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The effect of listening to lullaby music on physiologic response and weight gain of premature infants

Abstract

bstract: Objectives: The environment plays a key role in survival and brain development for premature infants. Recent interest lends consideration to non pharmacological interventions as a beneficial alternative. This study seeks to investigate the effect of lullaby music on the physiological response and weight gain of premature infants in Mashhad, Iran. Method: In this study, 44 very low birth weight infants ⩽ 34 weeks of gestational age that were admitted to the Neonatal Intensive Care Unit (NICU) of Imamreza Hospital in Mashhad, Iran were enrolled. Infants were randomly assigned to one of two groups: the Music group and the Control group. Lullaby music was played through earphones for the Music group. This continued for 8 days at 20 minutes per day. The Control group received routine auditory stimulation. Neonates in the two groups were in stable condition and kept in their isolettes. Infants were monitored for 40 minutes; 10 minutes baseline, 20 minutes into the intervention and 10 minutes post intervention. Data measures were heart rate, respiration rate, oxygen saturation and body weight. Result: The two groups differed significantly in the respiratory rate (p= 0.01) and oxygen saturation (p= 0.001). There were no significant differences in the heart rate (p= 0.24) and weight gain (p= 0.093) between the two groups. Conclusion: Preterm infants respond to lullaby music as evidenced by the changes in their respiratory rates and oxygen saturations. Although this study did not demonstrate an improvement in weight gain, further studies are recommended to examine the effect of music on other growth and developmental aspects
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Journal of Neonatal-Perinatal Medicine 3 (2010) 1–5 1
DOI 10.3233/NPM-2010-0101
IOS Press
The effect of listening to lullaby music on
physiologic response and weight gain of
premature infants1
a b,c d
a
aMedical School, Neonatal Research Center, Mashhad University of Medical Science, and NICU of Emamreza
Hospital, Mashhad, Iran
bFaculty of Nursing and Midwifery, Neonatal Research Center, Mashhad University of Medical Science, Mashhad,
Iran
cFaculty of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran
d
Received 18 June 2009
Revised 12 August 2009
Accepted 20 October 2009
Abstract.Objectives: The environment plays a key role in survival and brain development for premature infants. Recent interest
lends consideration to non pharmacological interventions as a beneficial alternative. This study seeks to investigate the effect of
lullaby music on the physiological response and weight gain of premature infants in Mashhad, Iran.
Method: In this study, 44 very low birth weight infants 34 weeks of gestational age that were admitted to the Neonatal Intensive
Care Unit (NICU) of Imamreza Hospital in Mashhad, Iran were enrolled. Infants were randomly assigned to one of two groups:
the Music group and the Control group. Lullaby music was played through earphones for the Music group. This continued for 8
days at 20 minutes per day. The Control group received routine auditory stimulation. Neonates in the two groups were in stable
condition and kept in their isolettes. Infants were monitored for 40 minutes; 10 minutes baseline, 20 minutes into the intervention
and 10 minutes post intervention. Data measures were heart rate, respiration rate, oxygen saturation and body weight.
Result: The two groups differed significantly in the respiratory rate (p=0.01) and oxygen saturation (p=0.001). There were
no significant differences in the heart rate (p=0.24) and weight gain (p=0.093) between the two groups.
Conclusion: Preterm infants respond to lullaby music as evidenced by the changes in their respiratory rates and oxygen saturations.
Although this study did not demonstrate an improvement in weight gain, further studies are recommended to examine the effect
of music on other growth and developmental aspects.
Keywords: Lullaby music, physiologic response, weight gain, preterm infants
1This study has been funded by Mashhad University of Medical
Science.
Corresponding author: Amiri Rana, Neonatal Research Center,
NICU, Emamreza Hospital, Mashhad, Iran. Tel.: +98 5112709006;
Mobile: +98 9153065625; E-mail: amirir1@mums.ac.ir.
