Music has the capacity to make us dance, smile, focus, cry, think outside the box, and heal. It stimulates and challenges countless brain areas, including those responsible for memory, executive function, pattern recognition, and movement. Music elicits strong memories, and is a staple in the day-to-day life of Canadians. I argue that music is the most powerful non-pharmacological tool that we can use in health care.
While many of us have seen the incredible influence of music, and truly believe in its importance, music is not yet an established pillar in the medical world. It is my belief that this will only change when sufficient research literature exists to support the use of music in care practices. Canadian health policy is influenced by evidence, and evidence is produced through rigorous research investigations. Rigorous research investigations in the use of music in health care is limited.
The quality and volume of scientific evidence required to change any health care practice is overwhelming. For example, consider the current gold standard treatment for meniscal tears. The meniscus is a piece of tissue that resides in your knee capsule, and is responsible for absorbing shock in the knee joint when you move. It plays an important role in the health of your knees. It is common for this tissue to tear between the ages of 45 and 65. In Canada and around the world, a surgery to remove the damaged meniscal tissue is the gold standard treatment. However, there are many studies that show little to no benefit of this surgery. These studies, between 50 and 100 in number, suggest that more conservative treatments like exercise and physiotherapy are just as effective as the surgery.
In June, a systematic review of the top research papers for meniscal knee surgery was published. A systematic review means that a group of authors compiles the results from the top-notch research papers on a subject. When the systematic review is published, a healthcare practice may change. The recent systematic review on meniscal knee surgery concluded that surgery does not provide any benefits over less invasive alternatives, such as physiotherapist-prescribed exercises and treatment.
In my music and health care journey, I have seen long-term care residents whose dementia medication dosages have been decreased simply by incorporating music into their daily routines. Using live or recorded music while bathing and dressing the residents significantly decreased their agitation during and after the care time. If I wanted to change current nursing and personal support worker practices to include music during these care times, I would have to produce 50 to 100 high quality studies showing the effectiveness of music during these daily routines that would need to go through the process of a systematic review. And even then, that might not be enough evidence to change practice.
Although the task of producing music and health research might sound daunting, it is important to note that many researchers, practitioners, and community members are on this journey together. It is organizations like Room 217 Foundation that come alongside educational institutions and regulating bodies like the Music Therapy Association of Ontario to cumulatively produce research evidence.
Canadian universities such as Toronto, McGill, Ryerson, Montréal, PEI, McMaster, Laurier, Western, Calgary and Edmonton are producing both laboratory controlled and care-centre validated research evidence. Room 217’s current focus is in front-line care settings, such as long-term care homes. Our goal is to conduct research while simultaneously changing the lives of current residents through music.
Music is a complex entity, with multiple applications in health care and has universal applicability to accomplish health-related goals. The biological and social properties of music can be used to target the isolation and loneliness of long-term care residents. Because we understand how music impacts the brain, it can be strategically applied to physiotherapy practices to improve movement-related outcomes. Music can be used in speech-therapy to improve speech production post-stroke, and used in autistic populations for language learning and information translation. Stimulating musical activities can be used to improve cognition following a brain injury.
Despite the compelling case studies and preliminary research reports, in the field of music and health, we are still in the grass roots stages of compiling evidence. Many more high-quality studies will need to be conducted before we can fully integrate music into our Canadian health care system. In the meantime, it is important for each of us to continue to advocate for the use of music in health care practices, and to educate others on the therapeutic power of music.
This post is written by Room 217’s new Research Coordinator, Chelsea McKinnon. In this post, Chelsea makes a case for the importance of more evidence-based music care research.