National Institutes of Health
Effects of Vibroacoustic Music on Symptom Reduction in Hospitalized Patients
by Tim Hulley, M.A., C.M.P. under the direction of Dr. George Patrick
Visual Analog Pre-Post Percentage Difference
|Mean % of Symptom Reduction||# of Patients in Each Study|
|Tention & Anxiety||54.59||74|
ProgramEvaluation Vibroacoustic Network Respondents:
"Our program evaluation at the Clinical Center of the National Institutes of Health has given us enough data to suggest a series of research protocols that we (four of us who use the acoustic recliners daily with our wide variety of patients) will be laying out in the next few months. So far, with N=190, we have seen statistically significant and clinically significant results in both tension-anxiety reduction as well as symptom reduction. We have revised our simple patient reported session evaluation form as attached. The data has been broken down into diagnostic groups (all chronic disease processes: cancer, AIDS, heart and lung, blood, and psychiatric disorders are the main groups), with no noticeable drop off in reported effectiveness by group. The results are not publishable since we did not do a randomized clinical trial, only simple program evaluation project. But we are VERY encouraged by the data."
Effects of Vibroacoustic Music on Symptom Reduction in Hospitalized Patients Brief description:
Patients experiencing a variant of symptoms were offered vibroacoustic music. Patient report of both state of relaxation and symptom intensity were collected before and after the 40 minute session. This program evaluation has provided information with which to develop a research plan.
The need for hospitalized patients to experience the relaxation response as an antidote to the stress of treatment and adjustment to the possibility of chronic or life threatening conditions is clear. The systematic application of music to promote positive changes in behavior has been used successfully in a variety of hospital settings. The effectiveness of music interventions has been measured physiologically and behaviorally.
In order to provide patients with assistance in achieving a relaxation response, recreation therapists at a major research hospital created several relaxation opportunities for patients and their family members. Among them are a weekly class, "The Art of Relaxation." This class is both didactic and experiential. Held in a patient lounge, it can accommodate up to nine individuals. The content includes a short introduction, an explanation of four components of relaxation (from Benson), and examples of short form relaxation techniques (i.e. eye roll-sigh). This is followed by a 15-20 minute experiential session using one of the following techniques: progressive relaxation, guided imagery, rhythmic breathing, body scan, or autogenic training.The recreation therapists also created a relaxation room with four Somatrons, a commercially available vibroacoustic recliner. The Somatrons deliver ear level stereo auditory and tactile vibrations that allow the body to feel the music that is normally only heard. Patients can access an initial session in the relaxation room using Therasound music titled "Balance" designed or its anxiolytic properties.
Subsequent uses of the relaxation room have used either "Balance" or music from "The Musical Body" (Therasound). In all cases, this is a therapist guided session with about 10 minutes of debriefing after the music.This presentation of the program evaluation data from the use of the vibroacoustic recliners with anxiolytic music gathered from 268 adult patients with varying diagnoses over the last 17 months. The measures were patient self-report instruments completed immediately pre and post to assess symptom intensity and relaxation. Symptoms, up to three, were identified by the patients. Symptom intensity was measured on a visual analogue scale. Relaxation was measured seven item Self-Report Rating Scale for Tension and Relaxation (Poppen, 1988, p.126).The results follow. The most frequently identified symptoms were tension-anxiety (73), pain (67), fatigue (62), nausea (27), headache (23), and depression (15) which comprised 92% of the first symptoms mentioned. (Note: patients could state up to three symptoms and rate each, But this report analyzed only the first mentioned symptom.) Each of these symptoms showed reduction in intensity based on pre-post mean scores. Cumulatively, the pre rating mean was 67.20 (of 100) and the post rating mean was 31.55, a 53% reduction of symptoms. The most frequently self-reported symptoms that were reduced included tension-anxiety (p <.001), pain (p <.0001), fatigue (p <.0001), nausea (p <.0005), headache (p <.0001), and depressed mood (p<.0004). The intensity of symptoms was reduced from pre to post by following percentages: tension-anxiety, 54.65%; pain, 58.31%; fatigue, 46.63%; nausea, 56.44%; headache, 51.64%; and depressed mood, 46.63%.
To measure the state of relaxation, the seven point Self-Report Rating Scale for Tension and Relaxation was used. With an N=272, the pre rating was 5.12(5 is "Feeling Some Tension in Some Parts of My Body") while the post rating was 2.77 (3 is "Feeling More Relaxed Than Usual"), a statistically significant difference (p<.0001). Although this scale is nominal, tests of fit allow for estimation of effective improvement of 33.4% in state of relaxation.
Clinical impressions of the group of five recreation therapists were commensurate with the statistical significance levels indicated. Most patients were buoyed by having a perceived effect on their symptom burden. We used this positive outcome to point out that patients could clearly benefit by regular practice of an effective relaxation technique. They were given additional training in the "Art of Relaxation" class, through individual instruction, or by readings.
This program evaluation data was not a research study. It did not use random assignment, control group, or a comparison group. Nonetheless, it did generate enough data to suggest the worthiness of writing a research plan for several sequential research protocols. Our group of recreation therapists have decided to continue focus on symptom reduction. We will measure the duration of the symptom intensity reduction beyond the vibroacoustic session. Furthermore, we will be comparing subsequent sessions to see whether the treatment effect is as robust with additional treatment. We have done preliminary analyses by diagnosis and see a different set of symptoms per diagnosis so we will continue to collect data based on diagnosis. We are considering what could constitute an adequate control group (e.g., no treatment, music with no tactile input, different kinds of music, music of choice vs. prescribed music). How does vibroacoustic music compare with the other relaxation techniques, such as progressive relaxation, autogenic training, mindfulness meditation, and guided imagery? In addition, what should be the research participant inclusion criteria? Should there be a minimum baseline of perceived tension-relaxation or symptom intensity? And finally, which study should come first and what is a proper sequencing so that a cluster of studies could be done in such a way as to build a body of knowledge around vibroacoustic music as a developing technology?
"The recliners referred to in this study are four Somatron Professional Power Models. NIH also has Somatron Clinical Recliners, Mats and other Somatron products in daily use."
Byron Eakin, Somatron Corporation
IEEE Engineering in Medicine and Biology Magazine
"Good, good, good, good vibrations..."
...proclaimed the Beach Boys in both words and vibrant harmony. As with most of their music, the simple lyrics are outweighed by harmonic message. Still, their teenaged composer and lyricist, Brian Wilson, was inspired by why dogs barked at specific people and why certain girls emanated exciting vibrations ("excitations"). Music and vibration would appear to be far from the concerns of human adaptation, but surprise has always been a driver of scientific investigation.
The need for hospitalized patients to experience the relaxation response as an antidote to the stress of treatment and adjustment to the possibility of chronic or life-threatening conditions is clear. The systematic application of music to promote positive changes in behavior has been used successfully in a variety of hospital settings. The effectiveness of music interventions in stress management has been measured physiologically and behaviorally.
This present study extends previous research by describing the outcome of a recreation therapy program of Vibroacoustic music (VAM) offered to hospitalized patients. In order to provide patients with assistance in achieving the relaxation response, recreation therapists at a major federal research hospital created several relaxation opportunities for patients and family members. Included in these opportunities were classes in:
In addition, the recreation therapists created a relaxation room, equipped with four Somatrons, which is commercially available Vibroacoustic Music Recliner delivering ear-level stereo sound and tactile vibrations that allow the body to feel the music that is normally only heard. Patients can access an initial session in the relaxation room using anxiolytically designed (relaxing) music titled "Balance." Subsequent uses of the relaxation room have employed either "Balance" or music from "The Musical Body" (Therasound). In all cases, the relaxation room is a recreation therapist-guided session with a 10-minute introduction, 25 minutes of music/vibration, and about 10 minutes of debriefing (a total of 45 minutes per session).
The researcher and colleagues were surprised at patients reporting that they received unintended (and unadvertised) symptomatic relief as a result of VAM. These unsolicited testimonials led the program evaluation to include a measure of patient symptoms in both pre and post VAM sessions. Method (Sampling Procedure)
A program evaluation yielded data from the use of these VAM recliners with anxiolytic music gathered from 272 adult patients in a major research hospital. This was a convenience sample of those who came to the relaxation room. Patients were recruited by several methods; physician referral, patient response to recreation therapist recommendation, or patient response to information about the relaxation room (printed materials and word of mouth from other patients). These patients had varying diagnoses; cancer (97); heart, lung, and blood disorders (55); infectious disease (54); mood disorders (32); and miscellaneous conditions (34). Their ages ranged from 21 to 67, with an average age of 43.7 years. Females made up 53% of the sample. Again, this study reports a program evaluation. As such, no effort was made to develop a meaningful control group.
Measurements and Variables
Data were gathered from two patient self-report instruments, completed immediately before and after the VAM session. State of relaxation was measured by selecting one of seven statements from the "Self-Report Rating Scale for Tension and Relaxation" asking "Which of the following best describes the way you feel right now?"
