory cortex amygdalamedial orbitofrontalcortex

emotions control of emotional behaviour

pitch height timbre roughness

intensity

How Music Affects the Brain


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a-c: pos. corr. with incr.

chills intensity

a l. dorsom. midbr.; r. Thal., bilat. Cereb.b l. ventr. striatum, bilat. Insulac r. orbitofr. cortex

Amygdala is switched of less fear


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You dont haveto be a musical

genius to havemusic runningthrough your

head!


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MUSIC promotes/regulates


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physical relaxation power of concentration

social behaviour

capacity of memory

MUSIC promotes


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MUSIC regulates

affective,

cognitive and

sensorimotoric components via: emotion

cognition attention behaviour

communication

Luisa Lopez: Music Therapy: The Long Way to Evidence-Based Methods - Pending Issues andPerspectives. Ann. N.Y. Acad. Sci. 1060:269-270 (2005); doi: 10.1196/annals.1360.064* Hillecke T, Nickel A, Bolay HV: Scientific Perspectives on Music Therapy. Ann. N. Y. Acad. Sci. 1060:271-282 (2005); doi:10.1196/annals.1360.020


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VITALISATION

autonomic nervoussystemcognitive integrationof musical- and non-musical information

electrodermal activity

heart rate

MUSIC

emotional reactions

bodily reactions

(tensioned or relaxed)

How the body reacts to music


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immune system

variations of (salivary)IgA concentrations

motor activity

overlap between neural

activities of the latestages of perception &those related to the earlystages of action

heard pieces of musicactivate

music perception

movement induction social functions

positiveeffects

How the body reacts to music

premotor activity


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perception

action

cognitionsocial cognition

emotion

learning

memory cognitive processes

MAKING MUSIC


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Enhance the

Quality of Life !

Content


Research Studies

Summary


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20 Minutes of Mozart mutes OA Pain

RCT examining the influence of music as a nursing interventionon osteoarthritis pain in elders (n = 66)

Measurement of differences in pain perceptions over 14 days

R McCaffrey, E Freeman: Effect of music on chronic osteoarthritis pain in older people.Journal of Advanced Nursing 2003, 44(5), 517-524.

Andantino fr Flte, Harfe und Orchester, KV 299;

Ouvertre von Le nozze di Figaro KV 492;

Beginning of Sonate Symphonie No. 40

significant decrease in pain

Results Those who listened to music for 20 minutes daily(experimental group) had less pain, when compared with those who satquietly and did not listen to music (control group).

Listening to music was an effective nursing intervention for the reductionof chronic osteoarthritis pain


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Listening to music can reduce chronic pain by upto 21 % and depression by up to 25 %. It canalso make people feel more in control of theirpain and less disabled by their condition:

n=60; 2 groups (mu,con); painful conditions (osteoarthritis, discproblems, rheumatoid arthritis....6,5 yrs)

1 h music/day/week reported improved physic., psychol.symptoms compared to Contr.

Sandra L. Siedlecki, Cleveland Clinic Foundation, Ohio, Journal of Advanced Nursing. Vol. 54,5, pg.553-562


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TAKE HOME MESSAGE

Music and Music guided imageryhave shown to be an ideal adjuvant

combination with other standardtherapeutical methods.

www.schmerzinstitut.org


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Music therapy not only reduces pain

BUTalso addresses associated

psychologicaldistress in a positive way.

Nickel AK, Hillecke T, Argstatter H, Bolay HV: A Step on the Long Road to an Evidence-Based Treatment.Ann.N.Y.Acead.Sci.1060:283-293 (2005)


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How does it work Music?

MUSIC MAY ALTER COMPONENTS

OF THE TOTAL PAIN EXPERIENCE

IT DECREASES THE PERCEPTION OF PAIN !


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Pipam W, Likar R, Klocker J, Bernatzky G, Platz T, Sittl R, Janig H. Results of a poll of cancer patientswith respect to pain and quality of life; Schmerz. 2002 Dec; 16(6): 481-9.

