Exploring the effectiveness of music therapy activities in improving the physical fitness, activity and depression in the frailty of the community elderly

• Main Authors: LU, MEI - LING, 盧美鈴
• Other Authors: Chen, Miao-Yen, RN, Ph.D.
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/f7e4xv

碩士 === 國立臺北護理健康大學 === 護理研究所 === 107 === Objective: To investigate the effectiveness of music therapy activities in improving the physical fitness and mobility and reducing the depressive emotions in the frailty of community elderly, in addition to constructing a suitable proposal for promoting the use of music therapy activities. Background: In March 2018, Taiwan officially became an aging society as the elderly accounted for 14.05% of the country’s total population. The aging process and increase in chronic diseases that the elderly experience have led to physical decline and depression, which are not only the most common health problems among community elderly but also great burdens for society and families as they increase medical costs and labor requirements for providing care. Hence, the only way to address this issue is to improve the physical and mental health of the elderly. Flexible adjustments can be made in music therapy activities according to the strengths, preferences, and requirements of the participating elderly individuals. Hence, music therapy programs that involve various group activities are well received among the elderly as they are a practical and low-cost approach to promote the overall health of the elderly, in addition to significantly improving their physical fitness and mobility while reducing their depressive emotions. Method: A single-blind randomized controlled trial (RCT) approach was used in this study. Purposive sampling was conducted at four community care centers where elderly individuals aged 65 and above were subjected to a pre-intervention test that aimed to check if they met any frailty criteria. The test was completed by measuring the elderly’s BMI and dominant hand grip strength and assessing their performances in the 30-second sit-to-stand test, 2-minute leg raise test, and 2.44 m up-and-go test. The Chinese version of the International Physical Activity Questionnaire - Short Form (IPAQ-SF) was used to assess the mobility of the elderly, while the Taiwan Geriatric Depression Scale (TGDS-30) and each elderly individual’s self-perceived health were used to check if the given elderly individual had depressive tendencies. Participants were selected if they had at least one of the five frailty criteria proposed by Fried, or if their TGDS-30 score was at least 15 or higher. Then, participants from the four community care centers were randomly divided into two control groups and two experimental groups. The experimental group participated in music therapy activities in addition to routine activities in the care center, while the control group only participated in routine activities in the care center. The music therapy activities were held once every week for 12 weeks, with each session lasting 90 minutes. The first post-intervention test was conducted in the 13th week, while the second post-intervention test was conducted in the 16th week in response to emotional problems experienced by some participants. The pre-intervention and the two post-intervention test results were analyzed and filed using IBM SPSS 22 and SAS statistical software. Descriptive statistics were obtained, such as the percentage, mean, and standard deviation. The t-test was used to analyze the homogeneity of the two groups; the Pearson correlation and the Linear Mix Model were used to analyze the interactions between the timing of the tests and the performance indicators of the two groups. Results: There were 55 participants in this study: 30 were in the experimental group while 25 were in the control group. After 12 weeks of participating in the music therapy activities, the pre-test, first-post-test, and second post-test results of the experimental group for the 30-second sit-to-stand test, were 14.77, 16.17, and 17.70 times, respectively, indicating an overall improvement of 2.93 times, whereas the overall improvement of the control group was 1.24 times. In the 2-minute leg raise test, the three test results of the experimental group were 77.53, 86.20, and 86.53 times, respectively, indicating an overall improvement of 9 times, whereas the overall improvement of the control group was 0.08 times. In the 2.44 m up-and-go test, the three test results of the experimental group were 10.60, 9.54, and 9.18 seconds, respectively, indicating an overall improvement of 1.42 seconds, whereas the overall improvement of the control group was 1.06 seconds. In terms of grip strength, the three test results of the experimental group were 20.37, 22.02, and 22.87 kg, respectively, indicating an overall improvement of 2.5 kg, whereas the overall improvement of the control group was 0.32 kg. In the first post-test, a statistically significant interaction was observed in both groups for the 2-minute leg raise test, in which the estimated intervention effect size was 10.29 (p = .02). Meanwhile, improvements were observed in the other performance indicators, but they were not statistically significant. In the second post-test, statistically significant interactions were observed in both groups for four performance indicators, namely, the 2-minute leg raise test results, for which the estimated intervention effect size was 12.86 (p = .00); the grip strength results, for which the estimated intervention effect size was 0.95 (p = .03); the TGDS-30 scores, for which the estimated intervention effect size was -1.59 (p = .03); and the mobility results (in terms of the IPAQ-SF), for which the estimated intervention effect size was 1098.47 (p = .00). In contrast, statistically significant interactions were not observed in either group for four other performance indicators, namely, the 30-second sit-to-stand test results, for which the estimated intervention effect size was 1.42 (p = .22); the 2.44 m up-and-go test results, for which the estimated intervention effect size was -0.22 (p = .67); the self-perceived health results, for which the estimated intervention effect size was 0.27 (p = .49); and the BMI results, for which the estimated intervention effect size was 0.78 (p = .39). Conclusion: Music therapy can improve the cardiovascular functions, upper body muscle strength, and lower body mobility of community elderly, in addition to reducing their depressive emotions and increasing their daily level of physical activity. Moreover, the findings from this study suggest that music therapy activities have a prolonged effect, as the physical fitness and mobility levels of the elderly still showed improvement and their depressive emotions were still reduced even after the activities had stopped for four weeks.