All 272 patients completed this Self-Report Rating Scale for Tension and Relaxation. It was used as a comparative value for the symptom intensity, visual analog scale.
Because this study attempted to track whatever symptoms patients were experiencing at the moment before the VAM session, the open-ended questions asked of them were: "What symptom(s) are you experiencing now?" and "At what level of intensity?". Up to three symptoms were requested from our patients, and they were asked to place a hash mark on a visual analog scale (VAS) to rate the intensity of each particular symptom. The line was anchored at its ends by the printed phases "not at all" and "very much." Some chose no symptoms.
The pre-post data set afforded a between-groups analysis among the dependent variables. To analyze the results, we employed a paired t-test to determine the probability of the changes in pre versus post differences.
Results (Descriptive Findings)
To measure the state of relaxation, the seven point Self-Report Rating Scale for Tension and Relaxation was used. With N=272, the pre rating was 5.12 (5 is "Feeling Some Tension in Some Parts of My Body") while the post rating was 2.77 (3 is "Feeling More Relaxed Than Usual"), a statistically significant difference. Although this scale is ordinal, anchored with descriptive language (categorically ordered), the Bartlett's test of fit allowed for an estimation of effective improvement of 33.4% in state of relaxation.
Aggregation of the symptom data showed an average participant pre (VAS) rating of 67.20 (of 100) and a post rating of 31.55, a 53% reduction in cumulated symptoms. Only the first (of up to three) symptoms was analyzed in this program evaluation to simplify the data displayed here. The most frequently identified symptoms were tension-anxiety, pain fatigue, nausea, headache, and depression, which comprised 92% of the symptoms mentioned. The post rating was done at the end of the VAM session in order to determine the perceived effect in order to determine the perceived effect of the session on the symptom and to reduce the influence of other variables. Each of these symptoms showed reduction in intensity based on pre-post mean scores. The intensity of symptoms was reduced from pre to post by the following percentages; nausea 61%; headache, 58%; tension-anxiety, 54%; pain, 53%; depressed mood, 49% and fatigue, 47%. A one-sample t-test (pre-post) was performed and all the results were statistically significant at P<.0001.
An inspection of the patient-reported symptoms showed that such symptoms frequently were not associated with the disease, only occasionally associated with the treatment (i.e. nausea from chemotherapy), and were clustered under what could be called psychosocial stress (a result of disease, hospitalization, and experimental treatment) secondary to primary diagnosis. Since both the room and program name were titled "relaxation," the author felt that changes in self-reported symptom intensity would be far from "leading" (not telling us what they thought we wanted to hear). Still, patients seemed to find a way to give us answers we wanted to receive. That kind of willingness, plus the nonrandom selection and lack of control group, should give rise to suspicion as to our results.
This program evaluation data yielded descriptive information showing symptom reduction over the period of a single 45-minute VAM session. Having conceived this program evaluation as an initial exploration, the researcher offered no initial hypotheses. The robustness of these salutary results, however, affords the opportunity to at least speculate on what might be going on during VAM.
The power of the relaxation response may yet to be fully documented. Hypnotic trance states have been used to help patients successfully through difficult medical procedures, such as surgery, with considerable less post-surgical complications and reduced recovery time. The whole area of mind-body medicine struggles with hypothesis development that requires an expanded view of reciprocal causation in the sympathetic and parasympathetic systems.
Another speculation offered is the role of the placebo effect and positive expectations. Our focus on the relaxation response (name of the room, program name, and asking for relaxation ratings) was helpful in minimizing any expectation for symptom reduction. Still many patients are given to please their caretakers and we might well have measured a response bias. The placebo effect has been measured as strong as 30 – 60%. It is clearly a real effect and ought to be optimized rather than ruled out. Even double-blind, random selection studies are unable to factor out the placebo effect; therefore, we acknowledge and embrace this limitation.
The focus of this study touches on the role of music/vibration in human adaptation. In some way, music/vibration of certain frequencies, intensities, rhythms, etc., might be implicated in the body's regulatory mechanisms. In general, most hospitalized patients could benefit from some form of down-regulation of "sympathetic tone" (an interesting phrase in this discussion). The researcher entertains the notion that multiple mechanisms of the body may use music/vibration to regain a healthy homeostasis. Indeed, Chesky has suggested that pacinian corpuscles, excited by vibrations of certain frequencies, may mediate pain and other noxious stimuli.
Disease can be seen as the inability of the human organism to cope with or handle disturbances insulting to its homeostatic systems. The science of medicine is being reshaped by the role of molecular messengers that communicate to regulatory mechanisms in ways that are well beyond our understanding of the "hard-wired" nervous system. The blood-brain barrier has become about as relevant as the Berlin wall. If the super-high-frequency vibrations of light effect our mood states and biological time clocks, how far afield is it to suspect that music and vibration (at much lower frequencies) have effects on psycho-neurophysiology?
In the future, when this program evaluation develops into a more carefully conceived research study, with attention to patient selection and assignment, an attempt at a control condition, and a range of calibrated dosage levels, our research team will be in a better position to make stronger claims generalizability. Nonetheless, sufficient data were generated to indicate that many patients using VAM experienced a deep relaxation response and reduced their symptom burden. Clinical impressions by the group of five recreation therapists were commensurate with the statistical significance reported. Having some personal control of their symptom burden pleased most patients. This positive outcome was used to point out that patients could clearly benefit by regular practice of an effective relaxation technique. Patients were given additional training in the "Art of Relaxation; class, through individual instruction, or by readings.
The present results suggest the value of using VAM to induce the relaxation response in order to reduce the symptom burden of hospitalized patients. These findings point to an avenue of future research using careful selection assignment, controls, variable dosage, and longer follow-up periods to test the durability of VAM interventions. Perhaps Brian Wilson was more right than he knew when he recommended that we would do well to "Keep good vibrations a happenin' to me."
Table 1 - Symptom Change from a Single VAM Session
|Symptom (N)||Pre||SD||Post||SD||% Diff||P|
|Tension (74)||67.9||19.9||31.2||19.9||54.00||< .0001|
|Fatigue (60)||72.2||17.5||38.0||22.6||47.36||< .0001|
|Pain (46)||65.0||20.3||30.3||18.1||63.33||< .0001|
|Headache (24)||60.5||20.8||25.7||19.9||57.64||< .0001|
|Depression (18)||71.0||19.8||35.9||19.3||49.45||< .0001|
|Nausea (16)||67.3||20.7||26.3||50.5||60.97||< .0001|
|Other (29)||62.0||19.4||27.1||22.5||56.27||< .0001|
|Combined (267)||67.2||19.7||31.5||20.7||53.04||< .0001|
The author wishes to acknowledge assistance in data collection and clinical expertise of the following recreation therapists who, with him, run the relaxation room: Sharon Ballard, Jane Ganz, Cindy White, Linda Scimeca, and Jim Ebel. Mark Mattiko helped with data analysis. George Patrick serves as chief of recreation therapy in the Rehabilitation Medicine Department, Clinical Center, of the National Institutes of Health. He earned his Ph.D. at the University of Illinois. His professional career as a recreation therapist spans five states and a wide variety of clients. Dr. Patrick plays golf, rides a sport motorcycle, serves food to the homeless in Washington, DC, and is enjoying grand fatherhood. With his wife, Jane, he enjoys music of the National Symphony and sings in a church choir.
Address for Correspondence:
Dr. George Patrick, NIH, 10 Center Drive, MSC 1950, Bethesda, MD 20892
Telephone: 301-496-2278, Fax. 301-402-2388
"'GOOD VIBRATIONS' MAY PREVENT BONE LOSS IN SPACE"
Dwayne Brown Headquarters, Washington
Oct. 1, 2001
University of New York, Stony Brook
New NASA research suggests bones that are slightly shaken may help astronauts stay healthier during long space flights, and could be used to help people suffering from bone loss here on earth.
Scientists funded by NASA and its National Space Biomedical Research Institute in Houston uncovered evidence that barely perceptible vibrations may stimulate bone growth, which would benefit astronauts on extended space missions, the elderly here on the ground, and other people immobilized by paralysis or bed rest.
A team of researchers, lead by Dr. Clinton Rubin of the State University of New York at Stony Brook, discovered that normally active animals exposed to 10 minutes per day of low-magnitude (.25g), high frequency (90 Hz) vibrations experienced increased bone formation when compared to the control group.
In addition, when animals prevented from regular, weight-bearing activity, were exposed to 10 minutes of vibrations per day, bone formation remained at near-normal levels. However, animals not exposed to the treatment, but participated in 10minutes of weight-bearing activity each day, still exhibited signs of significant bone loss.
While preliminary results are encouraging, "a full clinical study must be completed to demonstrate the effectiveness of using vibrations to recover bone mass and architecture in people with osteoporosis or to prevent the bone loss known to occur in astronauts during long duration space flight," Rubin said.
