Chuang, C. Y., Han, W. R., Li, P. C., & Young, S. T. (2010). Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: a pilot study. Complementary Therapies in Medicine, 18, 224–226.

To determine the effects of music therapy on subjective sensations and physiologic parameters of heart rate variability (HRV) in treated cancer survivors.The hypothesis was that music therapy significantly affects the sensations of fatigue, comfort, and relaxation, as well as the activities of the sympathetic and parasympathetic nervous systems.

Participants were asked to sit and rest for five minutes to stabilize their heart and respiration rates when they first arrived in the group therapy room. An electrocardiogram (ECG) signal then was measured for five minutes, and fatigue, comfort, and relaxation were rated subjectively on the visual analog mood scales (VAMS) as a pretest. After participating in two hours of music therapy, the same procedure was performed again as a posttest.  

The two-hour music therapy intervention consisted of three activities. In the first activity, the program aimed at establishing a rapport between therapists and participants through singing and listening. The song for the first activity was a popular Taiwanese song called ‘‘He is Our Treasure,’’ which had pleasant moderate rhythm and tempo. The second activity was to learn how to play the recorder. This activity used simple musical instrument learning to establish the participants’ self-confidence. The third activity was to perform the main five notes of a familiar melody song, ‘‘Grandfather’s Clock,’’ following the therapist’s electric keyboard accompaniment and conduct. This activity sought to encourage the participants to express themselves through playing the recorder and to create light and joyful emotions.

• The sample was comprised of 23 women with cancer (breast [n = 19], ovary [n = 2], cervical [n = 1], and bone [n = 1]).   
• Mean age was 49.9 years (standard deviation = 9.2 years) (range 30–67).
• Participants were recruited from the Hope Society for Cancer Care in Taipei, Taiwan.

• Single site
• Outpatient
• Taiwan

• Patients were undergoing the posttreatment phase of care.
• The study has clinical applicability for late effects and survivorship.

The study used a pre-/posttest, quasiexperimental design.

• ECG monitoring    
• VAMS
• HRV monitor
• The study assessed whether participants were fatigued, comfortable, and relaxed, but no questionnaire was described.
   

Comparison of the quantitative HRV measures at pre- and posttest revealed that the high frequency (HF) power and normalized HF power were significantly higher, and the low frequency (LF)/HF ratio and normalized LF power of HRV were significantly lower at posttest than at pretest (p < 0.05). The VAMS mean value for the fatigue level was significant lower after music therapy (p < 0.05). The VAMS mean value for relaxation level was significant higher after music therapy (p < 0.05).

In a small sample size including varied cancer diagnoses with limited information about the study participants, the assessment showed changes in fatigue, relaxation, comfort, and HRV.

• The study had a very small sample, with less than 30 participants.
• The study lacked a control group.
• The study included various cancer diagnoses.
• The study used a cross-sectional design.
• Symptom instruments were not multidimensional or psychometrically tested, and no description was given for how the symptom questions were presented to the participants.   

Additional research is needed, including the use of psychometrically tested symptom instruments. Based on the descriptive findings in this very small initial study evaluating HRV, fatigue, and relaxation, it may not be appropriate to include it in PEP topic research. This study was completed by colleagues in a biomedical engineering school. Describing the process of how this was accomplished (e.g., surveys with nurses assisting) might be useful.