US National Academy of Medicine
10/1/2021 - 9/30/2022
Elizabeth Murnane, PhD (Thayer School of Engineering, Dartmouth College)
Other Project Staff
PhD students Shirin Amouei and Songyun Tao
Music is potent medicine, positively contributing to human development, disease treatment, and overall well-being throughout the lifespan. Exploring how music-based interventions can transform how we promote healthy aging, this proposal focuses on managing pain, which increases with age and is linked with numerous aspects of functioning, mental health, and quality of life. Given the experience of pain is both physical and psycho-emotional, we propose an integrative new paradigm: leveraging music’s physiological, psychological, and neurological effects by developing interventions that combine self-expressive, music-making activities with movement-based therapies that aid pain recovery and management. We see interactive, sensor-embedded personal phones and wearables as a major opportunity to deliver and monitor the impacts of these interventions in an adaptive, personalized, and broadly scalable manner. We are particularly keen to explore musical interfaces that sonify body movement; for example, hand and finger exercises for osteoarthritis could be delivered through a virtual piano displayed on a smartphone screen, while a low-back pain patient’s reaching exercises could be sonified by mapping Fitbit gyroscope data to musical frequencies, notes, and chords. Our research will pursue the participatory design and proof-of-concept evaluation of such interactive musical interventions. Focusing on establishing feasibility, generating design guidelines, and informing technical implementation, we will examine people’s engagement with and the early efficacy of this style of intervention, in terms of short-term physical improvements (e.g., in pain intensity, impairment, proprioception) and psychological benefits (e.g., in anxiety, fear, mood, self-efficacy) as well as user experience metrics that foreshadow longer-term adoption and adherence.
Public Health Relevance
The World Health Organization recognizes pain as a serious public health problem, affecting tens of millions, with both prevalence and inadequate treatment disproportionately affecting vulnerable populations including older adults, children, and racial and ethnic minorities. Unfortunately, the experience of pain has widespread negative effects beyond physical functioning, also impacting mood, sleep, and numerous dimensions of life quality. Physical movement is crucial for pain management, inhibiting the neurophysiological mechanisms underlying pain spread and protecting against weakening, while helping to regain functioning, flexibility, and strength. At the same time, psychological factors significantly impact the pain experience, and emerging neurobiology research is shedding light on the brain mechanisms of pain. Therefore, as the understanding of pain has advanced, so has awareness of the value of integrative treatment approaches. Development of non-pharmacological and non-opioid strategies can also help combat the growing crisis of pain medication addiction and misuse. This project proposes novel therapeutics that marry movement with music, given growing evidence of music’s ability to ameliorate both acute and chronic pain due to endorphin release, distraction, and the spinally mediated nociceptive flexion reflex. Prior studies also demonstrate that physical music performance improves both pain tolerance and positive affect. Further, by re-envisioning patients as artists, musical interventions can help shift imbalances in therapist-patient power dynamics to foster more collaborative rehabilitation, which can be especially important for patient groups that face communication barriers such as individuals with cognitive, motor, or speech impairments due to age, injury, stroke, or stigma.