Search Results (72)

The impact of cultural identity on music performance anxiety (MPA) is under-researched. This retrospective case study explores the treatment of a professional musician in her 30s who presented with MPA associated with performing music related to her estranged father’s cultural background. The case formulation identified attachment ruptures and negative cognitions associated with her mixed cultural heritage that contributed to an experience of imposterism—referred to in lay literature as ‘racial imposter syndrome’ (RIS). It was hypothesized that RIS served to perpetuate her MPA. An attachment-based approach and Acceptance and Commitment Therapy framework was adopted, drawing on evidence-based treatment for MPA and mixed heritage individuals. The Depression Anxiety Stress Scale-21 (DASS-21), Outcome Rating Scale (ORS) and Session Rating Scale (SRS) were used as outcome measures. These measures fluctuated throughout the therapy. While improvements were observed in depression scores midway through treatment, elevated stress and depression scores at the conclusion of treatment were understood to reflect situational factors related to financial and housing precarity. Nonetheless, at the conclusion of treatment, the client showed improvement in managing MPA, evidenced by her progress in recording an album and reengagement with public performances. This case study adds to the limited research on treating MPA in racially minoritized and mixed-race individuals, Further research is required across larger and more diverse samples to better understand the relationship between MPA and RIS and to develop effective interventions. Full article

A process evaluation was embedded in the multinational Music Interventions for Dementia and Depression in ELderly care (MIDDEL) trial to better understand barriers and facilitators for implementing music-based interventions (MBIs). Stakeholders from 66 care home units across 5 countries completed a survey at baseline (n = 229) and after a six-month intervention period (n = 101), comparing expectations and experiences between countries, intervention groups, and stakeholders. MBIs were evaluated and found to be relevant and feasible. Barriers include a lack of support, turnover among employees, and a lack of motivation. Facilitators include individual stakeholders who proactively facilitate and stimulate implementation, as well as the presence of stable, well-functioning teams, clear communication, and adhering to project plans. Fewer barriers than expected related to care staff workload and the time needed for implementing new MBIs in care homes. MBIs can be beneficial for people with dementia, yet implementation in care homes can be challenging due to contextual factors. Involving stakeholders in key positions is essential: care home managers are pivotal for policy-making and the sustainable adoption of MBIs, whereas the commitment and the involvement of care staff are needed for day-to-day implementation. Insight into these barriers to and facilitators of implementation can contribute to the interpretation of trial results. Full article

Cognitive impairment is a prevalent and disabling feature of multiple sclerosis (MS), significantly impacting patients’ quality of life (QoL) and psychological well-being. Despite its clinical relevance, there are currently no approved pharmacological treatments for cognitive deficits in MS, highlighting the need for effective non-pharmacological interventions. This narrative review explores evidence from studies evaluating the efficacy of cognitive re-education (CR) approaches (including traditional, group-based, computer-assisted, virtual reality, and innovative methods such as music therapy) on cognitive and QoL outcomes in people with MS. The findings demonstrate that while CR consistently influences cognitive domains such as memory, attention, and executive function, its effects on QoL are more variable and often depend on intervention type, duration, and individual patient characteristics. Notably, integrative approaches like virtual reality and music therapy show promising results in enhancing both cognitive performance and psychosocial well-being. Several studies report that cognitive gains are accompanied by improvements in mental health and functional QoL, particularly when interventions are tailored to individual needs and delivered within multidisciplinary frameworks. However, some interventions yield only limited or transient QoL benefits, underlining the importance of personalized, goal-oriented strategies that address both cognitive and psychosocial dimensions. Further research is needed to optimize intervention strategies and clarify the mechanisms linking cognitive and QoL outcomes. Full article