1. Introduction
The neonatal period is the most vulnerable period
of human life, so it should be given careful considera-
tion [1]. The incidence of premature birth varies from
6–15% and is related to geographic and demographic
status [2]. Approximately 9% of all births are admit-
1934-5798/10/$27.50 2010 – IOS Press and the authors. All rights reserved
Biostatistics department, Mashhad University of Mghkvhujhjvubiljknm ;',;,'edical Science, Mashhad, Iran
Ahmadshah Farhat RanaAmiri Sohaila Karbandi Habibollah Esmaily
Ashraf Mohammadzadeh
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ted to the Neonatal Intensive Care Unit (NICU), 7.7%
of births are low birth weight (LBW) and 1.5% very
low birth weight (VLBW) [3]. The major challenges
preterm infants face is weight gain and lung develop-
ment. Medical therapy such as assisted ventilation,
antenatal steroids and surfactant replacement therapy
have been increasingly effective in reducing mortali-
ty [4]. The environment provided to premature infants
is important, not only fortheir survivalbut also for their
development.
The nursing environment can be unpredictable and
over stimulating exceeding the tolerance level of pre-
mature infants [5]. The environmental noise in the
NICU contributes to increased stress, decreased sleep
times with subsequent behavioral and physiological
disturbances [6,7]. The source of noise may arise from
crying infants, talking staff, ringing telephones, and
alarming equipment which can peak to 80–90 db even
insidean isolette. Recordedlullabymusic isintroduced
into this environment as a more predictable and sta-
ble source of stimulation which masks intermittent and
unpredictable sounds, thereby causing the amount of
stress experienced by the infant to decrease [5]. Lulla-
bies are an appropriate sedative music selection for in-
fants because they contain lyrical predictable and ton-
ic oriented melodies of around 8 bars in length with
a steady rhythm of 60–80 beats /minute [8]. Audito-
ry capability is an early, discriminative ability of a fe-
tus. At 30–35 weeks the fetus hears and responds to
maternal sounds; and it is also capable of distinguish-
ing it from other sounds [9]. Some studies indicated
favorable auditory stimulations as effective for weight
gain and respiratory functions. Weight gain may be re-
sultant of an increased sleep period, decreased caloric
expenditure and regulated respiratory function [6,10–
13]. Increasing oxygen saturation (Spo2) without ex-
cessive O2therapy is an important in order to avoid
oxygen related complications [14]. In this study we
aimed to investigate the effect of lullaby music on the
physiological responses and weight gain of premature
infants.
2. Patients and methods
This study was a randomized, controlled trial con-
sisting of a Control group who received no music in-
tervention and a Music group that was exposed to lul-
laby music. The study was conducted in the NICU
at Imam Reza Hospital in Mashhad, Iran from July
2006 to February 2007. Criteria for inclusion in this
study were: adjusted gestational age 34 weeks; birth
weight between 1000–1500 grams; post natal age of
4 days; and clinically stable neonates (not supported
by ventilator assistance or oxygen therapy). Exclud-
ing criteria were: diagnosed hearing impairment; con-
genital anomalies; maternal drug addiction; and use of
oxygen. Sample size was calculated by considering
the mean and standard deviation (SD) of previous stud-
ies [5,10]. Sample sized was calculated for all vari-
ables including SPO2, heart rate (HR), respiratory rate
(RR) and weight gain and a sample of 40 infants (20
in each group) was considered adequate. All infants
were checked for hearing loss by auto acoustic emis-
sion (OAE) before entering the study. Infants were
randomly assigned to one of two groups. Infants in
the Control group received routine NICU nursing care.
Infants in the Music group received routine NICU care
as well as 20 minutes of music intervention every day
for 8 days. The music was commercially recorded lul-
labies sung by Iranian female vocalists; played by an
MP3player at 60–65 db inside the isolette. The decibel
levels were tested at the subject’s ear using a sound
level meter and the volume level on headphones was
then adjusted and covered to avoid accidental unsafe
changes in volume. Each subject was breast or bottle
fed and their diapers were changed within half an hour
before the intervention. Infants in the two groups were
evaluated and observed for 40 minutes every day for
8 days. The data collection was divided into 40 one
minute time samples. Heart rates and oxygen satura-
tion levels as displayed on the pulse oximeter record-
ed every minute. Respiratory rate was recorded every
5 minutes and weight gain was measured daily by a
digital weight scale. Neonates were evaluated during
3 phases: 10 minute baseline, 20 minute intervention
and 10 minute post intervention. During the second
observation the selected music was played via head-
phones for the music group and during the post obser-
vation period music was discontinued and the infant
was observed by the researcher.