Pain and Quality of Life


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Russell E. Hilliard (2005)

Music Therapy in Hospice and Palliative Care: a Review of theEmpirical Data. eCAM 2005; 2(2)173-178

PURPOSE: Review of empirical studies found in the literature and todocument the emergence of an evidenced-based approach to theuse of music therapy in hospice and palliative care.

METHOD: Total of 11 studies are reviewed: 6 show sign. differences

support the use of music therapy.RESULT: The methodological quality of these small, short-term studieswas generally poor, as was the presentation of results. No usefulconclusions can be drawn.

The need to create an evidence-based approach tohospice and palliative care music therapy is articulated,and future researchers are empowered to continue to

conduct investigations among this population.


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Empirical studies in hospice/palliative care music therapy

Author Year Publication type Research design Randomization n Dependent variables

Curtis 1986 Journal Altering treatment Yes 9 Pain relief and relaxation

Whittall 1989 Conferenceproceedings

Pilot study;pre/post test

No 8 Heart and respiratory rate,extremity temperature

Calovini 1993 Masters thesis Pre/post test No 11 State anxiety

Longfield 1995 Masters thesis Quasi-

experimentalpre/post test

No 8 Mood and pain

Abbott 1995 Masters thesis Pre/post test No 28 Quality of life

Gallagher 2001 Journal Pilot study expost facto

pre/post test

No 90 Pain, mood, anxiety,shortness of breath

Hilliard EH. Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data. Advanced AccessPublication 2005, 2(2): 173-178.


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Empirical studies in hospice/palliative care music therapy

Author Year Publication type Research design Randomization n Dependent variables

Krout 2001 Journal Pre/post test No 80 Comfort, pain, relaxation

Hillard 2003 Journal Clinical trial Yes 80 Quality and length of life,time of death

Wlodarcyk 2003 Masters thesis ABAB, counter-balance

No 10 Spirituality

Batzer 2003 Masters thesis Experimental Yes 15 Discomfort behaviours

Hilliard 2004 Journal Ex post facto No 80 Time and duration of MTprovided, needs treatedby MT

Hilliard EH. Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data. Advanced AccessPublication 2005, 2(2): 173-178.

ABAB, session A consisted of cognitive-behavioural music therapy (30 min) and session B consisted of a no-

music visit (30 min)MT, music therapy


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Dependent variables positively affected

by music therapy (Review)

PainPhysical comfort

Fatigue and energyAnxiety and relaxation

Time and duration of treatment

MoodSpirituality and quality of life


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Cochrane Database of Systematic Reviews

Vink AC, Birks JS, Bruinsma MS & Scholten RJ (2003)Music therapy for people with dementia.

More rigorous studies are needed to establ.whether music therapy may play a role in the

treatment of older people with dementia.

Objectives: To assess the efficacy of music therapy in the treatment ofbehavioural, social, cognitive and emotional problems of older peoplewith dementia.

Results: 5 studies included (354 studies-254). Randomised controlled

trials that reported clinically relevant outcomes associated with musictherapy in treatment of behavioural, social, cognitive and emotionalproblems of older people with dementia.

Conclusion: The methodological quality and the reporting of theincluded studies were too poor to draw any useful conclusions.


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Frequenz der Unruhewhrend der Baseline,klassischer undindividualisierter Musik

Individualisierte Musikwar assoziiert mit einersignifikant grerenAbnahme des erregtenVerhaltens verglichen mitklassischer Musik

L.A. Gerdner (2000): Effects of individualized versus classical "relaxation" music on the frequency ofagitation in elderly persons with Alzheimer's disease and related disorders. Int Psychogeriatr. 12(1): 49-65.

Wirkung von individualisierter vs. klassischer

Musik auf Unruhe bei Alzheimer


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Objektives: examine the efficacy of music therapy with standard carecompared to standard care alone among people with depression andcompare the effects of music therapy for people with depressionagainst other psychological or pharmacological therapies.

Results: Analysis of 5 studies (RCTs): 4 studies: reduction in symptomsof depression; 1 study: no significant change in mental state; dropoutrates from music therapy conditions low in all studies.

Conclusion: small number and low methodological qualityof studies mean that it is not possible to be confident

about its effectiveness

Maratos AS, Gold C, Wang X, Crawford Mj (2008)Music therapy for depression.

