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Background: The present study aimed at examining whether methodological strategies from a previously implemented study design could be transferred to the evaluation of the psychological and physiological effects of a music therapy intervention working with vibroacoustic stimulation in palliative care. Method: Nine participants suffering from advanced cancer took part in single-sessions of music therapy, lasting for 30 min. The live music therapy intervention utilized singing chair sounds and vocal improvisation. Visual analogue scales (VAS) were used to assess self-ratings of pain, relaxation, and well-being before and after each session. During the intervention, we continuously recorded heart rate variability (HRV) as a measure of autonomic functioning. Data collection was complemented by a semi-structured interview to explore subjective experiences in more detail. Feasibility was defined as the ability to complete 80 % of the sessions in accordance with the study protocol. Results: In 5 out of 9 sessions (55 %) it was possible to deliver the intervention and obtain all data as intended. VAS assessment was feasible, although graphical and statistical examination revealed only marginal mean changes between pre and post. HRV recordings were subject to artifacts. While HRV parameters differed between individuals, mean changes over time remained relatively constant. Interview data confirmed that the individual perception was very heterogeneous, ranging from “calming” to “overwhelming”. Conclusion: The criterion of feasibility was not met in this study. Physiological data showed high attrition rates, most likely due to movement artifacts and reduced peripheral blood flow in some participants' extremities. Examination of individual-level trajectories revealed that vibroacoustic stimulation may have an impact on the autonomic response. However, the direction and mechanisms of effects needs to be further explored in future studies. Trial registration: German Clinical Trials Register - DRKS00006137 (July 4th, 2014). [ABSTRACT FROM AUTHOR]

Objectives The aim was to evaluate differences in the autonomic nervous system ( ANS) activity, indexed by heart rate variability ( HRV) in apparently healthy subjects with self-reported symptoms of pain ( SRSP) within an exploratory analysis. Methods HRV data from 14 apparently healthy male individuals were analyzed to address potential differences in subjects with and without SRSP. SRSP was assessed using the four pain-related items from the symptom checklist (SCL-90R). Subjects were stratified based on the presence of SRSP. Results Parasympathetic activity, indexed by pNN50, RMSSD, and high frequency ( HF) spectrum of HRV, was lower in subjects with SRSP. Low frequency ( LF) HRV and the LF/ HF ratio were greater in subjects with SRSP. However, analysis of variance revealed no significant differences between the groups. Pearson correlations showed a correlation of pNN50, HF, LF, and LF/ HF ratio and the presence and frequency of SRSP. Measures of parasympathetic activity (pNN50 and HF) were inversely associated with more SRSP, indicating that subjects with more frequent SRSP show decreased parasympathetic activity. Conclusions Consistent with evidence on changes in HRV in patients with clinical conditions of chronic or recurrent pain, this is the first study to show that healthy individuals who report symptoms of pain may have lower parasympathetic activity revealed by measures of HRV. [ABSTRACT FROM AUTHOR]

Background Music therapy is one of the most frequently used complementary therapies in different palliative care settings. Despite its long tradition and high acceptance by other health-care professionals, evidence on the effectiveness of music therapy interventions for terminally ill patients is rare. Recent reviews and health-care reports consistently point out the need of music therapists to provide an evidence-based rationale for their clinical treatments in this field. Therefore, the present study evaluates the psychological and physiological response of palliative care patients to a standardized music therapy relaxation intervention in a randomized controlled trial. Methods/design A sample of 84 participants from a palliative care unit in Heidelberg is randomized to either two sessions of music therapy or two sessions of a verbal relaxation exercise, each lasting 30 minutes. The music therapy sessions consist of live played monochord music and a vocal improvisation, the control group uses a prerecorded excerpt from the mindfulness-based stress reduction program containing no musical elements. Outcome measures include self- report data on subjective relaxation, well-being, pain intensity, and quality of life, as well as continuous recording of heart rate variability and blood volume pulse as indicators of autonomous nervous system functioning. Discussion To our knowledge, this study is the first clinical trial in Europe and one of very few randomized controlled trials worldwide to systematically examine the effects of music therapy in palliative care. [ABSTRACT FROM AUTHOR]

Background The cold pressor task ( CPT) was originally developed as a clinically indicative cardiovascular test, and quantifies vascular response and pulse excitability when a subject's hand is immersed into ice water. Since the test procedure results in a gradually increasing cold pain, the CPT has been widely used as a nociceptive stimulus in experimental studies on adults and children. Aim To evaluate the test-retest stability of response patterns using the CPT as a measure of pain threshold and pain tolerance. Materials and Methods In the present study, sixty-one undergraduate students received painful stimulation using the CPT either at 4°C or 6°C. Measurements of pain threshold, pain tolerance and pain intensity ratings using the short form of the Mc Gill pain questionnaire ( SF- MPQ), were derived. The assessment was repeated twice over an interval of 2 weeks. Test-Retest stability was assessed within a three-layered approach, using ANOVAs, interclass correlation coefficients and standard error of the mean. A Bland- Altman analysis was also performed. Possible predictors of pain threshold and pain tolerance were assessed using random effect panel regression models. Results No significant differences emerged as a function of temperature (4°C or 6°C) on pain threshold, pain tolerance, and pain ratings. Environmental variables (room temperature and humidity) show no impact on measures of pain threshold and pain tolerance. Conclusion Consistent with previous findings, regression analysis reveals that age is significantly associated with pain tolerance. The CPT procedure shows excellent 2 week test-retest stability to assess pain threshold and pain tolerance within a student population. [ABSTRACT FROM AUTHOR]

This Letter to the Editor reports findings from a randomized controlled cross-over trial, extending a previous study on the effects of music listening to reduce sensitivity to cold pain stimulation. Within this small replication, participants listened to music or white noise (compared to a silence condition) before nociceptive stimulation by the cold pressor task. Results show that in line with previous research pleasant music may increase pain threshold and tolerance compared to silence. Most interestingly we were able to show that annoying white noise may reduce pain threshold and tolerance. However, due to the small sample size these differences were not statistically significant. Clinical implications of these preliminary results linking pain sensitivity to environmental noise are discussed. [ABSTRACT FROM AUTHOR]