Objective: This study aims to investigate the feasibility of an online music therapy protocol for individuals previously diagnosed with COVID-19, focusing on their perceptions of their respiratory symptoms and the intervention’s impact on psychosocial measures. Methods: A within-subject experimental design was applied to examine an eight-week weekly online music therapy protocol, including singing, wind instrument playing, and music visualizations. All self-report data were collected bi-weekly throughout the 16-weeks study period, including baseline and post-tests. The measures for respiratory symptoms included the Medical Research Council’s Dyspnea Scale (MRC Dyspnea), Chronic Respiratory Questionnaire-Mastery Scores (CRQ Mastery), and Visual Analogue Scale for breathlessness. The measures for the secondary psychosocial outcomes were the Beck Depression Inventory-Short Form, the Generalized Anxiety Disorder 7-item, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, the Epworth Sleepiness Scale, the EuroQol 5-Dimension 5-Level, and the Connor-Davidson Resilience Scale. Results: Twenty-four participants were enrolled. The participants perceived a reduction in respiratory symptoms, and shortness of breath (MRC Dyspnea). Planned comparisons showed significant decreases in MRC from baseline to post-treatment (p = 0.008). The mixed-effects model, including pre-baseline and post-treatment, was significant (p < 0.001). Significant changes in Breathing VAS were consistent with improvements in MRC Dyspnea, showing a significant baseline-to-post difference (p = 0.01). The CRQ Mastery showed significant improvements from baseline to Week 12 (p < 0.001). No significant changes were observed in other secondary measures. Conclusions: Our preliminary findings suggest that this protocol is feasible, and as a result, may help individuals previously diagnosed with COVID-19 to cope with lasting respiratory symptoms and improve their perception of shortness of breath. Live music-making, including playing accessible wind instruments and singing, may contribute to an increase sense of control over breathing. As this was a feasibility study, we conducted multiple uncorrected statistical comparisons to explore potential effects. While this approach may increase the risk of Type I error, the findings are intended to inform hypotheses for future confirmatory studies rather than to draw definitive conclusions. Full article

Background/Objectives: Population aging and the rise in chronic diseases challenge healthcare systems to adopt person-centered approaches, especially in palliative care (PC), where symptom management remains limited. Physiotherapy plays a key role in alleviating discomfort but faces inconsistent integration in Portugal due to lack of recognition. Variations in intervention methods hinder uniform care delivery, limiting timely patient access to comfort-focused treatments and knowledge. This study aims to deepen the understanding of physiotherapy’s role in Portuguese PC to improve its integration into teams and enhance patient access to comfort care. Methods: This study used a descriptive qualitative approach with online focus groups (FG), guided by Krueger and Casey’s methodology and adhering to the COREQ checklist. A non-probabilistic convenience sample of physiotherapists working in palliative care across mainland Portugal and the islands was selected based on inclusion criteria. Three FGs were planned with up to ten participants each. However, due to availability and attendance issues, only 15 physiotherapists participated: 5 in FG1 (in-hospital PC units), 6 in FG2 (inpatient units), and 4 in FG3, the minimum appropriate number from community-based units. Results: Physiotherapy plays a crucial yet underrecognized role in PC, emphasizing the need for its full integration into care teams rather than reliance on late, on-call referrals. Techniques such as positioning, mobilization, pain and dyspnea relief, adapted exercises, massage, music therapy, and emotional support are employed. Conventional physiotherapy tools are used and personalized according to the patient’s context, duration, setting, dosage, and individual needs. Conclusions: Physiotherapy should be recognized as a fundamental part of PC, contributing not only to the prolongation of life but also to ensuring comfort and dignity for patients and their families. To achieve this, its role within multidisciplinary teams must be strengthened and supported by regulations that guarantee access and the formal integration of physiotherapists. However, a significant gap remains in patients’ regular access to comfort-focused interventions at the appropriate time, perhaps due to the considerable variation in physiotherapy practices depending on the patient and care setting, which presents a challenge for knowledge development both in Portugal and globally. Full article

Sleep disturbance is common among people with cognitive impairment and, when present, is an important target for intervention because it potentially leads to negative outcomes and cognitive decline. Given this association, sleep represents a potential public health target, although evidence for efficacy is lacking. For this study, a systematic review and meta-analysis was undertaken of controlled clinical trials of pharmacological and non-pharmacological interventions to improve sleep in mild cognitive impairment and dementia. A total of 144 trials involving 13,471 participants (median 50 per trial) were included. To measure sleep, 68 trials used subjective measures exclusively, and 41 used only objective measures, while 35 used a combination. In all, 287 discrete sleep outcome measures were reported. Bright light therapy was the most frequently examined non-pharmacological intervention, but results were equivocal. Other non-pharmacological interventions (such as physical activity, cognitive behavioural therapy for insomnia, music, and continuous positive airway pressure) showed promise but require further evidence. Results for melatonin, the most frequently examined pharmacological intervention, were inconclusive, but lower doses may be more effective. Other pharmacological interventions (such as trazadone and orexin-receptor antagonists) demonstrated effectiveness in a small number of trials but require further evidence. Overall, there is insufficient evidence upon which to base clinical decisions regarding the treatment of sleep disturbance in this population. Existing research is marked by wide heterogeneity, which limits opportunities for data synthesis. A core outcome set is urgently required to ensure that future research provides more coherent and reliable evidence to improve outcomes for people with cognitive impairment and sleep disturbance. Full article