High quality trials evaluating the effects ofMusic therapy on depression are required.

Cochrane Database of Systematic Reviews


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Gewichtung derEvidenz

Richtung derEvidenz

SchwerwiegendeSicherheitsbedenken

AlzheimerscheKrankheit

0 Ja

Angstzustnde 0 Nein

Depression 0 Nein

belkeit undErbrechen

0 Nein

Klinische Evidenz von Musiktherapie

fr verschiedene Krankheitsbilder

0 gering00 mittel000 hoch

unklar

Eindeutig negativ

eindeutig positiv

tendenziell positiv

Ernst E.: Praxis Naturheilverfahren Evidenzbasierte Komplementrmedizin. Spinger Medizin Verlag, 2001


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http://www.bethabe.org/MT_and_Motor_Rehabil220.html

MUSIC STIMULATION

IN PEOPLE WITH PARCINSON

Music, Rhythm and Motor Rehabilitation

What would you think if you saw a person unable to take a step on his ownwalk independently while listening to a rhytmic beat?

They cannot plan movements on their own - however they may still have the abilityto move, and this ability is unlocked by music.

Outcomes: Motion initiated in parts of the body that have limited movement Movement maintained in affacted extremeties Increased range of motion Repertoire of exercises built up resident can perform indipendently withconfidence Motivation to participate in daily activities Increased neuromuscular control


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AIMING - Fehlerdauer

Parkinson-Gruppe (n=11) Kontroll-Gruppe (n=10)

rechte Hand linke Hand rechte Hand linke Hand

e

erauersec

0,0

0,1

0,2

0,3

0,4

0,5

0,6

VOR MusikNACH Musik

rechte Hand: F(1,19)=7.253; p=0.015 linke Hand: F(1,19)=0.399; p=0.535

AIMING - Fehlerdauer - rechte HandInteraktion zwischen Gruppen- und Messwiederholungsfaktor

Parkinson-Gruppe (n=11) Kontroll-Gruppe (n=10)

Fehler

dauer(sec)

0,0

0,1

0,2

0,3

0,4

0,5

0,6

VOR MusikNACH Musik

F(1,19)=5.254; p=0.033

MLS - RESULTS

G. Bernatzky, P. Bernatzky, H.P. Hesse, W. Staffen, G. Ladurner (2004): Stimulating music increases

motor coordination in patients afflicted with Morbus Parkinson. Neuroscience letters 361: 4-8.


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http://www.bethabe.org/MT_and_Speech_Rehab221.html

MUSIC STIMULATION

IN PEOPLE WITH STROKEMusic and Speech RehabilitationWhat would you think if you met a person who had lost her ability to speakafter having a stroke, but who could sing with perfect clarity?

Speech and singing use different areas of the brain to complete their tasks MTallows people to reconnect with their voices & exercise vocal.

People who have not been able to talk for many years are slowly learning to sing, to

communicate, and finally to talk to others. Everyone can use singing to promotevocal support, organize conversational speech & improve communication skills thefocus is language & speech improvement, not professional musical achievements.

Outcomes:

Conversational phrases are embedded into familiar song phrases to supportspeech Improved Communication Skills: improved clarity and fluency, increasedexpressive speech and vocal range and volume. Increased confidence in communication attempts

Enhanced expression


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MUSIC STIMULATION

IN PEOPLE WITH STROKEHow Can Music Therapy Help Stroke Survivors?Particular areas of benefit include:

Movement and Muscle Control Speech and Communication Cognition Mood and Motivation

Playing a drum to increase range of motion in the arm Exercising to up-beat music Timing music to match your natural walking rhythm Exercising muscles of the mouth Setting a phrase to music, first singing the words, then

transferring these words to speech Rhyming, chanting, or rapping Creating a song with lyrics containing important information Conducting or performing in a band

Rhythm repetition games http://www.bethabe.org/MT_and_Stroke170.html


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P < 0,01

P < 0,05

Srkm T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM,Erkkil J, Laine M, Peretz I, Hietanen M: Music listening enhances cogntive recovery and mood after

middle cerebral artery stroke. Brain (2008), p 1 - 11


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p < 0,1p < 0,05

p < 0,1p < 0,05

Srkm T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM,Erkkil J, Laine M, Peretz I, Hietanen M: Music listening enhances cogntive recovery and mood after

middle cerebral artery stroke. Brain (2008), p 1 - 11

C


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Cancer

RCTs show that music therapy, compared with usualcare, improves quality of life1 or reduces odddisturbance in cancer patients2.