"The technique works by stimulating the bones' stress that are placed on them," said Dr. Bruce Hather, a muscle specialist at NASA Headquarters Office of Biological and Physical Research in Washington. "The people you see working out with barbells at the local gym typically have larger muscles and stronger bones than someone who does little or no exercise."
While researchers do not fully understand the physiological mechanism at work, the vibrations appear to fool the bones into thinking they are working hard. This results in the retention, and even additional growth, of bone tissue. This research may be particularly useful for long-duration space missions of the future.
The absence of mechanical stimulation to bones and muscles in micro gravity leads to substantial bone loss and muscle weakness in astronauts. In flights lasting four to six months, astronauts can lose bone mineral density approaching 1.6% per month.
Although there has not been enough long-term research to determine if such rates of bone loss would continue, scientists estimate that during a two and a half-year round trip mission to Mars, astronauts could lose up to half of their bone density from specific parts of the skeleton. This could seriously jeopardize an astronaut's health on return to Earth.
At the same time, current astronaut exercise regimes for long-duration space missions are time consuming, eating away at valuable crew time. Low-level vibrations may offer a countermeasure for this condition without the need for a medicinal Intervention.
Other members of the research team include Gang Xu and Stefan Judex, both of the State University of New York at Stony Brook.
Type of Facility:
Head Injury Recovery Services
Patient Population using the Somatron:
Neurologically impaired, head injured clients
Date of Reported Experiences:
Improvements in muscle tone/muscle tension. Reductions in agitation and pain.
Individualistic to suit client needs. Music with a forward tempo, a non percussive, full melody and a gradually changing base line was reported to be the most effective.
Jan M. Shuler, MT-BC
A Somatron recliner was introduced through Music Therapist Jan Shuler, MT-BC, to Rebound, Inc., a facility that provides head injury recovery services. During a demonstration of the product at the facility, Ms. Shuler reported the following successful findings with some of the facility's clients:
Client A: was reported to be normally "extremely off task and agitated". This client was noted to be on task for 10 of the 25 minutes of his Somatron session, his muscle tone was observed to decrease dramatically and he did not want to get up at the end of the session. Client A was very complementary about his experience with the Somatron describing it as "incredible" and reporting that his thoughts were clearer.
Client T: was provided with an opportunity to try the Somatron recliner and experience his favorite type of music, Reggae, vibrotactily. This client was observed to smile spontaneously during the session. Client T was reported to show a decrease in "muscle tone" which appeared to provide him with a better ability to move and at times he appeared to be "dancing" to the music.
The decrease in muscle tension that Client T was reported to experience was found to be commonly experienced by other clients at the facility. Ms. Shuler reported that 100% of those clients with high muscle tone experienced a decrease after using the Somatron. One particular client whose arms were drawn tightly into his chest and were "resistive to passive range of motion" exercises, was able to extend his elbows to -30 degrees while he was in the Somatron recliner.
Two other clients were also found to gain positive benefits from the use of the Somatron. These particular individuals were observed to transition from an agitated, moaning and pained state to a state of deep sleep only 5 minutes into the session.
Brain Fitness Center
Type of Facility: Brain Fitness Center
Patient Population using the Somatron:
Individuals suffering as a result of recent war activity. Students.
Date of Reported Experiences: August 1998
Primary Findings: Initial findings are reportedly positive.
Music Used: Not reported
Dr. Petar-Kreslimar Hodzic
Brain Fitness Center - Mateau
HRVATSKE - CROATIA
Phone: 385-1-4817 192
Staff at the Brain Fitness Center in Croatia have been using Somatron equipment with individuals attending the facility. The center offers both individual and group programs that are primarily aimed to improve cognitive functioning and the general overall well being of these individuals. The work at the center has received media interest and attention and has consequently been included in education broadcasting. The Brain Fitness Center expanded to collaborate with the School of Medicine at the University of Zagreb as well as with the Croatian Institute for Brain Research and the Croatian Medical Student International Committee (croMSIC). The initial goal of the center was to focus on providing healing for the "wounds of recent war". With their work already showing signs of success at this early stage, the staff report that they are hopeful they will meet their goal as their work progresses. More recently the center has begun to focus on a new issue. After conducting surveys, staff identified a possible link between students' health deterioration and their educational experiences. In order to investigate this further, a research project is being developed that will introduce a pilot group of students to relaxation and anti-stress methods in an attempt to see whether their stress levels decrease and also whether there are any positive effects on cognitive functioning (e.g. memory and learning). This project is currently ongoing and has received support from a number of other facilities and organizations (see "New and Ongoing Research" section for more details).
Effectiveness of Vibroacoustic Music for Pain and Symptom Management in Outpatient Chemotherapy Treatment
by Chris Brewer, MA, FAMI and Valerie Coope, RN, AOCN
Vibroacoustic Music for Pain and Symptom Reduction in Chemotherapy
The goal of modern medicine is unquestionably to provide patients with life-saving and/or life-improving treatment of injury or illness. Current discoveries about mind-body connections reveal that the state of mind has a great deal of effect upon the success of medical treatment. Much of this research indicates that the ability to attain a state of relaxation aids the healing process (1, 2, 10). The initiation of this relaxation response is a goal in various holistic health methods, including Tai Chi, guided visualization and mental imaging, Yoga and music therapy. Vibroacoustic music (VAM), music that is designed to be felt through tactile stimulation as well as heard, has been noted as a highly effective method of eliciting the relaxation response and other emotional and physiologic changes beneficial in medical settings (3,5, 7, 11).
Vibroacoustic music is generally administered through speakers built into a mattress, pad, recliner, or table. The sound is heard via these speakers or may also be channeled through headphones. The listener feels the music in his or her body as well as hearing it through normal auditory processes. This vibration and the innate musical properties of anxiolytic (anxiety-reducing) music are able to assist listeners in reaching slower brainwave states (alph/theta and possibly delta) as well as being able to trigger physiologic states of relaxation demonstrated by various physical measures (4, 6, 8, 9). This particular method of stimulating the relaxation response may have great application in hospitals and other care facilities due to its ease of administration, non-invasiveness and overall pleasing effects.
The Ella Milbank Foshay Cancer Center implemented a vibroacoustic music program in the Winter of 2000 with the goal of reducing patient pain and symptoms resulting from cancer and cancer treatment. Results of this Foshay evaluation of 41 sessions revealed 61% to 74% decrease of pain and symptoms in cancer patients. The project focused on the use of vibroacoustic music (VAM) to elicit the relaxation response and assist in pain and symptom management. This project was based upon a program developed by Dr. George Patrick at the National Institute of Health (NIH). Results of a program evaluation at the NIH site demonstrated reduction in pain and symptoms for hospitalized patients by 47.36% to 60.97% with a combined reduction of 53.04% ("The Effects of Vibroacoustic Music on Symptom Reduction" IEEE Engineering in Medicine and Biology, March/April 1999).
Chris Brewer, affiliate and Arts Therapy Project Director of the Mind Body Institute of Jupiter Medical Center, developed and coordinated the program and study at the Foshay Cancer Center. Assistance with program development and structuring of study parameters was provided by Dr. Patrick, NIH. Additionally, statistical analysis of the compiled data from the Foshay program was provided by the NIH.
All outpatient chemotherapy and radiation therapy patients and cancer survivors were offered the opportunity to experience a VAM session as a tool for the reduction of pain and symptoms resulting from cancer and cancer treatment. No charge was made for the service and patients could have as many sessions as they desired. The vibroacoustic sessions were monitored for results during a 5-week program evaluation period. The program is ongoing and data continues to be gathered for continued evaluation.
Information about the Foshay vibroacoustic music program was offered to three cancer support groups and at a public open house. Chemotherapy and radiation therapy nursing staff were trained in the use of vibroacoustic music. Nurses introduced patients to the vibroacoustic music program and were primarily responsible for assisting patients during the sessions. Additionally, the Arts Therapy Project Director for the Mind Body Institute spent 6 hours per week administering the program and assisting patients with sessions.
Interested patients were scheduled for one-hour sessions that included a brief introduction to vibroacoustic music, a 30- to 40-minute music session and a 5- to 10-minute debriefing. An evaluative survey was administered pre- and post-session to each patient. The BETAR (Bio-Energetic Transduction Aided Relaxation) model of vibroacoustic table was used for the program. Anxiolytic music played for all first sessions was the TheraSound "Balance" recording specifically designed for vibroacoustic use. Additional sessions used either "Balance" or the TheraSound recording entitled "The Musical Body-Harmonizer." Headphones were available but not mandatory. The vibroacoustic sessions were provided in a room specifically designated for this program. Information about the National Institute of Health program evaluation on vibroacoustic music and a handout on relaxation techniques was available to patients.