3. Statistical analysis
The anthropometric data are presented as means ±
SD. For quantitative variables, comparisons between
the groups were performed by using independent t-
tests, and within the groups the paired t-test was used.
Categorical variables were analyzed using the chi-
squaretest andtheFisherexact test. If therewas no nor-
mal distribution non-parametrictests, such as the Mann
2A Farhat et al. / The effect of listening to lullaby music on physiologic response and weight gain of premature infants
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Table 1
Characteristics of preterm neonates in two groups
Variable Music group Control group P– value
Mean ±SD Mean ±SD
(n=22) (n=22)
Birth weight (g) 1279 ±172 1298 ±133 0.36
Gestational age (week) 30.5 ±1.7 30.5 ±1.7 0.96
Birth head circumference (cm) 28.7 ±1.2 27.7 ±1.5 0.008
Caloric intake before intervention 84.6 ±23.6 83.1 ±24.3 0.83
Caloric intake after intervention 117.6 ±21.4 117.1 ±30 0.95
Phototherapy (hours) 78 ±2.56 72 ±1.72 0.47
O2therapy (lit/min) 5.1 ±1.8 4.2 ±2.1 0.058
Start feeding (day) 2.5 ±1.4 2.8 ±1.3 0.29
Sex (male) N (%) 12 (54) 11 (48) 0.36
Whitney test, were used. To control for confounders,
general linear model regression was used. The cut- off
level for significance was chosen at p<0.05. Changes
from baseline were calculated (mean ±SD) for HR,
RR and SPO2during the second phase (intervention)
and the third phase (post intervention). The two groups
were compared during the music period and post ob-
servation for any change from the baseline period for
every day and means for a total of 8 days.
4. Results
A total of 44 preterm infants were studied (Music
n=22 and Control n=22). As shown in Table 1 the
two groups did not differ in demographic and clinical
characteristics. For the duration of the intervention, the
changes in SPO2in the intervention period were high-
er in the Music group than in the Control group (p=
0.001). Post intervention, the changes in the Music
group was still significant when compared to the Con-
trol group (p=0.019) (Table 2). When compared to
the Control group, more stable SPO2(less fluctuation)
was observed in the Music group at Days 7 and 8 (p=
0.05 and p=0.022 respectively) (Fig. 1).
Throughout the entire study, changes in the RR dur-
ing the second phase (intervention) were different be-
tween the two groups (p=0.017). During the third
phase (post intervention), changes in the RR were not
different between the two groups (p=0.94) (Table 2).
Respiratory rate decreased in the Control group be-
tween Day 1 and Day 4, followed by an increase after
Day 4. In the music group RR increased in Day 2, 3
and 6; it decreased in Day 4 and 5; and it remained
steady in Day 7 and 8 (Fig. 1).
Throughout the entire study, changes in the HR in
the second (intervention) and third phase (post inter-
vention) did not differ between the two groups (p=
0.24 and p=0.32 respectively) (Table 2), (Fig. 1).
Daily weight gain did not differ between the Music
and Control groups (36.79 ±31.83 and 18.63 ±39.05
respectively, p=0.093), (Fig. 1). In the linear model
regression, after controlling for variables such as birth
weight, gestational age, caloric intake before and after
intervention, phototherapy, start feeding and sex, the
difference between the groups remained significant.
5. Discussion
In this study, we demonstrated that SOP 2and RR in-
creased in the Music, but HR and daily weight gain did
not change between the two groups. The SPO 2and RR
areimportant and effectivevariableson neonates. Most
neonates in the NICU suffer from respiratory compli-
cations and they have apnea or low SPO2. If an inter-
vention can affect SPO2and RR, it is a considerable
point to take into account when caring for neonates.