RCT (n = 60) suggested that procedural pain andanxiety are not influenced by music therapy whencompared with simple distraction3.

RCT (n = 8) showed that music therapy plus guidedimagery improved mood and quality of life ofcancer patients, compared with no additional

treatment1 Hilliard RE. The effects of music therapy on the quality and length of life of people diagnosed with terminalcancer. J Music Therap 2003, 40: 113-137.

2 Cassileth BR, Vickers AJ & Magill LA. Music therapy for mood disturbance during hospitalization forautologous stem cell transplantation. Cancer 2003, 98: 2723-2729.

3 Kwekkeboom KL. Music versus distraction for procedural pain and anxiety in patients with cancer. Oncol

Nurs Forum 2003, 30: 433-440.

M lti l S l i


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Multiple Sclerosis

2 small RCTs of active music therapy showed positivetrends for respiratory muscle strength 1 or self-

esteem, depression and anxiety in MS patients 2

The effects failed to reach statistical significance possibly because of too small sample size

1 Wiens ME, Reimer MA & Guyn HL. Music therapy as treatment method for improving respiratory musclestrength in patients with advanced multiple sclerosis: a pilot study. Rehabil Nurs 1999, 24: 74-80.

2 Schmid W & Aldridge D. Active musc therapy in the treatment f multiple sclerosis patients: a matched

control study, J Music Ther 2004, 41: 225-240.

H d h ld l b fi


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ENHANCEMENT OFQUALITY OF LIFE

How do the elderly benefit

from music therapy ?

H d th ld l b fit


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Better awareness and concentration

Enhances interest levels and social

interaction

Improves memory and recall

Happier outlook on life and higherself-esteem

H d th ld l b fit


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MT increases mobility and coordination

MT diminishes pain and improves

recovery time

MT reduces tension and promotes

relaxation

Was ist zu beachten?


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Was ist zu beachten?

PRIMR

Bildung, Hrerfahrung und Herkunftprgen den Musikgeschmack

Selbstwertgefhl muss erhaltenbleiben; persnlicher Geschmack,Prferenzen miteinbeziehen!

Musikerfahrungen, die in Jugendgemacht werden, sind in lebhafterErinnerung

SEKUNDR

Optimale Tonwidergabe

Altersgebrechen(Schwerhrigkeit)

Technikumgang

Durch aktives Musizieren, Musikhren & Singen erfolgt eineStrkung der Kommunikations- und Kontaktfhigkeit unddes Selbstvertrauens.

Einer Isolation und Vereinsamung wird so entgegengewirkt.

Standardisierte Musiktherapien


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Welche Musik hat bei

welchen Menschenunter

welchen Bedingungen

welche Wirkung?


ZIEL:Enhancement of

quality of life

REZEPTIVEAKTIVE



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AKTIVE MUSIKTHERAPIE

nicht fr jeden altenMenschen geeignet, daEnergie aufgewendetwerden muss.

setzt Lebens- undSpielfreude und Mut zumImprovisieren voraus

es muss mglich sein nurruhig zuzuhren, dieGruppe zu verlassen

REZEPTIVE MUSIKTHERAPIE fr alle alten Menschen

geeignet

Gesprche, die dem Hrenfolgen, sind sinnvoll.

setzt leicht handhabbareTechnik voraus!

AKTIVIERENDE oderBERUHIGENDE Musik ?



Indications for music therapy


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in palliative medicine (1)

communication disordersstress / other psychological

problemspain

neurological disability

Ernst E. et al. (2006): The Desktop to Complementary and Alternative Medicine

An Evidence-based approach. Mosby,Elsevier



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Pain/Anxiety

Extreme muscle contractions of body

InsomniaBreathing problems

Introversion, depressionDeficits with acceptance of life situation

Delhey M. (1997): Musiktherapie. In: Aulbert E, Zech D. (Hrsg.):

Lehrbuch der Palliativmedizin. Schattauer, Stuttgart, 916-922


in palliative medicine (2)

Content


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Enhance the

Quality of Life !