The program evaluation yielded data from the use of the BETAR vibroacoustic table using anxiolytic music with 27 adult patients at the Ella Milbanks Foshay Cancer Center, a department of Jupiter Medical Center. Data was compiled from 41 of 45 observations. Four sessions were not used as data was incomplete in both pre- and post-evaluations. Subject ages ranged from 33 to 78 with an average age of 61 overall, 58 for females and 64 for males. Data for statistical analysis was taken from 23 of the 27 patients, 13 female and 10 male.
Patients represented a convenience sample of individuals volunteering for a vibroacoustic music session. Patients were recruited from 1) nurses referral in either the Chemotherapy or Radiation Therapy departments, and 2) patient response from information about the program via printed materials, word of mouth, or demonstration during a cancer-related support group meeting. The patients had various cancer diagnosis and were either in treatment at the time or were cancer survivors. One patient was a hospital volunteer experiencing back pain. Of the 45 sessions in the evaluation sampling, 18 were repeat sessions. Patients completed a range of one to seven sessions with an average of 1.7 sessions per patient. Four women and three men completed more than one session, representing 26% of all patients. As no attempt was made to develop a meaningful control group, this paper reports as a program evaluation rather than a comparative study.
Measurements and Variables
Data for this study was gathered from two patient self-report instruments provided by George Patrick of the National Institute of Health. These measurement tools were completed immediately before and after the vibroacoustic session. The tension/relaxation state of the patient was measured using the Poppin "Self-Report Rating Scale for Tension and Relaxation." This instrument lists seven statements regarding tension/relaxation state. Patients select the statement most accurately describing their state at that moment, both pre- and post-session. Twenty-two patients completed this rating scale in 39 of the session reports. This scale was used as a comparative value for the symptom intensity. A visual-analog scale was used to measure effects upon pain and symptoms.
The patients' state of relaxation was measured using the seven-point Poppin Self-Report Rating Scale for Tension and Relaxation. With an N=39, the pre-rating was 5.23 (5 is described in the scale by the words "Feeling Some Tension in Some Parts of My Body") while the post-rating was 2.84 (3 is described as "Feeling More Relaxed than Usual). This represents a 34% reduction of tension during the vibroacoustic sesson, a statistically significant difference.
Patients reported several symptoms on the symptom intensity evaluation. They were: anxiety, pain, fatigue, nausea, headache, tension, anger/hostility and a category compiled as miscellaneous symptoms. No suggestion was made to patients about symptoms to consider in the evaluation. Anxiety, pain and fatigue were the symptoms listed most frequently in this evaluation.
The symptom intensity scale used was an anchored, unmarked scale of 100. An aggregation of all symptom data showed an average participant pre-session rating of symptom intensity of 62.505 (+ or -3) and a post-session rating of 22.206 (+or - 2). Data determined a 64% cumulative reduction of symptom intensity for all symptoms reported. The evaluation provided patients the opportunity to list and rate three symptoms. In an analysis of the three most frequently reported symptoms, the intensity of symptoms were reduced as follows: Anxiety (N = 36) was cumulatively listed as 68.500 (+ or - 4) in pre-ratings and 25.500 (+ or - 2) in post-ratings, representing a 62.8% reduction of anxiety. Pain symptoms (N = 23/20) were pre-rated as 52.783 (+ or - 4) with a concluding rating of 20.250 (+ or - 3) and an improvement in pain intensity of 61.6%. Fatigue symptoms (N = 12) were rated pre-session as 60.500 (+ or - 6) and rated post-session as 15.583 (+ or - 4) demonstrating a 74.3% reduction of fatigue symptoms. All results were performed as unpaired t-tests and were statistically significant at P< .0001.
Statistics were also determined for the other reported symptoms. These symptoms had sample sizes of four to seven and demonstrated between 47% and 89% reduction of intensity.
All statistics reported here for symptom intensity were analyzed by the National Institute of Health from the data compiled by Chris Brewer, Arts Therapy Project Director.
Symptom Intensity Change from a Vibroacoustic Music Session
|Symptom (N)||Pre||SD||Post||SD||% Diff||P|
|Pain (23 pre, 20 post)||52.78
The program evaluation yielded descriptive data gathered immediately prior and post-VAM session. No attempt was made to use a meaningful control group or to design this as a comparative study. There was also no attempt to alter variables to isolate or determine critical elements for program success. Additionally, neither the Foshay or NIH programs evaluated long-term effects. Both measured pain and symptom reduction immediately following the VAM session. Future research on length of effect would be quite valuable as would studies investigating specific variables in VAM for pain and symptom reduction.
Results of the Foshay evaluation of 41 sessions revealed 61% to 74% decrease of pain and symptoms in cancer patients. The NIH program demonstrated 49% to 61% reduction from 267 patients. It is possible from these program evaluations to make conjecture that the use of vibroacoustic music is indeed, effective, for pain and symptom management in oncology and other hospital settings. Though the Foshay program was based upon the success and structure of the National Institute of Health VAM program, differences in program structure existed which are important to note.
The NIH program is based in a Recreation Therapy department of a medical center. On-staff recreation therapists assist patients in the VAM session and are available at all times to assist patients as their primary duty. The therapists facilitate the VAM session by providing an explanation of the process and procedure and also lead the patient through a brief guided relaxation to assist the patient in attaining the desired relaxation response. The music portion of the VAM experience is 25 minutes long and is followed by a short debriefing. A recreation therapist is with the patient for the entire length of the experience.
At the Foshay Cancer Center, no staff is available to facilitate VAM sessions in the manner available at the NIH. Nursing staff at Foshay, as in most hospital settings, feel pressured for time to perform their varied duties. The VAM program was therefore set up so that nursing staff could use the vibroacoustic music as a part of their nursing care in a manner that demanded as little time as possible. Therefore, the Foshay program evaluated the potential of using vibroacoustic music as a nursing care tool as much as it evaluated the ability of vibroacoustic music to manage patient pain and symptoms. It became clear during this program evaluation that it is viable for nursing staff to integrate the use of vibroacoustic music as a nursing care method under a program designed to accommodate the multi-tasking of most nursing positions. Foshay nurses voiced some initial concern about the amount of time the vibroacoustic music program would take to implement. However, the nurses were successful in being able to add the VAM sessions into their tight time schedule without unduly affecting their effectiveness in other duties. Several nurses shared personal stories of patients who were greatly aided from the VAM sessions and for whom the nurses felt highly pleased to have been able to help. In a post-study meeting and in surveys filled out by nursing staff, the nurses indicated that they felt the VAM sessions helped them to fulfill their role of carrying for patients' overall well-being. The implication of this discovery is the potential for this program to be duplicated in other hospital and care facilities that do not have recreation therapy departments or on-staff music therapists but whose role it is to provide extended nursing care services. It is important to note that all nurses facilitating VAM sessions in this program were trained in the use of vibroacoustic music. It is considered essential by the author that the facilitators of any form of therapy be trained in its use. As part of the nurses training at Foshay, the Arts Therapy Project Director spend six hours per week for five weeks facilitating the program, including troubleshooting any problems encountered by the nursing staff.
Issues of patient safety were also a consideration in this setting. Solutions for leaving patients alone during VAM sessions included the availability of an easily-accessed call button and the placement of the vibroacoustic equipment in close proximity to areas of high use where nurses have easy access for checking on patients. Nursing staff were made aware of situations in which patients might not be good candidates for VAM. These included patients whose condition required constant visual supervision, and patients with particular injuries or health issues: severe back problems which did not allow them to lay flat on the BETAR table, and certain head or neck injuries which might be adversely affected from the vibration.
The time constraints experienced by nurses also eliminated the possibility of having the nursing staff provide a pre-session guided relaxation exercise as is done at the NIH. Rather than attempt to add this task to the nurses busy schedule, the Foshay program was designed to compensate for the positive relaxation effect of the guided exercise by simply extending the amount of time patients spent experiencing the vibroacoustic music. The NIH program used 25 minutes of music whereas the Foshay program used 40 minutes for the first session when "Balance" was used (playing the 20-minute program twice) or 35 minutes for the "Musical Harmonizer" music session which was an option for patient use after the first session. It had been the observation of the Arts Therapy Project Director that deeper brain wave and relaxation states appeared to occur after 20 minutes on the BETAR. This observation was not scientifically tested. However, it was reasoned that by increasing the session to 35 or 40 minutes, patients had more opportunity to reach deeper levels of relaxation. The successful reduction of pain and symptoms in the Foshay program indicate that this strategy may indeed be effective. Again, no comparisons were made during this study but would be an important variable to research in the future.