Weight is a challenging issue among pre term infants
and an effective intervention for it is important. Al-
though, in this study, there was no difference in daily
weight gain between the two groups, further studies
are needed to confirm the lack of change (p=0.093).
Previous studies have shown harp music to be an effec-
tive intervention on weight gain and salivary cortisol
of neonates. Their methods were very similar to this
study but it was a pilot study and they studied only
8 neonates during 3 days. Their results showed that
weight gain differed between the harp music group and
the control group (p<0.05). Music may enhance
weight gain by decreasing activity and caloric expendi-
ture [15]. In 1991, Collin and Kuck [11] observed that
just one 10-minute music presentation significantly in-
creased SPO2among preterm infants (gestational age
of 24–37 weeks) who were in an agitated state. Chou
and Wang [13] also found exposure to lullaby music
caused increased SPO2in infants during tracheal suc-
A Farhat et al. / The effect of listening to lullaby music on physiologic response and weight gain of premature infants 3
Panel A Panel B
Panel C Panel D
Fig. 1. Comparison between the Music group (solid lines) and Control group (dashed lines) during the duration of the study. The graphs
illustrate the changes in SPO2(Panel A), respiratory rate (Panel B), heart rate (Panel C), and weight gain (Panel D). Data are expressed in means.
Significant differences are observed in SPO2(P =0.001) and respiratory rate (P=0.017).
tioning. Caine [10] also observed that music can af-
fect weight gain, caloric expenditure and hospital stay.
Coleman and Pratt [16] observed that music decreased
heart rate, increased oxygen saturation, reduced dis-
tressed behaviors and increased weight gain. Other
studies [6,12] obtained the same results. Lullaby mu-
sic may be useful because of its effect on the nervous
canter (limbic and autonomic) thus decreasing stress,
andinducing comfort and relaxation. Whenrespiratory
rates are regulated, oxygenation improves [17,18].
In their study, Cassidy and Standley [12] observed
preterm infants responded music on the first day in-
creased. However this response gradually decreased
because of habitation. Our findings do not support this;
in our study, response to the music fluctuated but we
did not see a decreased response in the following days.
Standley and Moore compared baseline, interven-
tionand post observation periodsandfound that lullaby
music increases SPO2. However after interrupting the
music, physiological responses decreased below base-
line. In our study there was a difference between the
2 groups; during the third phase (post-intervention),
SPO2remained high so even after the lullaby music
was interrupted the effect of music remained steady. In
our study, we did not observe a significant difference
in weight gain between the two groups (p=0.093),
(Table 3). However, we speculate that if lullaby music
was presented more frequently (2–3 times) each day
or the duration of the study period was increased (8+
days) then a significant difference would plausibly oc-
cur. This is the first study in Iran that evaluated the
effect of lullaby music on preterm infants and more
research is needed.
Acknowledgement
The authors would like to thank Research Vice
Chancellor of Mashhad Science University for fund-
ing this study. Additionally, we would like to thank
Mr. Farifteh (Music Training Professional), the Pejvak
Hearing Center and Miss Sedighee (data collection).
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4A Farhat al. / The effect of listening to lullaby music on physiologic response and weight gain of premature infants
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Financial disclosure
The authors do not have any financial interest to
disclose.
References
[1] S.J. Dureau, The effect of gender on one-day-old infants’ be-
havior and heart rate responses to music decibel level, J Music
Ther 42 (2005), 168–184.
[2] M. Michael and J. Slattery, Preterm Delivery, Lancet 36
(20020, 1489.
[3] J.S. Barbara and I. Adams-Chapman, The High-Risk Infant,
Chapter 97, in: Nelson Textbook of Paediatrics, (18th ed.),
R.M. Kliegman, Philadelphia: Saunders, 2006.
[4] M. Kennedy, Where does themusic come from? A comparison
case-study of the compositional processes of a high school and
a collegiate composer, Br J Music Educ 16 (1999), 157–177.
[5] J.A. Calabro, R.O. Wolfe and H.E. Shoemark, The Effect
of Recorded Sedative Music on Physiology & Behaviour of
Premature Infants with Respiratory Disorders, Australian J
Music Therapy 14 (2003), 3–19.