Content

Introduction

Physiological Effects of Music

Research StudiesSummary

Effects of Music Therapy for


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Effects of Music Therapy for

Older People

PYSIOLOGICAL (pain, shortness of breath)

PSYCHOLOGICAL (depression, anxiety, anger, fear,frustration)

SOCIAL (isolation, loneliness, boredom)SPIRITUAL (lack of spiritual connection, need for spiritually-

based rituals)

COGNITIVE (neurolog. impairments, disorient., confusion)

Promote the quality of life !

Enhance the Well-Being Reduce Stress and Suffering

RESEARCH


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RESEARCH

Lack of controlled studies with largesizes that would allow for generalization.

Need for studies with higher levels ofcontrol and randomization of subjects.

Guidelines for future studies should be

established.

LIMITATIONS


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LIMITATIONS

MUSIC SHOULD NOTEXCEED 90 dB AS THIS MAY LEAD TOHEARING IMPAIRMENT



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Welche Musik hat bei

welchen Menschenunter

welchen Bedingungen

welche Wirkung?


MUSIC AT HOMEMUSIC AT HOMEMUSIC AT HOMEMUSIC AT HOME

Musiktherapie Definition


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Musiktherapie Definition

Musiktherapie ist diewissenschaftlich fundierte,

diagnosespezifische Nutzungvon Musik oder von musikalischenElementen zu Heilzwecken.

formuliert von H.P.Hesse, 1980

Sie bedient sich entweder derMusikrezeption (REZEPTIVE MUSIKTHERAPIE)

oder der musikalischen Aktivitt des Patienten

(AKTIVE MUSIKTHERAPIE),wobei jeweils sowohl Einzel- als auchGruppenverfahren mglich sind.

Universitt Salzburg, Naturwissenschaftliche FakulttFachbereich fr Organismische Biologie

Arbeitsgruppe fr Neurodynamics & Neurosignaling


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ALLTAGSERFAHRUNGENALLTAGSERFAHRUNGENALLTAGSERFAHRUNGENALLTAGSERFAHRUNGEN

1. Musik aktiviert Krper und Psyche,versetzt in Stimmung,

regt zum Mitsingen/zur Bewegung an.

Beispiel Klarinette: ...........

Beispiel Klavier: W.A. Mozart, Sonate A-Dur, KV 331,Alla turca

Der therapeutische Einfluss erstreckt sich


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p

in Abhngigkeit vom Charakter derverwendeten Musik in folgende Richtungen:

AKTIVIERUNG Krper & Psychekrperliche Aktivierung,emotionale Neuorientierung (Stimmungsvernderung)

Ouvertren & Mrsche regen an und zerstreuen negative

Gedanken.

ENTSPANNUNG ... Krper & PsycheLsen von krperlicher Verspannung, Beseitigungvon psychischen Spannungen (z.B. Angst)

Entspannungsmusik entspannt Krper und Geist und hat

konzentrationsfrdernde Wirkung.

1.AKTIVIEREND 2. BERUHIGENDAnregung Entspannung


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Anregung Entspannung

Einwirkung primr ber den Krper Aktivierung des Krpers (z.B. Tanz)

Beruhigung des Krpers (z.B. Wiegenlied)

Lsung von krperlicher Anspannung

Einwirkung primr ber die Psyche Emotionale Aktivierung (Stimmung)

Befreiung von ngsten und Lsung von angstbedingteSpannungszustnden

Mglicher therapeutisch nutzbarer Einflussvon Musik


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? ?


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(Claudio Abbado, geb. 1933)

Musik ist die beste Medizin. Mehr als jede Behandlunghat mir die Musik geholfen, diese schwierigen Monatezu berstehen.

Musikalische Hausapotheke = Musikament


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SCHMERZ: BIO-PSYCHO-SOZIALE EINHEIT

Ko-analgetika

Mozart: Eine kleineNachtmusik

Radetzky-Marsch

Walzer

L.v. BeethovenRondo a capriccio

Bobby McFerrinDon`t worry...