The third and final difference in this program from the NIH program was the model of vibroacoustic table used. The NIH study used a Somatron recliner model designed for hospital use. The BETAR table was available for use at the Foshay Center. This is a flat table that also has differences from the Somatron in the distribution of sound delivery in the speaker system. Since both programs yielded significant reduction in pain and symptoms it could be assumed that there is no significant difference in effectiveness based upon the vibroacoustic equipment used. However, there could be merit in studying the two models to determine if any significant difference exists. One relevant item of note by the Foshay staff was their interest in experimenting with the use of a recliner system. Overall the nursing staff felt that a recliner had more practical application than did a flat table. Three points were important here: 1) the recliner position is usable by all patients, including those who might not be able to lay flat due to back problems, and 2) the recliner eliminates any concern about patients potentially rolling off of a flat table and 3) a recliner feels less "medical" and creates a mental attitude of greater comfort. It should also be stated that a recliner allows the patient to be in the trendallen position, that of having the knees slightly bent and elevated. There is some indication that this position may be beneficial in triggering the relaxation response. Further research would be necessary to determine the significance of this position.
Based upon the success of the Foshay and NIH program evaluations, it is clear that vibroacoustic music can indeed offer patients assistance in attaining a relaxed state and reducing pain and symptoms in medical situations. Additionally, the Foshay Cancer Center program offers a model for developing vibroacoustics as a nursing tool. Refinement of program design would be beneficial as would future research into specific aspects of the application of vibroacoustic music in pain and symptom management.
The author wishes to acknowledge the assistance of Dr. George Patrick and Mark Mattiko of the National Institute of Health for their advice, direction, and assistance in program development and statistical analysis. Appreciation is also extended to the fine nursing staff and administration at the Ella Milbank Foshay Cancer Center of Jupiter Medical Center for their willingness to experiment and participate in this program.
1. Benson, Herbert and Miriam Z. Klipper. The Relaxation Response. New York: Avon Books, 1976.
2. Benson, Herbert and William Proctor.Beyond the Relaxation Response. New York: Berkley, 1985.
3. Dileo, Cheryl. The Context of Music and Medicine, Music Vibration, Tony Wigram and Cheryl Dileo, eds. Missouri: MMB Music, Inc., 1997.
4. Hodges, D. Handbook of Music Psychology, San Antonio: Institute for Music Research Press, 1980.
5. Patrick, George. The Effects of Vibroacoustic Music on Symptom Reduction, in IEEE Engineering in Medicine and Biology, March/April 1999.
6. Rider, Mark. The Rhythmic Language of Health and Disease. Missouri: MMB Music, Inc.1997.
7. Standley, J.M. (1991). The effect of vibrotactile and auditory stimuli on perception of comfort, heart rate, and peripheral finger temperature. Journal of Music Therapy, (28) 3, 120-34.
8. Taylor, Dale B. Biomedical Foundations of Music as Therapy., Missouri: MMB Music, Inc.1997.
9. Wedlin, C and Eagle, C.: An Historical Overview of music in medicine, in C. Maranto (ed) Applications of Music in Medicine. Washington DC: National Association of Music Therapy, 1991, pages 7-27.
10. Weil, Andrew. Health and Healing: Understanding Conventional and Alternative Medicine. Boston: Houghton-Mifflin, 1983.
11. Wigram, Tony. The measurement of mood and physiologic responses to vibroacoustic therapy in non-clinical subjects, from Music Vibration, Tony Wigram and Cheryl Dileo, eds., Missouri: Magna Music Baton Books, 1997.
"The Effects of Vibrotactile Stimulation via the Somatron
on the Relaxation, Tension, Pain, and Mood Levels of Chronic Pain Patients"
Source: Unpublished pilot research project
Capitol Medical Rehabilitation Hospital
Under the supervision of Dr. Jayne Standley
Department of Music Therapy
Florida State University, Tallahassee, FL
Date: Fall, 1993
Catherine L.W. Szuch, MM, MT-BC
Research conducted under the name of Catherine L. Walters
This research consisted of a pilot investigation carried out with four adult, male, chronic pain patients. Each patient received twenty minute sessions of vibrotactile stimulation via a Somatron table using music that reflected their individual musical tastes. Patients rated their levels of pain on a 0-7 scale (0=no pain, 7= extreme pain) both before and after their session(s) with the Somatron. Generally, the patients did appear to gain some pain relief reporting slightly lower pain ratings at the end of their session(s) than they did before their session(s) started. The findings were not statistically significant, however, the number of patients that participated was small.
"The Effectiveness of the Somatron to Enhance Relaxation"
Unpublished research paper
St. Mary's Hospital, West Palm Beach, Florida
Chuck Feeman, M.M., RMT-BC
901 45th Street, PO Box 24620
West Palm Beach, Florida 33416-4620
Twenty individuals, patients and staff of a psychiatric facility, experienced fifteen minutes of music, vibrotactily, via a Somatron recliner. Twenty similar individuals experienced the same fifteen minutes of music, non-vibrotactily but under the same environmental conditions, while sitting in an ordinary reclining chair. The study's participants reported an overall reduction anxiety following the music regardless of how it was presented. These reductions in anxiety were found to be statistically significant. The researcher reported however, that the reduction in anxiety experienced by the individuals using the Somatron was greater than that experienced by the individuals listening to music via a cassette player while sitting in the recliner. This difference between the groups was also found to be statistically significant.
"Clinical Trial of a Music Generated Vibrotactile Therapeutic Environment for Musicians:
Main Effects and Outcome Differences Between Therapy Subgroups"
Published Journal Article
Journal of Music Therapy, XXXIV (1)
1997, p. 2-32
North West England
Dr. Warren Brodsky, CMT/RMT-BC
Department of Behavioral Sciences
Ben-Gurion University of the Negev
POB 653, Beer-Sheva 84105, Israel
Having identified the prevalence of performance anxiety amongst professional musicians, the authors of this study compared a "music enhanced therapy", that utilized vibrotactile stimulation via a Somatron recliner along with traditional counseling techniques, with counseling alone, and counseling in combination with music. Each of the three counseling techniques were found to benefit the musicians who reported reduced levels of anxiety, improvements in mood, and a reduction in the amount of pressure they reportedly felt before performing. The positive effects of the counseling interventions were also found to still be present 2 months after the study had been completed.
"The Effects of Whole Body Acoustic Stimulation on Subjective Relaxation, Verbalization,
and Visual Imagery among Professional Orchestra Musicians"
Paper presented at third triennial ESCOM conference, Uppsala, Sweden
Location: North West England
Date: 1997 (Research presented June 1997)
Dr. Warren Brodsky, CMT/RMT-BC
Department of Behavioral Sciences
Ben-Gurion University of the Negev
POB 653, Beer-Sheva 84105, Israel
This study followed Dr. Brodsky's prior research "Clinical Trial of a Music Generated Vibrotactile Therapeutic Environment for Musicians: Main Effects and Outcome Differences Between Therapy Subgroups" published in the Journal of Music Therapy (See previous synopsis) and was presented at the Third Triennial ESCOM conference in Uppsala, Sweden.
Based on the results of the previous research, Dr, Brodsky and his research colleagues noted some differences in the responses of musicians using a Somatron recliner. These differences were found in the responses of these musicians to relaxation, verbalization, and visual imagery interventions implemented to deal with stress. Dr. Brodsky and his colleagues reported that they felt that the differences they observed could be attributed to "whole body stimulation" i.e., applying the vibrations of music to large surface areas of the body.
In order to look at this idea further, Dr, Brodsky and his colleagues designed another study to look specifically at the differences they had found previously.
Dr Brodsky approached professional orchestra musicians to volunteer to participate in this study by sending out questionnaires to orchestra management personnel at three cities in North West England. Fifty four professional musicians agreed to participate in the study. The average age of the musicians was 36 years and there were about equal numbers of men and women volunteering. The majority of the musicians were string players.
The study matched the volunteers both between as well as within the three different cities in an attempt to make sure that the musicians at each different location were similar for comparison.
Each participating volunteer was assigned at random to one of three study conditions:
Each musician, regardless of group, received 8, individual, 50 minute relaxation sessions over a period of 8 weeks. At the beginning and end of every session, the musicians completed copies of the questionnaire "Profile of Mood States" (POMS).
At the end of the study, the researchers found several statistically significant results showing that patients experienced a reduction over time of tension-anxiety, depression-dejection, anger-hostility, and confusion-bewilderment. However, these results were found in all groups indicating that all three of the relaxation programs were beneficial to the musicians that participated. Dr. Brodsky and his colleagues then looked more closely at the specific relaxation interventions to see if differences between the three groups could be identified. Differences between the groups were noted as follows:
Verbal Relaxation: Musicians assigned to the Somatron group were found to have more emotional responses to this intervention, some individuals were reported to experience unexpected "flooding " of emotions, other times musicians reported that they were elevated to a "peak".
Verbal Conversation: Musicians were asked to talk about the meaning and impact that music had had in their lives prior to and during the process of becoming a professional musician. Both the musicians assigned to the "Music" group and those assigned to the "Somatron" group were found to give much more in-depth and emotional descriptions of their experiences. The musicians assigned to the "Verbal" group seemed rather to provide much shorter and less in-depth explanations.
