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A Prospective Randomized Controlled Trial on The Effect of Music Therapy Intervention on Pain and Anxiety in Adult Patients Undergoing Total Shoulder Arthroplasty
Raymond Y Kim, MD
1; Hannah H Nam, MD
2; Janice W Stouffer, MT-BC
1; Christina A Myers, MMT
1; Susan E Hassenbein, CCRP
1; Gary F Updegrove, MD
1; Vernon M Chinchilli, PhD
3; Yue Zhang, MPH
3; Sanjib Adhikary, MD
1; April D Armstrong, MD
11Penn State Milton S. Hershey Medical Center, Hershey, PA; 2Massachusetts General Hospital, Boston, MA; 3Penn State College of Medicine, Hershey, PA
Background: Leading studies have demonstrated that music therapy has decreased pain intensity, anxiety, length of hospitalization, and increased pain relief. This study investigated weather a music therapy interventions would reduce pre- and post-operative pain and anxiety in patients undergoing total shoulder arthroplasties as compared with patients who received standard of care without music therapy.
Methods: Patients were prospectively identified from a list of scheduled elective shoulder surgeries. Consented patients were randomized into 3 groups: live music therapy, recorded music therapy, and control (no music therapy). An evidence-based intervention was designed by board-certified music therapists to include components of induction, autogenic muscle relaxation, and imagery with sedative guitar playing. All patients completed the PROMIS Emotional Distress-Anxiety-Short Form and Pain Scale Survey at 6 designated care point times pre- and post-surgery. Linear mixed-effects models were developed to account for the repeated measurements within each patient, analyzing pain scores and anxiety-T scores separately.
Results: A total of 108 patients were included in this study. 35 patients were included in the live music group, 34 in the recorded music group, and 39 in the control group. Pain scores were significantly decreased in the live music compared to the control group (p = 0.0013) and the recorded music compared to the control group (p = 0.0142). Anxiety scores were also significantly decreased in the live music compared to the control group (p = 0.0002) and between the recorded music compared to the control groups (p = 0.0186). There were no statistically significant differences in the change of pain scores (p = 0.4663) or the change of anxiety scores (p = 0.1791) between the live music and recorded music groups.
Conclusions: Patients receiving the designed music therapy intervention had significantly lower pain and anxiety scores compared to the control group patients. Findings were not dependent on live versus recorded presentation. This study demonstrates the potential benefits of incorporating music therapy to minimize anxiety and post-operative pain in patients undergoing total shoulder arthroplasty.
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