[6] J.M. Standley and R. Moore, Therapeutic Effects of Music and
Mothers Voice on Premature Infants, Pediatr Nurs 21 (1995),
574.
[7] J. Kaminski and W. Hall, The Effect of Soothing Music on
Neonatal Behavioural States in the Hospital Newborn Nursery,
Neonatal Netw 15 (1996), 45–54.
[8] A.M. Unyk, S.E. Trehub, L.J. Trainor and E.G. Schellenberg,
Lullabiesand Simplicity: A Cross-CulturalPerspective, Psych
of Mus 20 (1992), 15–28.
[9] J.M. Standley, The Effect of Contingent Music to Increase
Non-Nutritive Sucking of Premature Infants, Pediatr Nurs 26
(2000), 493–499.
[10] J.A. Caine, The Effect of Music on the Selected Stress Be-
havioural, Weight, Caloric and Formula Intake and the Length
of Hospital Stay of Premature and Low Birth Weight Neonate
in a Newborn Intensive Care Unit, J Music Ther 24 (1992),
180–192.
[11] S. Collins and K. Kuck, Music Therapy in Neonatal Intensive
Care Unit, Neonatal Network 9(1991), 23–26.
[12] J.A. Cassidy and J.M. Standley, The Effect of Music Listening
on Physiologic Response of Premature Infants in the NICU, J
Music Ther 32 (1995), 208–227.
[13] L.L. Chou, R.H. Wangand S.J. Chen, Effect of Music Therapy
on Oxygen Saturation in Premature Infants Receiving Endo-
tracheal Suctioning, J Nurs Res 11 (2003), 209–216.
[14] M.X. Repka, Ophthalmologic problems of the premature in-
fant, Ment Retard ber disabil Res Rev 8(2002), 249–257.
[15] K.J. Kemper and C. Hamilton, Live harp music reduces ac-
tivity and increases weight gain in stable premature infants, J
Altern Complement Med 14 (2008), 1185–1186.
[16] J. Coleman, R. Pratt, R. Stoddard, D. Gerstmann and H. Abel,
The Effects of Male and Female Singing and Speaking Voices
on Selected Physiological and Behavioural Measures of Pre-
mature Infants in the Intensive Care Unit, Int J Arts Med 5
(1998), 4–11.
[17] K.J. Kemper and S.C. Danhauer, Music as therapy, South Med
J98 (2005), 282–288.
[18] C.H. Patrick and K.U. Ashir, Loud Noise or Soothing Notes,
Int Pediatr 18 (2003), 204–208.
. A Farhat et al. / The effect of listening to lullaby music on physiologic response and weight gain of premature infants 5
... It can be concluded that lullabies can cause a decrease in heart rate. This is compatible with the work of Farhat (34) and Keith (35). They found that music causes a diminished rate of respiration (34,35). ...
... This is compatible with the work of Farhat (34) and Keith (35). They found that music causes a diminished rate of respiration (34,35). However, Coleman (36) found that music leads to an increase in respiratory rate, and the cause of this difference may be that the infants in the control and interventional groups in his study were not homogenous in terms of clinical diagnosis as neonates with different diagnosis could have other hemodynamic conditions that may have affected physiological parameters and disturbed the results (36). ...
... This is one important goal that could diminish oxygen complications. Earlier studies supported this finding that infants experienced high level of oxygen saturation after hearing music (12,34,35). In contrast, some researches indicated that there was no significant difference between music and oxygen saturation: This difference might be caused by the music type and number of participants compared to this study in which it is stated that a mother's sound may exert more effect on physiological parameters. ...
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... From the retrieved studies, only 6 (15.4%) had interventions delivered by a music therapist (MT intervention). 24,30,35,36,41,43 The remaining interventions follow under the categorisation of MM , [17][18][19][20][21][22][23][25][26][27][28][29][31][32][33][34][37][38][39][40]42,[44][45][46][47][48][49][50][51][52][53][54][55] and included diverse music genres (such as classical music or western lullabies), pre-recorded and selected by the researcher without consultation from a music therapist. ...