Visual Imagery: This exercise involved various imagery exercises including having musicians visualize performing on stage. The researchers noted that only musicians assigned to either the "Music" or "Somatron" groups actually reported feeling sensations as if they were actually performing on stage.
Dr. Brodsky and his colleagues concluded that music as well as music vibration appeared to both enhance the experience of imagery as well as evoke more memories and associations. Comparing the "Music" and the "Somatron" musicians further, the researchers found that the imagery of the musicians in the "Music" condition was both shorter and mono-thematic than that of the musicians in the "Somatron" condition.
Dr. Brodsky discussed the limitations in the methods they used to interpret the sessions with the musicians as possible reasons for the limited statistical significance. However, he also pointed out that his findings were consistent with the findings of other researchers who have reported that the effects of using the Somatron may be more subtle and indirect.
Rexation Techniques: A Combined Approach to Reduce Muscle Tension
"Music and Relaxation Level"
Unpublished research paper completed during a degree program at the University of Miami
University of Miami, Miami, Florida
Date: September, 1986
Jose Hernan Serra
Twelve college students participated in this research project which looked at the success of the Somatron in reducing muscle tension. All students received a relaxation session using a Somatron. One group of students were presented with a selected piece of "soothing music", a second group of students were presented with a pre-recorded muscle relaxation program, and the remaining group of students were presented with the pre-recorded relaxation program and soothing music at the same time. Electromyographic equipment (EMG) was used to measure the muscle tension of the students. The researcher found that the students using the soothing music with the Somatron had a tendency for increased muscle tension whereas the students using the pre-recorded relaxation program with the Somatron and those using the relaxation program and soothing music together with the Somatron had a tendency for reduced muscle tension. The results were not found to be statistically significant and in fact were reported to be somewhat contradictory to verbal reports provided by the students. The students that used the soothing music with the Somatron reported that they felt a good degree of relaxation, despite the fact that their muscle tension was found to increase. Similarly, the students using the pre-recorded relaxation program with the Somatron felt that the program itself caused them to experience an increase in tension, despite the fact that their muscle tension was found to be reduced. The researcher suggested the small number of students involved in the study and the lack of adequate control over noisy distractions and other interruptions during the study as possible suggestions for the discrepancies that were found.
Type of Facility: Private psychotherapy practice
Patient Population using the Somatron: Patients receiving psychotherapy
Date of Reported Experiences: February, 1992
Primary Findings: Relief of tension, anxiety, stress and tiredness. Assistance in the processing of information. Relief of pain.
Secondary Findings: Speeding up the course of psychotherapy and encouraging more focus during that therapy.
Music Used: "Cassette programs created specifically for the Somatron"
Music selected individually by clients.
Contact Information:Patricia H. Berne, Ph.D.
5201 MacArthur Terrace, N.W.
Washington, D.C. 20016
Dr. Patricia Berne, a practicing Clinical Psychologist, offered a Somatron to some of her patients to use following Psychotherapy sessions. After observing these patients, Dr. Berne reported several benefits of using this intervention as a complement to her therapy. Those patients using the Somatron appeared to become more "centered", were able to release tension, tiredness and pain (mostly headaches and muscle soreness), and also became more energized and refreshed.
Dr. Berne encouraged her clients both to rest on the Somatron by themselves as well as to use the experience to integrate and process anything that may have come to light during the course of their therapy. Along with using the Somatron to assist in the integration and processing of information, Dr. Berne encouraged those clients who were experiencing tension, anxiety and stress to use the Somatron between their scheduled Psychotherapy sessions. When used in this manner, she reported that the Somatron had a calming effect. In addition, Dr. Berne observed that those clients taking advantage of the opportunity to use the Somatron seemed to progress through her therapy "faster and with more focus".
"Music and its Effects on Mood"
Unpublished research completed in partial fulfillment of the requirements for BA Program
Florida State University
Under the supervision of the Center for Music Research
Catherine L.W. Szuch, MM, MT-BC
(Research conducted under the name of Catherine L. Walters)
This study looked at the mood of twenty-nine college students before and after they experienced one of three current popular songs...
...either vibrotactily via a Somatron or non-vibrotactily via a stereo system. All participants rated their mood using the Multiple Affect Adjective Check List (MAACL). The author found that the students who used the Somatron reported a greater general improvement in their positive mood state after experiencing the music than similar students who experienced the same music via a stereo system. This finding was statistically significant (p<0.001) for the song "So Hard to Say Goodbye. Similarly, students that were presented with the Kenny G selection via the Somatron reported feeling a greater reduction in depression following the experience than those experiencing the same music via a stereo system. This finding was also statistically significant (p<0.05). It appeared that the vibrotactile experience of the Somatron affected the mood state of college students in an overall more positive way than when the same songs were experienced via a stereo system. When asked, the vast majority of the students said that they enjoyed their experiences with the Somatron, would repeat it if they had the opportunity, and would recommend it to others. In addition, the students generally felt that it enhanced their experience of the particular song that they heard.
"The Effects of a Vibrotactile Device, Somatron, on Physiological and Psychological Responses:
Musicians versus Non-Musicians"
Source: Published Journal Article
Location: Florida State University
Center for Music Research
Contact Information: Dr. Clifford K. Madsen, Dr. Jayne M. Standley, and Dianne Gregory
Florida State University, Tallahassee, FL
This research consisted of two studies that compared the responses of musicians and non-musicians to music experienced via a Somatron. During the first study, all participants (college students) were presented with two pieces of music, one simulative in nature, the other sedative. For half of the subjects, the speed of the music was altered gradually becoming either faster or slower. None of these participants, regardless of their musical background, reported being aware of the change. All students had their heart rate monitored during their session however, no statistically significant differences in the heart rate of musicians or non musicians were found. Students did report that they liked the experience and that they would repeat it in the future if given the opportunity. Some of them reported that they did not want to get up once the music was over. The students also reported that they found the experience to be both stimulating and relaxing at the same time. The second study was almost exactly the same as the first however, this time those participants who were going to experience the music with altered speed, were warned that something would be changing. Despite this preparation, the students were still not able to correctly identify what was different about their experience.
"The Effect of Vibrotactile and Auditory Stimuli on Perception of Comfort, Heart Rate, and Peripheral Finger Temperature"
Journal of Music Therapy, XXVIII (3), 1991, p.120-134
Florida State University
School of Music, Tallahassee, FL
Dr. Jayne M. Standley
Department of Music Therapy
Florida State University, Tallahassee, Florida
This study was carried out to compare how music and the sound of a dentist's drill, were experienced by college students when presented both via a tape player, and via a Somatron. One hundred and thirty college students participated in this study. The author found that, regardless of the type of sound, vibrotactile stimulation appeared to "blunt perception" and students reported that both their comfort and discomfort levels were reduced. When the sounds were experienced via the Somatron, students' temperature was more likely to increase which, when measured via the finger, has been shown to indicate improved relaxation. The increases in temperature were found to be statistically significant (p<0.05). Students using the Somatron appeared to be more likely to have an decrease in their heart rate following the first sound that was presented (regardless of whether it was the music or the sound of the dental drill) and then an increase when the second sound was presented . This was the reverse case for the students that heard the sounds via a tape player. Those students who used the Somatron reported that they generally liked the experience regardless of whether the dental drill or the music were presented, in fact the sound of the dental drill was preferred more when experienced this way. Males were found to prefer their experiences with the Somatron more so than females.
"The Effect of Vibrotactile Stimuli and Selected Music on Mood Descriptors Chosen by Music Majors"
Unpublished Research Paper
University of Kansas
Psychology of Music Laboratory
Rebecca A. Lord
This study looked at the effects of vibrotactile stimulation via a Somatron on the mood of college-age music students. Sixteen to twenty students participated in this research, half of whom listened to a selection of music while sitting in a chair that faced 2 speakers, the other half experienced the same music while lying on a Somatron. All students rated their mood both before and after the music was played. The test used to measure mood (Multiple Affect Adjective Check List (MAACL)) measured levels of anxiety, depression, hostility and also provided a total mood score. The students that used the Somatron reported a decrease in the number of negative mood responses at the end of their vibrotactile experience. The differences between the two groups of students were found to be statistically significant for both depression and total overall mood scores (p<0.05). The researcher concluded that "vibrotactile stimulation and selected music does have an effect on mood descriptors chosen by music majors".
"The Effect of Vibrotactile Stimuli on Subject's Descriptive Responses for Familiar and Unfamiliar Music
and Preferences for Music Listening Conditions"
Location: University of Kansas
Psychology of Music Laboratory
This research was carried out to look at the effects of vibrotactile stimulation via a Somatron on the words chosen by students to describe both familiar and unfamiliar pieces of music. Thirty psychology students participated in two separate music listening sessions. During one of these sessions, music was played via a stereo under "normal listening conditions", during the other session, the same music was experienced via a Somatron mattress. The researchers found that the students preferred the experience of using the Somatron over hearing the same music under "normal listening conditions". It was also found that the music that was unfamiliar to students was described differently when experienced via the Somatron when compared to "normal listening conditions". The level of bass recognized by students in the various pieces of music appeared to have an effect on the particular words chosen by the students to describe it. This finding was statistically significant.