Background: Music therapy and music-based interventions are increasingly recognized as valuable adjuncts in pediatric neurorehabilitation, leveraging rhythm, singing, instrument playing, and improvisation to support children with neurological disabilities. Objective/Method: This narrative review synthesizes evidence from studies published between 2000 and 2025, focusing on children aged 3 to 18 years receiving neurorehabilitation. Results: The literature demonstrates that music therapy and music-based interventions can improve motor function—particularly gait and upper limb coordination—as well as speech production, while also reducing anxiety and enhancing participation. Techniques such as rhythmic auditory stimulation and melodic intonation therapy have shown promise in targeting movement and communication deficits. Music therapy is further associated with positive effects on vital signs and emotional well-being, supporting its role in holistic care. Neurobiological findings suggest that music-based interventions may promote neuroplasticity and strengthen brain connectivity, though high-quality mechanistic studies remain limited. Conclusions: Despite methodological heterogeneity and small sample sizes in the current literature, the overall evidence supports music therapy and music-based interventions as accessible, cost-effective, and child-centered complements to standard neurorehabilitation. Future research should prioritize rigorous clinical trials and neurobiological investigations to clarify mechanisms and optimize therapeutic protocols. Full article

Background/Objectives: Psychosocial interventions bring mental and social benefits to paediatric and young adult patients. Gaining insight into the optimal psychosocial intervention strategies and their process mechanisms can contribute to the deepening of practice in this field. Methods: This systematic review evaluates the psychosocial interventions that promote adaptability, resilience, and positive changes among paediatric and young adult patients. Following the Cochrane guidelines, the literature from 2000 to 2024 was reviewed, focusing on randomised controlled trials (RCTs). Results: Eighteen studies were included and analysed using a logic model framework. Therapeutic interventions that involved the reframing of cognition activities shaped personality changes, including resilience and adaptation, requiring significant investment, and they were influenced by individual characteristics and background. Process-oriented activities, such as art-, play-, and music-based therapies, improved emotional well-being and were affected by pain, cognitive abilities, and language skills. Behavioural changes are best achieved through interactive interventions, particularly group-based and parent-involved approaches, which improve social integration and physical abilities. Conclusions: Psychosocial interventions lead to positive changes in paediatric and young adult patients in terms of personality, emotion, and behaviour. Although the sample size for the behavioural changes is insufficient, understanding the mechanisms underlying these interventions benefits practice. Full article

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with transarterial chemoembolisation (TACE) being a primary treatment for intermediate-stage disease. However, post-procedural pain remains a significant challenge due to inconsistent management practices and a lack of standardised protocols. This scoping review synthesises current evidence on pain management strategies in HCC patients undergoing TACE, evaluates their effectiveness, identifies practice gaps, and proposes optimisation strategies. Methods: A comprehensive database search according to the methodological approach given by Arksey and O’Malley with the aid of the PRISMA-ScR guidelines across Cochrane Library, Web of Science, CINAHL, PubMed, and Scopus was performed. The terms associated with pain, TACE, and liver cancer were included in the search strategy. Two independent researchers systematically screened study titles, abstracts, and full texts and extracted key study characteristics and approaches to pain management. Results: Of 1515 identified studies, 29 met the inclusion criteria. Most (72.7%) focused on pharmacological interventions, with dexamethasone and lidocaine being the most frequently investigated agents. Non-pharmacological approaches, including psychological interventions, physical therapies, music therapy, health education, and comprehensive nursing, were also reported. Pain was primarily assessed using the visual analogue scale (VAS) and numeric rating scale (NRS). Conclusions: Pharmacological interventions, particularly dexamethasone and lidocaine, remain the cornerstone of pain management in TACE, yet consensus on their optimal use is lacking. Non-pharmacological strategies provide complementary benefits. standardised, evidence-based pain management protocols integrating both approaches are needed. Future large-scale, multicentre trials are essential to establish the most effective strategies for optimising patient outcomes. Full article