... 41 14 However, in the current review, conflicting results were found for outcomes such as HR, RR, satO2, BP, weight gain, circadian rhythm, feeding behaviour or rate and behavioural states . 29,[32][33][34]37,39,40,46,49,[51][52][53][54][55] This suggests that a more detailed analysis is needed in order to comprehend the type of interventions that were carried out. ...
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Background: Preterm babies are exposed to many repetitive painful interventions in NICU. Aims: This study aimed to comparatively determine the effect of white noise and lullabies on pain perception and vital signs of premature babies during painful interventions. Design: Randomised controlled trialParticipants/Subjects; A sample group of 66 premature babies with a gestational age of 3237 weeks and a weight more than 1000 g were included in this study conducted between May and August 2019 in the NICU of a university hospital. Methods: The babies were randomly divided into three groups: lullaby, white noise, and control. The behavioral responses of the babies were recorded with a camera during the whole procedure. Before, during, and after the procedure, the heart rate, respiratory rate, and oxygen saturation level were measured and recorded, and the pain was evaluated using the premature infant pain profile (PIPP) after the procedure. The mean PIPP score, heart rate during and after the procedure, mean respiratory rate, and oxygen saturation were significantly lower in the white noise and lullaby groups compared with the control group (P < 0.001). Results: The premature babies in the white noise group were found to have the lowest mean PIPP score, mean heart rate, and respiratory rate, and the highest mean oxygen saturation rate (p < 0.001). Conclusions: The white noise and lullabies played to premature babies during the blood collection process were effective in pain reduction, and the pain score was lower in the white noise group than in the lullaby group.
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Aim This paper summarises published evidence on the use of recorded music in high-risk infants to reduce stress and improve neurodevelopment, forming recommendations for proposed clinical applications in neonatal intensive care units. Methods We searched two comprehensive library catalogues and two databases for articles evaluating the impact of recorded music interventions on hospitalised preterm infants. Original and review papers published in English in the 10 years prior to this search were selected if the study included a component of recorded music interventions. Results Most original studies (80.95%), and all literature reviews (100%) reported positive effects of recorded music interventions for preterm infants, primarily in the short term. No negative effects were reported. Evidence is emerging regarding the neurobiological mechanisms of recorded music on longer-term effects on preterm infant neurodevelopment. Clinical applications were suggested drawing upon available evidence. Due to generally small sample sizes and variability in study design, unanswered questions remain. Conclusion Carefully designed recorded music interventions appear to be safe, feasible, and effective in reducing stress and improving neurodevelopment of hospitalised infants. Additional rigorous, well-powered trials with relevant outcomes are needed to further refine specific elements for recorded music interventions to better inform practice.
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Background and Objectives: Hearing loss is one of the most common childhood disorders, which has a great impact on communication and the development of speech and language skills. In recent years' researchers have emphasized the importance of timely intervention in the treatment and rehabilitation of hearing loss from the beginning of the infancy. Cochlear implantation is one of the promising therapies recently developed for deaf children. It is a new technology in hearing aids and is an accepted treatment for children with severe to profound sensory neural hearing loss. The age of diagnosis and intervention has also received much attention recently, and the reduction in the age of diagnosis to the first week after birth as well as the decrease in cochlear implantation age to ten months is a testament to this (Daneshi & Hassanzadeh, 2007). The effect of Music therapy in the field of complementary therapies has also been expanded. Therefore, the present study aims to develop an educational program based on music therapy and the content of lullabies and motion and rhythmic songs and its effectiveness on communication skills and parent-child interaction for deaf cochlear implantation children under the age of three years was performed in the auditory cochlear implantation Center of Rasoul-e-Akram Hospital. Method: The present study is a Quasi-experimental experimental design with two groups of test/control, pre-test, and post-test. The research populations of this study were children with cochlear implants under the age of 3 and their mothers with normal hearing. Firstly 30 samples including children and their hearing mothers were selected through nonrandom available and targeted sampling in the auditory cochlear implantation Center of Rasoul-e-Akram Hospital. But according to a lack of continuous cooperation, the numbers of samples decreased to 22 which remained 10 children and their mothers in the test group and 12 ones in the control group. The experimental group participated in sessions that were performed with lullaby content and rhythmic songs and motions in the sensory integration room of the cochlear implant center of Rasoul-e-Akram Hospital .The control group only had the usual rehabilitation program in the center and their city which lived. The two groups, respectively, evaluated by the Category of auditory performance of the Persian version (Hasanzadeh, 1393) and the Speech intelligibility rating, the Persian version (Hasanzadeh, 1393) and the parent-child interaction scale (Pianta, 1994) in two stages of pre-test and post-test. The scores were processed by Spss 23 software and descriptive statistics (mean and standard deviation) and inferential statistics were used for the analysis of univariate analysis of covariance.