"The Psychological and Physiological Effects of Vibrotactile Stimulation, via a Somatron,
on Patients Awaiting Scheduled Gynecological Surgery"
Published Journal Article adapted from Masters Thesis
Journal of Music Therapy, XXXIII (4), 1996, p. 261-287
Tallahassee Memorial Regional Medical Center
Under the supervision of Dr. Jayne Standley
Florida State University, Tallahassee, FL
Catherine L.W. Szuch, MM, MT-BC
Research conducted under the name of Catherine L. Walters
Thirty-nine women admitted to a medical facility for day case gynecological surgery participated in this study. Some of the women had opportunities to use a portable Somatron mat, using music that reflected their musical taste, immediately prior to having their surgery. Other women had opportunities to listen to the same music via a tape player immediately prior to having their surgery.
Both the women using the Somatron and the women listening to music via the tape player were found to spend less time in surgery than expected, less time in the post-anesthesia care unit, and received less post-operative medication than similar women who did not receive a musical intervention of any kind. These findings were all statistically significant (p<0.05). The same women also had a tendency for lower blood pressure following their musical experiences although this finding was not statistically significant.
The women who used the Somatron were found to experience lower reported apprehension (defined as combined ratings of their tension, anxiety, relaxation, stress, and mood) following its use than either the women who listened to music via a tape player, or the women who did not experience either.
This finding was also statistically significant (p<0.05). The women who used the Somaton were also found to have the least fluctuation in blood pressure throughout their surgery. Women rated their experiences with the Somatron positively stating that it "increased relaxation", "helped to ease anxiety", and provided a distraction resulting in "less time to focus on the surgical procedure".
Sound Body Wholistic Health Center
Dear Byron, I am the founder and director of the Sound Body Wholistic Health Center in St. Petersburg, FL. As a Licensed Massage Therapist, sound healing practitioner and distributor of Somatron products for over 15 years, I thought it time to share a little of my experience with Somatron products.
I have worked with clients with advanced cancer, chronic pain, rheumatoid arthritis, fibromyalgia, scoliosis, post-surgery, emotional trauma, Parkinson's Disease and a host of other conditions. Rarely have I seen a client who did not benefit in some way from this therapy. At the very least there are consistent reports of deep relaxation and reduced pain. It is my experience that the Somatron is also useful to increase circulation, reduce edema, as well as relieving stress, anxiety and depression. Many people who have reported having a headache when they come in said it disappeared during the treatment. Some people have reported dramatic pain relief from chronic conditions which have never recurred to the original severity even if they did not receive another treatment and the condition was not "cured". I have also seen clients have tremendous relief from acute injuries including reduction of swelling, increased range of motion and pain relief.
I have found that the effect of a Vibroacoustic Sound Therapy treatment is often long-lasting and profound on many levels- not just a panacea or a wonderful experience while it is happening which comes to an end when you get off the mat or recliner. (We have both at our center.)
I am also now certified through the Florida State Board of Massage Therapy to teach Continuing Education Courses to Licensed Massage Therapists in the state of Florida and am very excited to be able to bring this modality to other massage therapists. It is such an effective tool for deep relaxation allowing the therapist to work deeper without working harder. In fact it greatly reduces the physical strain on the therapist while bringing the clients level of enjoyment and benefit to another level altogether.
For those who are interested in learning more about sound therapy, vibroacoustic therapy or are interested in classes or private sessions my website is www.wholisticsound.com.
Thank you for what you do.
Sound Body Wholistic Health Center
5530 1st Ave N, St. Petersburg, FL 33710
Hydes Herbal Clinic
Type of Facility: Herbal Medicine Clinic
Patient Population using the Somatron:
Herbal medicine patients being treated primarily for pain
Date of Reported Experiences: July and August 1995
Pain Relief, reduced need for pain medication(s)
Improvements in sleep, improved walking, reduction in swelling.
Music Used: "The Musical Body Program", Therasound
Mr. Terry Walters, MNIMH
Hydes Herbal Clinic
68 London Road, Leicester, LE 2 OQD
Phone Number: 01144 116 254 3178
A Somatron mat was used by Medical Herbalist Mr. Terry Walters with two of his patients as a complementary therapy to standard Herbal treatments. Both of the patients that experienced the Somatron were having problems with the management of their pain.
Patient 1 presented to the clinic with severe abdominal pain, nausea and lethargy as a result of the effects of prolonged medication use. This patient received 4 sessions with a Somatron mat using the "Musical Body Program" which comprises a set of cassette tapes written to correspond to different areas of the body. Mr. Walters reported that patient 1 experienced a reduction in her pain, improvements in the quality of her sleep and also a reduction in swelling around her abdomen after using the Somatron.
Patient 2 presented to the clinic with lung cancer. After completing chemotherapy, this patient was still experiencing a marked amount of pain that was being controlled with the medication Morphine. This patient received Somatron sessions on two occasions again using the "Musical Body Program". After the first session, the patient reported a reduction in pain to the point where he could no longer feel any and at the next session he reported that the pain relief lasted well into the early hours of the next morning. This patient continued to experience pain relieving effects as he repeated sessions using the Somatron.
Type of Facility: Published Journal Article, The Harp Therapy Journal, Fall 2000
Location of Research: Silva Vocat Music Gallery , Bethlehem, Pennsylvania
Date/Year of Research: Concluded 1999
Sarajane Williams, M.A.
Silva Vocat Music Gallery
9 East 3rd Street
Bethlehem, PA 18015
This research was carried out by the author, Sarajane Williams, a psychologist who uses her harp in her practice. Ms. Williams wanted to look at the effects of combining the already beneficial effects of harp music with the vibrotactile sensations experienced via a Somatron. Specifically, she allowed patients to experience her harp music vibrotactily by playing it through a portable Somatron table. Twenty five patients aged between 13 and 85 years participated as subjects in this research. Five of the 25 patients were male and 20 were female.
Each patient was given the opportunity to receive 30 minutes of live harp music amplified through the Somatron table. The author lists 13 responses provided by the various participants in the study after their experience with vibrotactile harp music. These responses were as follows: localized tension / pain reduction; overall relaxation; increased body awareness / sensation / tingling; "flushed" feeling; floating sensation; feeling energized; sinus drainage; felt like they were dancing; felt restored / nurtured / indulged / protected; positive imagery / associations; affective release; myolclonic release.
The author reports that her findings were consistent with the findings reported in other vibroacoustic literature and suggests that more research be conducted in this area.
VIBROACOUSTICS - WHAT IS IT?
What is Vibroacoustic Music?
Vibroacoustics-from vibro-to vibrate-and acoustics---to hear-is an innovative technology in which music and/or sound vibrations are felt as well as heard. The sound vibrations are administered through specially-designed speakers or transducers built into a recliner, bean bag chair, mattress, pad, table or other equipment-even a floor and wall! There are numerous benefits to health and well-being from the experience of feeling the sound vibrations as you relax onto vibroacoustic equipment.
Vibroacoustic technology has experienced widespread use in hospitals, healthcare facilities, wellness programs, education, and corporate organizations as well as being used extensively in private settings. Vibroacoustic technologies were first developed in Scandinavia between 1970 and 1980 independently by Olav Skille and Petri Lehikoinen. The U.S.-based Somatron Corporation began distributing designs in 1985. Since then, the technology has continued to evolve with new and more refined designs. See the Somatron models in our Vibroacoustic Equipment catalog and links for other currently marked models in our Links section. Find out more about the history, technology development and research in our Articles section.
What are the benefits of vibroacoustic technology?
Research and clinical programs have reported that vibroacoustics provides a wide variety of mental and physical benefits. Vibroacoustics has been found to:
• reduce stress
• facilitate the Relaxation Response
• increase quality of life
• decrease the experience of pain
• reduce nausea, headache, anxiety, fatigue and depression
• calm and soothe restless behavior
• relax muscular hyper-tauticity
• improve range of motion
• promote muscle tone
• offer auditory and physical stimulation
• enhance communication skills
• develop sensory awareness
• promote a feeling of calmness
• enhance music appreciation
Research has provided clear data on these outcomes of vibroacoustics but there are other effects that have not yet been quantified or perhaps even identified. Scientific research continues to investigate the effects that vibroacoustics have on body chemistry, brain wave frequencies, pain suppression, and a number of other responses. This research will bring a greater understanding of the effects of sound vibration. Specific information about vibroacoustic effects and research is provided in our Research and Articles sections.
How does it work?
The physical experience of sound vibrations combined with the use of calming music in vibroacoustic therapy has beneficial effects both physically and psychologically. The mechanisms behind these effects are not fully understood although it is clear that the vibroacoustic music experience triggers the Relaxation Response, a mind/body response with a myriad of positive health benefits.
