Melbourne Conservatorium of Music - Research Publications

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    Older adults' music listening preferences to support physical activity following cardiac rehabilitation
    Clark, IN ; Baker, FA ; Taylor, NF ( 2016-01-01)
    Background: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population. Objective: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation. Methods: Twenty-seven participants aged 60 years and older (21 men, 6 women; mean age = 67.3 years) selected music to support walking over a 6-month intervention period, and participated in post-intervention interviews. In this two-phase study, we first identified predominant characteristics of participant-selected music using the Structural Model of Music Analysis. Second, we used inductive thematic analysis to explore participant experiences. Results: Predominant characteristics of participant-selected music included duple meter, consistent rhythm, major key, rounded melodic shape, legato articulation, predictable harmonies, variable volume, and episodes of tension with delayed resolution. There was no predominant tempo, with music selections ranging from slow through to medium and fast. Four themes emerged from thematic analysis of participant interviews: psycho-emotional responses, physical responses, influence on exercise behavior, and negative experiences. Conclusions: Findings are consistent with theory and research explaining influences from music listening on physiological arousal and subjective experience during exercise. Additionally, for older adults with cardiac disease, a holistic approach to music selection considering general well-being and adjustment issues, rather than just exercise performance, may improve long-term lifestyle changes and compliance with physical activity guidelines.
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    Older Adults' Music Listening Preferences to Support Physical Activity Following Cardiac Rehabilitation
    Clark, IN ; Baker, FA ; Taylor, NF (OXFORD UNIV PRESS INC, 2016)
    BACKGROUND: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population. OBJECTIVE: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation. METHODS: Twenty-seven participants aged 60 years and older (21 men, 6 women; mean age = 67.3 years) selected music to support walking over a 6-month intervention period, and participated in post-intervention interviews. In this two-phase study, we first identified predominant characteristics of participant-selected music using the Structural Model of Music Analysis. Second, we used inductive thematic analysis to explore participant experiences. RESULTS: Predominant characteristics of participant-selected music included duple meter, consistent rhythm, major key, rounded melodic shape, legato articulation, predictable harmonies, variable volume, and episodes of tension with delayed resolution. There was no predominant tempo, with music selections ranging from slow through to medium and fast. Four themes emerged from thematic analysis of participant interviews: psycho-emotional responses, physical responses, influence on exercise behavior, and negative experiences. CONCLUSIONS: Findings are consistent with theory and research explaining influences from music listening on physiological arousal and subjective experience during exercise. Additionally, for older adults with cardiac disease, a holistic approach to music selection considering general well-being and adjustment issues, rather than just exercise performance, may improve long-term lifestyle changes and compliance with physical activity guidelines.
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    Participant-selected music and physical activity in older adults following cardiac rehabilitation: a randomized controlled trial
    Clark, IN ; Baker, FA ; Peiris, CL ; Shoebridge, G ; Taylor, NF (SAGE PUBLICATIONS LTD, 2017-03)
    OBJECTIVE: To evaluate effects of participant-selected music on older adults' achievement of activity levels recommended in the physical activity guidelines following cardiac rehabilitation. DESIGN: A parallel group randomized controlled trial with measurements at Weeks 0, 6 and 26. SETTING: A multisite outpatient rehabilitation programme of a publicly funded metropolitan health service. SUBJECTS: Adults aged 60 years and older who had completed a cardiac rehabilitation programme. INTERVENTIONS: Experimental participants selected music to support walking with guidance from a music therapist. Control participants received usual care only. MAIN MEASURES: The primary outcome was the proportion of participants achieving activity levels recommended in physical activity guidelines. Secondary outcomes compared amounts of physical activity, exercise capacity, cardiac risk factors, and exercise self-efficacy. RESULTS: A total of 56 participants, mean age 68.2 years (SD = 6.5), were randomized to the experimental ( n = 28) and control groups ( n = 28). There were no differences between groups in proportions of participants achieving activity recommended in physical activity guidelines at Week 6 or 26. Secondary outcomes demonstrated between-group differences in male waist circumference at both measurements (Week 6 difference -2.0 cm, 95% CI -4.0 to 0; Week 26 difference -2.8 cm, 95% CI -5.4 to -0.1), and observed effect sizes favoured the experimental group for amounts of physical activity (d = 0.30), exercise capacity (d = 0.48), and blood pressure (d = -0.32). CONCLUSIONS: Participant-selected music did not increase the proportion of participants achieving recommended amounts of physical activity, but may have contributed to exercise-related benefits.