In the current landscape of hearing rehabilitation, ear mold manufacturing typically involves the injection of silicone into the external ear canal (EEC) of each patient. This invasive procedure poses several risks, including the potential for silicone residue retention and tympanic membrane perforation, which may necessitate surgical intervention. To mitigate these risks, we present the design of a video otoscope that integrates a scanner capable of capturing high-precision, real-time images of the EEC’s geometry. The developed device allows (i) the generation of a 3D CAD model leading to the direct, quick, and low-cost production of customized hearing aids using 3D printing and (ii) the establishment of medical protocols for carrying out diagnoses and monitoring of hearing pathology evolution using methodologies based on Artificial Intelligence. Furthermore, the use of customized hearing aids that allow the application of Rhythmic Auditory Stimulation (RAS) and music therapy enhances audiology as an alternative and innovative way to treat cognitive and degenerative diseases, as well as pathological disorders. Full article

Background: Music intervention (MI) is a promising complementary therapy for alleviating psychological distress in patients with cancer undergoing radiotherapy. This systematic review and meta-analysis assessed the efficacy of MI in reducing anxiety, depression, and fatigue in these patients. Methods: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the International Clinical Trials Registry Platform from inception to 9 January 2025. We included randomized controlled trials (RCTs) and cohort studies investigating MI’s impact on psychological outcomes in patients with cancer receiving radiotherapy in this review. The study quality was appraised using the Cochrane Risk of Bias 2.0 for RCTs and the ROBINS-I tool for cohort studies. A meta-analysis was performed using a random-effects model in Review Manager 5.4. Results: A total of 13 studies (11 RCTs and 2 cohort studies) with 1073 participants were included. The pooled analysis revealed a significant reduction in anxiety (mean difference [MD]: −3.53, 95% confidence interval [CI]: −5.98 to −1.07, p = 0.003), a non-significant effect on depression (MD: −1.12, 95% CI: −3.25 to 1.01, p = 0.29), and a significant improvement in fatigue (MD: −15.88, 95% CI: −28.19 to −3.57, p = 0.01). A subgroup analysis based on intervention type indicated that music medicine (MM) was more effective in reducing anxiety compared to music therapy (MT). Conclusions: The findings of this study suggest that MI, particularly MM, may be beneficial in alleviating anxiety and fatigue in patients with cancer undergoing radiotherapy, but its impact on depression remains inconclusive. Future studies should employ standardized methodologies and rigorous RCT designs to validate these findings. Full article

The aim of this systematic review was to summarise and evaluate the published literature on interventions for treating music performance anxiety (MPA). Adhering to the PRISMA guidelines, a comprehensive literature search of three electronic databases was conducted: PubMed, Web of Science, and PsychInfo (Ovid). Records were included in this review if they were quantitative pre–post interventional studies that utilised a recognised outcome measure or a clinical diagnosis for evaluating MPA. A narrative synthesis was orchestrated on 40 extracted studies assessing 1365 total participants. The principal intervention types observed included cognitive behavioural therapy, acceptance and commitment therapy, music therapy, yoga and/or mindfulness, virtual reality, hypnotherapy, biofeedback, and multimodal therapy. Although most of the reviewed studies demonstrated encouraging improvements in musicians’ MPA following delivered interventions, the current evidence base remains in its infancy, and numerous methodological weaknesses exist across studies. Small sample sizes, heterogeneity amongst treatment programmes, lack of follow-up data, a scarcity of standardised MPA assessments, and few randomised controlled designs render it imprudent to draw definitive recommendations concerning the interventions’ efficacy. Full article

