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Id 173
Author Sliwka, A.; Wloch, T.; Tynor, D.; Nowobilski, R.
Title Do asthmatics benefit from music therapy? A systematic review

Sliwka, A., Wloch, T., Tynor, D., & Nowobilski, R. (2014). Do asthmatics benefit from music therapy? A systematic review. Complementary therapies in medicine, 22(4), 756-766.

Keywords asthma; music therapy; complementary medicine
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Abstract More than 300 million people from countries all over the world suffer from asthma. Rates vary between countries, as prevalence ranges from 1 to 18%. This chronic inflammatory disease of the respiratory tract affects people of all ages. When left untreated, asthma can lead to a significant reduction in the patient’s physical activity. Studies on the quality of life in asthma patients have indicated that symptoms depend not only on the severity and duration of the disease, but also on the social and psychological condition of the patient and their family. Additionally, it is described how stress impacts the perception of asthma symptoms, respiratory tract health, and asthma control. Strong emotions can be responsible for the exacerbation of asthma. Furthermore, depression can affect the patient’s compliance to treatment. Consequently, a lack of patients’ adherence decreases asthma control, leading them to lose faith in conventional treatment’s effectiveness. More and more often patients with asthma are turning to complementary and alternative treatments. Their great variety allows each patient to reach their individual needs and preferences. Literature also shows a development of multidisciplinary programs for asthma treatment that are complemented by relaxation methods such as progressive muscle, mental, muscular and functional relaxation, guided imagery, hypnotherapy, autogenic training, biofeedback techniques and music therapy. According to the American Music Therapy Association, music therapy is ‘‘the (. . .) use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program’’. Music therapists provide a targeted treatment including both intrumental and vocal music activities. Creating, singing, moving to, and/or listening to music are all popular methods of employing the music therapy. It has been successfully used in different branches of medicine. The method is easy to use in a clinical setting, is non-invasive, and relatively inexpensive. Similarly to other asthma treatment interventions that fit the category of CAM, there is lack of a defined statement concerning music therapy effectiveness in asthma treatment. The aim of our article is to systematically review the evidence of music therapy as a treatment approach for asthma.

Metodology The final selection of papers, along with the decision for their exclusion at particular stages of the review process, was carried out according to the PRISMA statement (preferred reporting items for systematic reviews and meta analyses). Two reviewers independently established whether each study met the inclusion criteria. Disagreements were resolved by discussion. First, the titles and abstracts of all publications identified through the primary search were independently reviewed. Then, full texts of all potentially eligible papers determined after the first level of screening were subsequently reviewed to ensure that each paper met the inclusion criteria for population and outcome of interest. Articles that met the eligibility criteria were further assessed for quality by two authors independently using the Cochrane Risk of Bias tool. This tool assesses the risk of bias in six domains: sequence generation; allocation concealment; blinding of participants, personnel and outcome assessors; incomplete outcome data; selective outcome reporting; and other source of bias. Studies were rated as having low risk of bias if at least 6 of the 12 criteria were assessed positively and the studies did not have serious flaw. Studies that met fewer than six criteria or had a serious flaw were rated as having high risk of bias.Strength of the recommendation for music therapy in asthma was judged according to GRADE recommendation as either strong or weak, based on quality of evidence for each primary outcome as well as the results’ consistency, directness, precision, and publication bias.

Findings The literature search identified 867 citations, from which 8 (three RCTs and five nRCTs) low and high risk of bias studies were included in the review. All RCTs used music listening as a form of complementary treatment. One RCT of the low risk of bias indicated positive effects on lung function in mild asthma. In two others, despite the decrease in asthma symptoms, music was not more effective than the control condition. In two nRCTs a decrease in asthma symptoms was reported as an effect of playing a brass or wind instrument; in two nRCTs the same effect was observed after music assisted vocal breathing exercises and singing. Mood improvement, decrease of depression and anxiety were also observed.Based on the results of the review, only a weak recommendation for using music therapy in clinical practice can be stated. It must be taken under consideration that research conducted in the field of behavioral interventions, which music therapy belongs to, demands both quantitative and qualitative approaches. A study design should be developed to allow future reassessment of music therapy influence on asthma symptomatology and lung function. Although the current trend in asthma management is to use more complementary therapies, music therapy needs to be explored further, as it possesses the potential to serve as an adjunct to conventional intervention in clinical practice.
Open Access NO
DOI 10.1016/j.ctim.2014.07.002
Search Database Snowball
Technique Literature review; Systematic Review
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