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    Music interventions for acquired brain injury
    CLARK, I ; Magee, W ; Tamplin, J ; Bradt, J ; Magee, W ; Clark, I ; Tamplin, J ; Bradt, J (John Wiley & Sons, Ltd, 2017)
    Background: Acquired brain injury (ABI) can result in impairments in motor function, language, cognition, and sensory processing, and in emotional disturbances, which can severely reduce a survivor's quality of life. Music interventions have been used in rehabilitation to stimulate brain functions involved in movement, cognition, speech, emotions, and sensory perceptions. An update of the systematic review published in 2010 was needed to gauge the efficacy of music interventions in rehabilitation for people with ABI. Objectives: To assess the effects of music interventions for functional outcomes in people with ABI. We expanded the criteria of our existing review to: 1) examine the efficacy of music interventions in addressing recovery in people with ABI including gait, upper extremity function, communication, mood and emotions, cognitive functioning, social skills, pain, behavioural outcomes, activities of daily living, and adverse events; 2) compare the efficacy of music interventions and standard care with a) standard care alone, b) standard care and placebo treatments, or c) standard care and other therapies; 3) compare the efficacy of different types of music interventions (music therapy delivered by trained music therapists versus music interventions delivered by other professionals). Selection criteria: We included all randomised controlled trials and controlled clinical trials that compared music interventions and standard care with standard care alone or combined with other therapies. We examined studies that included people older than 16 years of age who had ABI of a non‐degenerative nature and were participating in treatment programmes offered in hospital, outpatient, or community settings. We included studies in any language, published and unpublished. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of the included studies. We contacted trial researchers to obtain missing data or for additional information when necessary. Where possible, we presented results for continuous outcomes in meta‐analyses using mean differences (MDs) and standardised mean differences (SMDs). We used post‐test scores. In cases of significant baseline difference, we used change scores. We conducted a sensitivity analysis to assess the impact of the randomisation method. Main results: We identified 22 new studies for this update. The evidence for this update is based on 29 trials involving 775 participants. A music intervention known as rhythmic auditory stimulation may be beneficial for improving the following gait parameters after stroke. We found a reported increase in gait velocity of 11.34 metres per minute (95% confidence interval (CI) 8.40 to 14.28; 9 trials; 268 participants; P < 0.00001; moderate‐quality evidence). Stride length of the affected side may also benefit, with a reported average of 0.12 metres more (95% CI 0.04 to 0.20; 5 trials; 129 participants; P = 0.003; moderate‐quality evidence). We found a reported average improvement for general gait of 7.67 units on the Dynamic Gait Index (95% CI 5.67 to 9.67; 2 trials; 48 participants; P < 0.00001). There may also be an improvement in gait cadence, with a reported average increase of 10.77 steps per minute (95% CI 4.36 to 17.18; 7 trials; 223 participants; P = 0.001; low‐quality evidence). Music interventions may be beneficial for communication outcomes in people with aphasia following stroke. Overall, communication improved by 0.75 standard deviations in the intervention group, a moderate effect (95% CI 0.11 to 1.39; 3 trials; 67 participants; P = 0.02; very low‐quality evidence). Naming was reported as improving by 9.79 units on the Aachen Aphasia Test (95% CI 1.37 to 18.21; 2 trials; 35 participants; P = 0.02). Music interventions may have a beneficial effect on speech repetition, reported as an average increase of 8.90 score on the Aachen Aphasia Test (95% CI 3.25 to 14.55; 2 trials; 35 participants; P = 0.002). There may be an improvement in quality of life following stroke using rhythmic auditory stimulation, reported at 0.89 standard deviations improvement on the Stroke Specific Quality of Life Scale, which is considered to be a large effect (95% CI 0.32 to 1.46; 2 trials; 53 participants; P = 0.002; low‐quality evidence). We found no strong evidence for effects on memory and attention. Data were insufficient to examine the effect of music interventions on other outcomes. The majority of studies included in this review update presented a high risk of bias, therefore the quality of the evidence is low. Authors' conclusions: Music interventions may be beneficial for gait, the timing of upper extremity function, communication outcomes, and quality of life after stroke. These results are encouraging, but more high‐quality randomised controlled trials are needed on all outcomes before recommendations can be made for clinical practice.