Background/Objectives: Cognitive challenges in attention and executive function worsen over time in individuals with major depressive disorder (MDD) and suicidal risk. These difficulties persist beyond acute episodes, with limited targeted treatments available. Neurologic music therapy (NMT) is effective for cognitive rehabilitation in brain injuries and developmental disabilities, suggesting potential benefits for adults with MDD and suicide risk. This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of short-term NMT on cognitive function in adults with MDD. Methods: Adults aged 18+ with MDD and suicidal ideations participated in an 8-week single-arm open label study with 45-min individual in-person NMT sessions using musical attention control training (MACT) and musical executive function training (MEFT). Participants provided feedback on feasibility and acceptability, and pre- and post-intervention assessments included neurocognitive tasks and questionnaires on suicidal ideation, depressive symptoms, and quality of life. Results: A total of 18 individuals enrolled, and 10 participants completed the study protocol. Of the participants, 100% were satisfied with their experience with NMT, with 100% noting improvements in attention and 80% in executive function. Participants experienced some improvements in short-term memory (Digit Span Forward Test), cognitive flexibility (Trail Making Test B), and inhibitory control (Stroop Task). Significant reduction in suicidal ideation intensity (Beck Suicidal Scale of Ideation) was observed, as well as significant improvements in quality of life. Conclusions: This is the first study using NMT to demonstrate feasibility, acceptability, and effectiveness with respect to cognitive function in adults with MDD and suicide risk, providing preliminary data for future randomized controlled trials. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder, affecting both children and adults, which often leads to significant difficulties with attention, impulsivity, and working memory. These challenges can impact various cognitive and perceptual domains, including music perception and performance. Despite these difficulties, individuals with ADHD frequently engage with music, and previous research has shown that music listening can serve as a means of increasing stimulation and self-regulation. Moreover, music therapy has been explored as a potential treatment option for individuals with ADHD. As there is a lack of integrative reviews on the interaction between ADHD and music, the present review aimed to fill the gap in research. Following PRISMA guidelines, a comprehensive literature search was conducted across PsychInfo (Ovid), PubMed, and Web of Science. A narrative synthesis was conducted on 20 eligible studies published between 1981 and 2023, involving 1170 participants, of whom 830 had ADHD or ADD. The review identified three main areas of research: (1) music performance and processing in individuals with ADHD, (2) the use of music listening as a source of stimulation for those with ADHD, and (3) music-based interventions aimed at mitigating ADHD symptoms. The analysis revealed that individuals with ADHD often experience unique challenges in musical tasks, particularly those related to timing, rhythm, and complex auditory stimuli perception, though these deficits did not extend to rhythmic improvisation and musical expression. Most studies indicated that music listening positively affects various domains for individuals with ADHD. Furthermore, most studies of music therapy found that it can generate significant benefits for individuals with ADHD. The strength of these findings, however, was limited by inconsistencies among the studies, such as variations in ADHD diagnosis, comorbidities, medication use, and gender. Despite these limitations, this review provides a valuable foundation for future research on the interaction between ADHD and music. Full article

Background: Few studies are reported on interventions that have been carried out in children and adolescents using diaphragmatic breathing (DB) together with methods like counseling, muscle relaxation, therapeutic exercise, and music therapy. Objective: The goal of the review is to evaluate the effectiveness of DB as complementary therapy in the stress of the pediatric population (6–18 years old). Methods: Detailed research was carried out in the current literature to find relevant studies published from 2010 to October 2024 in PubMed and Cochrane Library. Thirteen studies that fulfilled the inclusion criteria were included in the study. Nine studies involved obese and overweight pediatric populations and the other four involved pediatric patients. Results: The interventions comprised two 8-week studies in an obese pediatric population, seven studies in healthy children and adolescents with normal weight. The studies were based on DB, muscle relaxation, nutrition, counseling, music therapy, and slow breathing exercises. The participants in the intervention group improved in comparison to those in the control group in terms of stress and depression in most included studies, in terms of school performance in two studies, in terms of better family relationships in one study, and showed improvement in anthropometric indicators in two studies. In four studies that involved pediatric patients, stress and fear of medical procedures were reduced. Conclusions: DB can effectively contribute on its own or in combination with other therapeutic methods to improving physiological and psychological indicators in the pediatric population. It is useful to integrate stress management programs that include DB training as clinical practice in primary healthcare and in school schedules for elementary and high-school students. Full article