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Introduction: Low birth weight (LBW) infants who have been hospitalized are exposed to various conditions that provoke discomfort, which could trigger a stress response and growth disorders. This study aimed to identify the effects of auditory stimuli from Murottal Quran when it comes to the comfort and weight of LBW infants. Methods: This study used a clinical randomized controlled trial design involving 52 low birth weight infants. The infants were randomly assigned to either the intervention group (n=26) or the control (n=26). The intervention of Murottal Quran was given using a speaker 4 times a day for 20 minutes every 3 hours. This intervention was conducted for three days. Results: The results of this study show that there is a significant difference in the comfort of low birth weight infants after Murottal Qur’an on the first, second, and third days between the intervention and control groups (p=0.014;
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Aim: Music is increasingly being used in neonatal intensive care units to aid neurode-velopmental care. The aim of this pilot study was to examine the possible effects of music on quiet sleep (QS) in neurologically healthy newborns. Methods: Twenty newborns ‡32 weeks' gestational age admitted to the neonatal intensive care unit at The Royal Children's Hospital in Melbourne for specialist consultation were randomly assigned to experimental or control groups. Ten subjects were exposed to music (Music for Dreaming, (Sound Impressions, Pty. Ltd.) using a CD player (50–55 decibel A). Amplitude-integrated EEG was recorded on the BrainZ Monitor (BRM2, Version 8.0, Natus). Background pattern, presence and quality of sleep–wake cycles (SWC) were assessed before and after exposure to music. Results: All 20 subjects showed continuous background patterns with developing SWC. Whereas no subject in the control group showed differences in their QS and eight patients in the intervention group showed lower minimum amplitudes of their QS after music exposure. Also, the length of QS and interval between QS epochs became progressively longer in all ten subjects of the intervention group. Conclusion: We report a trend to more mature SWC in subjects who were exposed to music when compared to controls suggesting that there might be a small effect of music on quiet sleep in newborns.
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Pairs of folk melodies and comparison songs from different cultures were presented to adult listeners, who were required to choose the simpler song in each pair. Adults judged the lullaby excerpts as simpler whether presented with original field recordings, low-pass filtered versions that made the words unintelligible or excerpts synthesized with a uniform (piano) timbre. Structural analyses of the songs failed to reveal musical features that differentiated lullabies from other songs. Nevertheless, such analyses revealed melodic features that predicted adults' identification of lullabies.
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Music is widely used to enhance well-being, reduce stress, and distract patients from unpleasant symptoms. Although there are wide variations in individual preferences, music appears to exert direct physiologic effects through the autonomic nervous system. It also has indirect effects by modifying caregiver behavior. Music effectively reduces anxiety and improves mood for medical and surgical patients, for patients in intensive care units and patients undergoing procedures, and for children as well as adults. Music is a low-cost intervention that often reduces surgical, procedural, acute, and chronic pain. Music also improves the quality of life for patients receiving palliative care, enhancing a sense of comfort and relaxation. Providing music to caregivers may be a cost-effective and enjoyable strategy to improve empathy, compassion, and relationship-centered care while not increasing errors or interfering with technical aspects of care.
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It is well known that listening to music makes a person feel good and it is also believed that it expedites the body's healing processes so that the person may return to a normal state. This project was undertaken to review the relevant literature to find out why and how this occurs. The first portion of this paper discusses the proposed physiologic mechanisms through which music is thought to affect the body, while the second portion of this paper examines two types of case studies - those in which physiological indices such as heart rate and blood pressure were analyzed, and those in which hor- mones, chemical, and cytokine levels were analyzed. Int Pediatr.
