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Music interventions linked to improved mental and physical aspects of health-related QOL

Music interventions are associated with an improvement in the mental and physical aspects of health-related quality of life (QOL). This is according to the results of a meta-analysis of studies by researchers from the Institute of Music Physiology and Musicians’ Medicine, Hannover University of Music, Hannover, Germany. However, the authors were unable to determine which specific type of music intervention provided the greatest benefit.

The use of music interventions (MIs), which include listening to music, playing an instrument or singing, have been shown to positively impact on the global and social functioning of patients with mental health conditions such as schizophrenia. Furthermore, there is also reliable evidence for the positive effects of music and singing on wellbeing (a concept related to the positive aspects of a person’s life) in adults without any underlying mental health problems. Additionally, evidence from an umbrella review of performing arts as a health resource, concluded that positive health effects were associated with as little as 30 to 60 minutes of performing arts participation.

The CDC in the US, defines Health-related quality of life (HRQOL) as an individual’s or a group’s perceived physical and mental health over time. HRQOL can be assessed using specific questionnaires such as the 36-item Health Survey Short Form (SF-36) and related, reduced 12-item Health Survey Short Form (SF-12). In fact, both tools have been used in studies of music interventions.

Although music interventions appear to give rise to improvements in both HRQOL and well-being, what remains uncertain is the association between different types of MIs and changes in HRQOL and this was the purpose of the current study. The German team included randomised and non-randomised trials that investigated music making (singing, listening, playing music) interventions and which reported changes in SF-36 or SF-12, before and after the intervention. The researchers focused on both the mental component summary (MCS) and the physical component summary (PCS) of the SF-36 or SF-12 with higher scores in either domains indicative of better mental and physical HRQOL. The threshold mean difference in MCS scores was set as a mean difference of 3 or more.

Music interventions and MCS and PCS scores

The literature search identified 26 eligible studies with 779 participants (mean age = 60 years) and which comprised listening to music, music therapy, singing with one study exploring the effect of gospel music.

Overall, a music intervention was associated with a significant improvement in both MCS (total mean difference, TMD = 2.95, p < 0.01) and PCS scores (TMD = 1.09, p = 0.02) compared to pre-intervention values.

In subgroup analysis, in which MIs were added to usual treatment, there was a significant increase in MCS scores vs usual treatment alone (TMD = 3.72, 95% CI 0.40 – 7.05) but not for PCS. However, it was not possible to identify any important differences based on the type of musical intervention.

The authors concluded that while MIs led to a significant increase in mental HRQOL the changes in PCS although significant were deemed to be equivocal. Furthermore, they added that given the variation in the effect of the different interventions such as singing, listening to music etc, it was impossible to provide any firm recommendations about the optimal intervention or dosage for use in specific clinical scenarios.

McCrary JM et al. Association of Music Interventions With Health-Related Quality of Life: A Systematic Review and Meta-analysis JAMA Netw Open 2022

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