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The Efficacy of Music Therapy Protocols for Decreasing Pain, Anxiety, and Muscle Tension Levels During Burn Dressing Changes: A Prospective Randomized Crossover Trial

Tan, Xueli MM, MT-BC*; Yowler, Charles J. MD, FACS, FCCM†; Super, Dennis M. MD, MPH‡; Fratianne, Richard B. MD, FACS†

doi: 10.1097/BCR.0b013e3181e4d71b
Original Articles

The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. On control days, they received no music. On music days, patients practiced music-based imagery (MBI), a form of music-assisted relaxation with patient-specific mental imagery before and after dressing changes. Also, on music days during dressing changes, the patients engaged in music alternate engagement (MAE), which consisted of active participation in music making. The dependent variables were the patients' subjective ratings of their pain and anxiety levels and the research nurse's objective ratings of their muscle tension levels. Two sets of data were collected before, three sets during, and another two sets after dressing changes. The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.

From the *The Music Settlement, Cleveland, Ohio; and Departments of †Surgery and ‡Pediatrics, MetroHealth Medical Center Campus of Case Western Reserve, University School of Medicine, Cleveland, Ohio.

Supported by the Kulas Foundation, Cleveland, Ohio, grant and in part by NIH/NCRR CWRU-CTSC grant UL1 RR024989.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Address correspondence to Charles J. Yowler, MD, FACS, FCCM, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, Ohio.

© 2010 The American Burn Association