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Examined the effect of music listening on the physiological responses of 20 low birthweight infants with normal hearing in the 1st wk of life. 10 infants listened to lullabies, and 10 infants did not. Oxygen saturation levels, heart rate, respiratory rate, and number of apnea/bradycardia episodes were recorded once per minute for the duration of baseline and treatment conditions. Results indicate that music was not contraindicated in the 1st wk of life for these Ss for whom sensory stimulation is usually restricted. Music had noticeably positive effects on oxygen saturation levels, heart rate, and respiratory rate. No increase in apnea/bradycardia episodes following music treatment was observed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This comparison case-study examines the compositional processes of a high school and a collegiate composer engaged in a similar task. Procedures included interviews with the composers, observations, and the collection of compositional sketches and ‘audio-journals’. Analysis involved the preparation of field-notes and interview transcripts, document analysis and study of the field note/interview text. Two professional composers and the researcher analysed the compositions to locate similarities and differences. Important similarities were the use of an exploratory phase at the piano and the acknowledgement of both inspiration and revision as components of the composition process. Differences were found in the uses of time and structure.
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Dear Editor: Music enhances weight gain in premature infants on fixed feeding regimens.1 To better understand the mechanism of this effect, we assessed the effects of live harp music on salivary cortisol (SC), heart rate variability (HRV), and activity in a pilot study of 8 stable premature infants. All infants were at least 34 weeks gestation, had passed a newborn hearing screen, and had no medical conditions or medications affecting cortisol levels, cardiac function, activity, or caloric intake. Infants were randomly assigned to usual care (4), quiet room (2), or harp music (2) for 45 minutes at the same time daily for 3 days. For the quiet room, infants were moved to a room used for transition to home where noise levels were approximately 30 decibels quieter than in our intermediate care nursery. For the harp music group, the infants were moved to the same room, but provided with 45 minutes of harp music, with volumes similar to those in usual care. Outcomes were measured at the same time daily. SC was measured twice (before and after the intervention, approximately 1 hour apart). HRV was measured using a MiniMitter 2000 (MiniMitter Inc., Bend, OR) and calculated in standard fashion.2 Activity was measured using a wristwatch actimeter (Actiwatch Model 64, Respironics Inc., Pittsburgh, PA), placed on the left lower leg. This study was approved by the Institutional Review Board of the Wake Forest University School of Medicine. At baseline, the 8 study infants had an average gestational age of 36.4 weeks and weight of 2279 grams, which was similar for all three groups. Weight gain during the study was greatest in the harp music infants (average gain of 19.1 g/kg-day), next highest in the quiet room infants (17.2 g/kg-day), and least in the usual care infants (13.3 g/kg-day) (p < 0.05). SC and HRV parameters were similar in all three groups; SC fell equally in all groups. Activity fell by approximately one order of magnitude in the 2 hours after the study intervention (from 5000 to 490 movements per hour, p < 0.01). This activity change was not observed in the other groups. Music may enhance weight gain by decreasing activity and caloric expenditure. Although it is not possible to rule out effects of music on SC or HRV, these pilot data suggest that larger studies should focus primarily on the effects of music on activity to promote weight gain in premature infants.
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Forty-four of the 262 pupils at the school for blind and visually handicapped children in Nuremberg, i.e., 17%, suffer from sequelae of retinopathy of prematurity (ROP); this condition is currently top of the list of causes of blindness. The risk factors involved were identified by analyzing 294 histories of premature children born between 1981 und 1984. In the case of 16 children, ophthalmoscopic criteria were taken from the 1984 international classification. The data of the children with ROP, at birth and at the time when ROP developed, were recorded on a prognosis card, in each case between the child's absolute age (abscissa) and birthweight in g (ordinate). In this way it was possible to read off the critical phase of retinal development for each newly examined child. This card facilitates monitoring, the provision of forensic evidence, the timing of ophthalmoscopy during critical phases of retinal development, and may also enable further relationships to be detected.