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    Topical issues in music therapy
    Clark, I (Australian Music Therapy Association, 2017-11)
    AJMT Volume 28 marks the first 12 months of AJMT online, and is a tribute to the legacy set up by our previous Editor, Dr Helen Shoemark. Both analytic data and anecdotal feedback suggest that AJMT is widely read and enjoyed throughout the world, and that readers value the new, freely online format. This year’s edition promises more informative and inspiring reading with 5 articles covering diverse and topical issues within contemporary music therapy practice.
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    Music interventions for acquired brain injury: Findings from an updated Cochrane review
    Tamplin, J ; Clark, I ; Magee, WL ; Bradt, J (The Australasian Society for the Study of Brain Impairment, 2017-06-01)
    Background and aims: This Cochrane review update examined the effects of music interventions and standard care versus standard care alone or standard care combined with other therapies for adults with non- degenerative acquired brain injury (ABI). Primary outcomes were gait and upper extremity function. Secondary outcomes were communication, cognition, mood and emotions, social skills, pain, behavioral outcomes, activities of daily living, and adverse events. Method: We searched electronic databases, dissertation and specialist music databases, and hand-searched grey literature. All randomised controlled and controlled clinical trials with quasi-randomised or systematic methods of treatment allocation were included, in any language, published and unpublished. Results: We included 29 trials with 775 participants. Meta- analyses indicated that music interventions may improve gait velocity, stride length (affected side), gait cadence, stride symmetry, general gait, and timing of upper extremity function. Using a rhythmic auditory stimulus embedded in music may lead to greater improvements in gait velocity than using rhythmic auditory stimulus without music e.g. metronome. Interventions delivered by a credentialed music therapist generated greater improvements than interventions delivered by other professionals. Music interventions may also improve quality of life and overall communication with beneficial effects in naming and repetition. Conclusions: Rhythm-based interventions remain important for movement rehabilitation in ABI. Future research should examine music intervention effects on cognition. Measures used for mood outcomes require greater uniformity and improved reporting. Across all domains, improved agreement on the core outcomes examined will enable more comprehensive meta-analyses and more accurate evaluation of the effectiveness of music interventions.
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    Musical memories: Connecting people with dementia and their caregivers through song.
    Clark, I ; Tamplin, J ; Lee, J ; Baker, F ; Mercadal-Brotons, M ; Clements-Cortes, A (World Federation of Music Therapy, 2017)
    Active music participation may offer benefits for people with dementia (PWD) and their family care givers (FCG) living in the community (Baird & Samson, 2015). For the PWD, this capacity to respond to music-making activities, such as singing, may facilitate reminiscence and successful social engagement (Vanstone & Cuddy, 2010). As a consequence, FCG may experience meaningful and satisfying connection with their loved one (Baker, Grocke & Pachana, 2012). Receptive music listening interventions may also assist with the management of challenging symptoms of dementia, such as agitation and anxiety, offering FCG strategies to use in the home.
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    Supporting Healthy Ageing and Management of Age Related Disease in Australia
    Clark, I (World Federation of Music Therapy, 2017)
    As the global population ages, more people are experiencing the privilege of growing old. By 2050, estimates suggest that over 2 billion people will be aged 60 years or over (WHO, 2016). Current buzz terms, including healthy ageing and active ageing, are used to describe the notion of optimal health, independent life participation and security required for high quality of life through the full course of life. In Australia, 2 major policies support principles of healthy ageing (AIHW, 2017): 1) Preventative health, promotes healthy lifestyle choices, such as physical activity participation; 2) Living longer better, has a strong focus on supporting people with dementia (PWD) and their family caregivers (FCG). This presentation will discuss recent music therapy research in Australia targeted to address these policies.
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    Music therapy research in dementia: fostering a global approach
    Tamplin, J ; Clark, I ; Ridder, HM ; McDermott, O ; Odell-Miller, H ; Laitinen, S ; Gold, C (GRIEG ACADEMY, 2016)
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    Authors' roundtable: scientific writing, peer review, and publication across journals
    Bradt, J ; Baker, F ; Bergmann, T ; Bonde, LO ; Clark, I ; Gold, C ; Loewy, J ; McFerran, K ; Meadows, A ; Robb, S ; Vaillancourt, G ; Alexis, E (GRIEG ACADEMY, 2016)