Music fromthe Coffee lands

AKTIVIERUNGAKTIVIERUNGAKTIVIERUNGAKTIVIERUNG

Nicht-Opioide+/- Adjuvant.

++++

Schwache Opioide undNicht-Opioide+/- Adjuvant.

Starke Opioide +/-Nicht-Opioide+/- Adjuvant.

U

niversittSalzburg,

Nat

urwissenschaftlicheFak

ultt

F

achbereichfrOrganism

ischeBiologie

A

rbeitsgruppefrNeuro

dynamics&Neurosigna

ling

Universitt Salzburg, Naturwissenschaftliche FakulttFachbereich fr Organismische Biologie



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Beispiel Klarinette: ........

Beispiel Klavier: W.A. Mozart, Sonate A-Dur,KV 331, Var. V

2. Musik entspannt (beruhigt) Krper undPsyche,

lst Erinnerungen und Assoziationen aus,regt zum Trumen an.

Musikalische Hausapotheke = Musikament

ENTSPANNUNGENTSPANNUNGENTSPANNUNGENTSPANNUNG


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SCHMERZ: BIO-PSYCHO-SOZIALE EINHEIT

Ko-analgetika

Entspannungbei Schmerzen.

Mentalis VerlagTraumreise

Mentalis VerlagEchoes of Silence

Schumann:Trumerei

Franz Liszt:

Liebestr. Nr. 3

Enya

ENTSPANNUNGENTSPANNUNGENTSPANNUNGENTSPANNUNG


Bruder Jakob: Happy Baby Guten MorgenAde zur guten Nacht. Abendlieder HappyBaby

Baby Dreams: Close your eyes

Mozart: Hornkonzert Kv447

MOZART-MUSIKAMENT++++

Schwache Opioide undNicht-Opioide+/- Adjuvant.

Starke Opioide +/-Nicht-Opioide+/- Adjuvant.

U

niversittSalzburg,

NaturwissenschaftlicheFak

ultt

F

achbereichfrOrganism

ischeBiologie

A

rbeitsgruppefrNeuro

dynamics&Neurosigna

ling

----

EMOTIONALE REAKTIONEN AUF MUSIK


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Juslin PN (2001) Cue Utilization in Communication of Emotion in Music Performance:Relating Performance to Perception: J. Exp. Psych. 26:1797-1813

Schneller Rhythmus und Stakkato (meistens Dur)Frhlichkeit ... strkeres Atmen ...Freude wird durch hohe Frequenz, groe Intervalle,

hohe Lautstrke und hohe Stimmlage ausgedrckt.

Bsp.: Joseph Haydn: Symphony No. 70 D major, ClassicalJohann Strauss II: Tausendeine Nacht,RomantikGeorges Bizet: Carmen Suite No. 1. 2nd movement:

Musette de Choisy, Classical(G. Kreutz et al., 2008)

G.B. 2001

EMOTIONALE REAKTIONEN AUF MUSIK


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Juslin PN (2001) Cue Utilization in Communication of Emotion in Music Performance:Relating Performance to Perception: J. Exp. Psych. 26:1797-1813

Langsamer Rhythmus und Legato (berwiegendMoll) Traurigkeit ... Puls, Hautwiderst., Htemp.erniedrigt

typisch mittlere Aktivierung, Kleinschrittigkeit derMelodie und fallende, sequenzierende Abschnitte

Bsp.: Tomaso Albinoni, Adagio, G minor, BaroqueJohn Dowland, Dances from Lachrimae: Semper

Dowland Semper, Dolens, Goe Nightly CaresW. A. Mozart: Piano concerto no. 21, KV 467, C minor,2nd movement: Andante Classical

(G. Kreutz et al., 2008)

G.B. 2001

MUSIK UND EMOTIONMUSIKALISCHE CHARAKTERISTIK UNDDEREN KRPERLICHE WIRKUNG BEI SPRACHE/MUSIK


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DEREN KRPERLICHE WIRKUNG BEI SPRACHE/MUSIK

hoch

stark

schnell

grossauf/ab

hell, strahlend

tief

gering

langsam

gering

abwrts

weich,dunkel

GRUNDFREQUENZ,TONHHE

VARIABILITT(MELODIE)