Olaf Skille, one of the original creators of vibroacoustic technology, presents a theory that builds on the work of Drs. Karel and Heda Jindrak exploring the concept that physical vibrations of sound provide an internal cleansing massage. Sound vibrations conducted throughout the body from our own vocal sounds (and vibroacoustic music) actually vibrate cells, organs, brain structures and tissues. It is speculated that this stimulation may help eliminate cellular wastes and assist in cleansing the body of these and other toxins. If this is true, vibroacoustic music and the vocal sounds we make may be the only ways we can actually get an internal massage!
Research has also demonstrated that vibroacoustics can work within the effective range of a vibration-induced, natural pain-suppressing mechanism of the Pacinian Corpuscles, pressure-sensitive nerve endings located in the subcutaneous and connective tissues surrounding visceral organs and joints. Kris Chesky, Director of Education and Research of the Texas Center for Music and Medicine at the University of North Texas, conducted research and correlated information about this natural process and vibroacoustics, reinforcing the concept that vibroacoustics can trigger this pain-mediating mechanism.
Existing scientific research helps us to understand why vibroacoustics can reduce stress, pain and disease symptoms but there is much more to learn. More in-depth information about vibroacoustic effects is provided in our Research and Articles section.
The Relaxation Response
A primary outcome of the vibroacoustic music experience is the facilitation of a state of deep relaxation. Triggered by what is called the Relaxation Response, this mental, physical, and emotional state is characterized by lowered blood pressure decreased heart, breathing, and metabolic rates and mind/body coherence. Harvard professor Dr. Herbert Benson, the founder of the Mind/Body Medical Institute at Boston's Deaconess Hospital, coined this term. He found that the Relaxation Response yields many long-term health benefits in addition to the immediate effects created during the experience. The relaxing effect of music alone is well-known and used extensively in music therapy.
The combination of relaxing physical vibration and soothing music is a dynamic method to trigger the natural healing mechanisms of our body!
What does the Relaxation Response do?
You can trigger the Relaxation Response in many ways. Tai Chi, meditation, prayer and Yoga are among the numerous wellness modalities known to facilitate relaxation. Regardless of the method used, the physical and mental changes are similar. When the mind becomes focused and free from intrusive, worrisome or anxiety-laden thoughts, the autonomic nervous system responds by stabilizing and down-regulating (slowing down) the heart rate, blood pressure and breath as well as relaxing muscle tone and reducing the production of stress hormones.
Physiologically, the relaxation response initiates the following changes:
· reduces oxygen consumption (hypometabolism)
· decreases blood pressure
· slows heart rate
· slows respiration rate
· relaxes muscles
Mentally, deep relaxation:
· changes brain wave frequencies (generally slowing down from beta to alpha and alpha to theta or delta)
· clears the mind from anxiety
· creates a feeling of calm and peacefulness
A particularly positive side effect of using vibroacoustics to get into the relaxation response is a long term benefit---the more people use this technology the more they learn to recognize the state of relaxation and, over time, become able to reach relaxation at will. Vibroacoustics is a great way to learn how to relax and develop relaxation as a daily habit!
THE SOMATRON PAIN AND ANXIETY MANAGEMENT PROGRAM
The Somatron Corporation offers a field-tested program using vibroacoustic music to reduce pain and anxiety. This includes an instruction manual and four vibroacoustic music recordings. The manual provides information on how to develop and manage a pain and anxiety management program based on successful programs demonstrating over 50% reduction of pain, anxiety and stress-mediated symptoms. Instructions for completing a program evaluation are included in the manual and are useful for reporting pain management practices to JCAHO and for internal quality control. The four vibroacoustic music recordings in the program were designed and tested for use in pain and anxiety management. Training and assistance in program development is also available. Click here for more information.
A Clinically Proven Non-Pharmacological Pain and Anxiety Management Tool
In a program at the Clinical Center of the National Institutes of Health (NIH), researchers attained more than 50% reduction of pain and other symptoms using Somatron vibroacoustic technology. A program evaluation study, published in 1999, revealed a reduction of pain and other symptoms between 49% and 59% at the NIH. Because of this success, the Somatron vibroacoustic program has been an ongoing patient and family treatment offering at the NIH for over eight years and continues to obtain these effective results.
The NIH evaluation monitored pain and symptoms in 267 patients hospitalized for a variety of illnesses including cancer and cardiac-related issues. Patients were given the opportunity to use the Somatron recliner for a 45-minute vibroacoustic session that included a 10-minute introduction to the process with a short guided relaxation exercise and 10 minutes of debriefing. Using the TheraSound Balance recording, patients experienced Somatron vibroacoustics for approximately 25 minutes. Pre and post self-evaluations were given using two measurement tools. The chart below shows pain and other symptom reduction percentages from this study.
Symptom Change from a Single Vibroacoustic Session at the National Institutes of Health
|% Reduction||Symptom||Number of Patients|
|54.00 reduction of --||Tension||with 74 patients|
|47.36 reduction of --||Fatigue||with 60 patients|
|53.33 reduction of --||Pain||with 46 patients|
|57.54 reduction of --||Headache||with 24 patients|
|49.45 reduction of --||Depression||with 18 patients|
|56.27 reduction of --||Nausea||with 16 patients|
|56.27 reduction of --||Other||with 29 patients|
The NIH Clinical Medical Center continues to use six Somatron vibroacoustic recliners in a specially-designed relaxation room. This program has been in continuous use since the pilot program began and results continue to be consistent with the initial findings. The program is facilitated by recreation therapists under the guidance of Dr. George Patrick, Chief of recreation therapy in the Rehabilitation Medicine Department. See full study report in our Research section.
A follow-up pilot program was conducted by Chris Boyd Brewer at Jupiter Medical Center, Jupiter, Florida. Using vibroacoustic technology in the Foshay Cancer Center, a replication of the NIH study was completed using data from 41 patients. This study intended to determine if a busy nursing staff could administer the vibroacoustic pain and anxiety management program and attain the same significant results as the NIH. Data collection was accomplished primarily by the nursing staff. Results of this pilot program were equal in success to that of the NIH and confirmed that, if set up appropriately, medical center facilities could develop and manage a successful vibroacoustic pain and anxiety management program. As a result of these findings, the Somatron Pain and Anxiety Management Manual was created to assist medical centers in developing effective vibroacoustic music programs. See the full cancer center study report in our Research section.
The Vibroacoustic Music Pain and Anxiety Management program has multiple benefits including that it:
About Anxiety and Tension (Stress) Reduction
Anxiety and tension are common side effects of illness and disease that patients frequently identify and medical personnel must constantly address. Research demonstrates that high anxiety levels inhibit the healing process and perhaps increase susceptibility to cardiac and immunological disorders, among other health problems.
Tension, reported by patients also as anxiety and stress, was one of the symptoms most frequently identified in the NIH vibroacoustic evaluation of pain and symptom reduction. Among the patients who identified tension as a primary symptom, an average of 54% reduction was reported from a single vibroacoustic session. The study also measured patients' state of tension-relaxation using an additional self-report tool. All 267 patients used this scale and indicated that their tension symptom was reduced by 53.4% overall.
With clinical results demonstrating a one-half reduction of tension in a single session, vibroacoustics clearly provides a significant method for handling tension without drugs or negative side-effects.
Type of Facility:
State Facility for Blind and Multihandicapped Individuals
Patient Population using the Somatron:
Students enrolled in the Massachusetts Association for the Blind
Multihandicapped Children's Program
Date of Reported Experiences:
Improved communication. Assisting in post-seizure recovery.
Dr. Beth Denisch, DMA-ABD
Massachusetts Association for the Blind
200 Ivy Street
Brookline, MA 02146
Phone: (508) 537-1514
In a letter written to Senator Kennedy, Dr. Beth Denisch, Music Therapist for the Massachusetts Association for the Blind, discussed the success of Music Therapy with residential students at the Massachusetts Association for the Blind's Multi-handicapped Children's Program. Children whose physical handicaps prevent their participation in live Music Therapy sessions are provided with opportunities to experience vibrotactile stimulation via a Somatron. Dr. Denisch discusses several clinical uses of the Somatron with her students during her letter. For students that are hearing impaired, she tells how "feeling" music through the Somatron "accentuates" anything that they may be able to hear. Dr. Denisch reports that the experience "effects communication, creating an understandable link to them between what they are hearing and feeling". One technique adopted by Dr. Denisch during these Somatron sessions is to reinforce the student's experience by tapping the rhythm and / or melody being experienced through the Somatron on the student's body. This, she reports, brings the student in touch with the outside world, allowing him or her to share their experience with another person.
Many of the students of the facility suffer from chronic seizures. Dr. Denisch reports, in her letter, that the Somatron has been used successfully after a seizure to help students "transition back to a more daily awareness".