SPRECHTEMPO

LAUTSTRKE

TONHHENVERLAUF

KLANGFARBE

FREUDE TRAUER(PRESTOTYP) (ADAGIOTYP)

SCHERER (1982); EIBL-EIBELSFELD (1984)

MUSIK UND EMOTIONMUSIKALISCHE CHARAKTERISTIK UNDDEREN KRPERLICHE WIRKUNG BEI MUSIK


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DEREN KRPERLICHE WIRKUNG BEI MUSIK

TEMPO schnell, mit Accelerandi langsam, mit Ritardandi

RHYTHMUS punktiert, synkopiert, konturlos, mit Tendenz zumabwechslungsreich Stehenbleiben

LAUTSTRKE/KLANGF. laut, hell, strahlend leise, dunkel, verschmelzend

MELODIK groer Ambitus, sprung- geringer Ambitus, kreisendhafte Intervalle, aufwrts- schrittweise fallendestrebende Motive Motive

HARMONIK einfache Harmonien, komplexe Harmonik mitBetonung der Diskant- komplizierten Akkordfort-tne schreitungen

FREUDE TRAUER(PRESTOTYP) (ADAGIOTYP)

SCHERER (1982); EIBL-EIBELSFELD (1984)

Music examples


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Wolfgang A. Mozart

Klarinettenkonzert A-dur, KV 622, 2. Satz: Adagio

Edvard GriegPeer Gynt, Suite Nr. 1 op. 46, 1. Satz: Morgenstimmung

Peter TschaikowskyKonzert Nr. 1 fr Klavier u. Orchester b-moll op. 23,

2.Satz, mehrstzig

Antonio VivaldiDie vier Jahreszeiten; Konzerte fr Violine, Streicher und

Basso continuo op. 8, Nr. 1-4



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Schmerztherapie: multimodales Konzept


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SCHMERZ = BIO-PSYCHO-SOZIALE EINHEIT


Schwache Opioide


Starke Opioide

+/- Nicht-Opioide+/- Adjuvant.

Ko-analgetika

Physikalische,

psychologische,physiothera-

peutische

Verfahren:- Musik

- TENS

- Biofeedback

- Akupunktur

adjuvante pharmakologische Basistherapie&


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MUSIK HAS ENOUGH

POWER TO INCREASEQUALITY OF LIFE AND SHOULD

BE SEEN/USED LIKE APHARMACON !

MUSIC AS A PHARMACON ?


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PHARMACOKINETIC/DYNAMIC

DOSIS/MAX/MIN

INDICATION/CONTRAINDICATION

SIDE EFFECTS

APPLICATION (ACTIVE/RECEPTIVE)

Enhance theQuality of Life !


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Musik und Gehirn

ZORN

J. Panksepp, G. Bernatzky: Emotional sounds and the brain: the neuro-affectiveFoundations of musical appreciation, Behavioural Processes 60 (2002) 133-155

p


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MUSIC

OF LIFE


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Fotos: O. Anrather (Salzburg) Musik: MozartKlarinettenkonzert, KV 447 (Mozarteffekt)

Thank you !


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FURTHER INFORMATION: www.schmerzinstitut.org

[email protected]

Literature Survey


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Art der Musik Erhobene Parameter & Ergebnisse Autoren

Allgemein

Verbales, unruhestiftendes Verhalten sank zu 31% Cohen-Mansfield, 1997

Verbessertes Selbstwertgefhl und bessereLebensqualitt

Ellis, 2004

Verbesserung der physischen und kognitivenFunktionen Hagen et al., 2003

Durchgefhrte Tests wurden besser ausgefhrt Hanser, 1994

Selbstausdruck, Sozialisation und Rckblickgefrdert

Johnson et al., 1992

Scheinbar vergessene Assoziationen & Gefhleknnen durch Musik als Gedchtnishilfe wiedergefunden werden

Sacks & Tomaino, 1991

Mentale und physische Anregung Sorell, 2008

Gesang Verbesserung der Fhigkeit zur Namensgebung Carruth, 1997

AktiveMusiktherapie Verbesserung der UnruheChoi et al., 2009

Vor allem rastloses Umherwandern wird reduziert Fitzgerald-Cloutier, 1993

Aktive &RezeptiveMusiktherapie

Vermehrtes Selbstvertrauen; verbesserteKommunikation

Fukamizu et al., 2009

Verbessertes Umfeld; verbesserte Lebensqualitt McCaffrey, 2008

Literature Survey


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Art der Musik Erhobene Parameter & Ergebnisse Autoren

RezeptiveMusiktherapie

Entspannende Musik verbessert Unruhezustnde Denney, 1997

Klassische Musik erhht die Gedchtnisleistung Mammarella et al., 2007

Entspannungsmusik verbessert die Schlafqualitt

und AngstreduktionZiv et al., 2008

Verbesserung der Unruhezustnde; musikalischeVorlieben sollten beachtet werden

Gerdner & Swanson,1993

Verbesserung von Unruhezustnden whrend derMahlzeiten

Goddear & Abraham,1994

Verbesserung des Sprachgedchtnises von 60% Srkmo et al., 2008

Teilnehmer prferieren Physiotherapie mitMusikbegleitung

Johnson et al., 2001

Weniger Arthroseschmerzen McCaffrey et al., 2003

Vermehrte Bewegung und Aktivitt Olson, 1984Verbesserung beim individuellen Erkennen undReduktion der Angstwerte

Irish et al., 2006

Beruhigende Musik und Handmassage verndernUmwelt positiv

Remington, 1999

Scientific Publications on Music Therapy


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European Pain in Cancer Survey


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68% of cancer patients receiving treatment for their pain usealternative methods the most popular are massage and vitamins

14%

13%

12%

11%

11%

9%

9%

8%

8%

7%

4%

4%

3%

2%

2%

1%

1%

1%

1%

19%

32%

0% 5% 10% 15% 20% 25% 30% 35%

Massage

Vitamins

Heat (heating pad)

ExerciseAcupuncture

Physical therapy

Herbal supplements

Support groups

Change in diet

Relaxation therapy

Meditation

Ointments/creams

Therapy/counselling

Alcoholic drinks

Cold (ice packs)

Alcohol rubs

Nerve stimulation or TENS

Hypnosis

Imagery

Other

I don't use any other methodsBase: all who receive

treatment (n=506)Q52: What, if any, othermethods, remedies ortreatments, apart from

medications have youever tried to relieveyour pain we havebeen discussing?

European Pain in Cancer Survey,European Association of Palliative Care.Half of European cancer patients havemoderate to severe pain: one in five patientsdoes not receive treatment. J pain PalliatCare Pharmacother. 2007; 21(4):51-3

Depression


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RCT of depressed elderly patients (n = 30) Superior results with music-based therapy (various

therapeutic modalities) than no treatment1

PCTs with depressed adolescent females who listenedto rock music control groups received massage 2

or simply relaxed3

Changes to physiological & biochemical parametersbut not mood or behaviour.

1 Hanser SB & Thompson LW. Effects of music therapy strategy on depressed older adults. J Gerontol1994, 49: 265-269.

2 Jones NA & Field T. Massage and music therapies attenuate frontal EEG asymmetry in depressedadolescents. Adolescence 1999, 34: 529-534.

3 Field T, Martinez A, Nawrocki T, Pickens J, Fox NA & Schanberg S. Music shifts frontal EEG in depressedadolescents. Adolescence 1998, 33: 109-116.

MUSIC STIMULATION


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http://www.bethabe.org/MT_and_Motor_Rehabil220.html

IN PEOPLE WITH PARCINSONMusic, Rhythm and Motor Rehabilitation

What would you think if you saw a person unable to take a step on his ownwalk independently while listening to a rhytmic beat?

They cannot plan movements on their own - however they may still have the abilityto move, and this ability is unlocked by music.

Outcomes: Motion initiated in parts of the body that have limited movement Movement maintained in affacted extremeties Increased range of motion Repertoire of exercises built up resident can perform indipendently with

confidence Motivation to participate in daily activities Increased neuromuscular control

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