Immediate responses to individual dialogic music therapy in patients in low awareness states

Abstract

Objective: The aim of this study was to analyse immediate responses to individual dialogic music therapy (IDMT) of patients with unresponsive wakefulness syndrome (UWS) and individuals in a minimally conscious state (MCS) and to develop an assessment tool for IDMT.

Methods: Seven patients were subjected to three conditions: (1) sounds and stimuli of the daily environment immediately before IDMT, (2) specific improvisational music therapy intended to establish a dialogue with the patient (IDMT) and (3) sounds and stimuli of the daily environment immediately after IDMT. Video recordings were analysed by six independent assessors using ‘Music Therapy in a Vegetative or Minimally Conscious State (MUVES)’, an assessment tool developed in this study. Diagnosis of UWS or MCS was established using the coma recovery scale-revised (CRS-R).

Results: During IDMT, MUVES total score was higher than during the other conditions (mean difference = 3.36; p = 0.02). During IDMT, there was no significant difference in MUVES total score between the UWS and MCS sub-groups (p = 0.29). Mean inter-rater-reliability of MUVES total score was 0.76.

Conclusions: IDMT may induce immediate responses in patients in low awareness states, particularly also in patients with UWS. MUVES appears to be an acceptably reliable assessment tool for IDMT.

Keywords:

• Music therapy
• unresponsive wakefulness syndrome
• vegetative state
• minimally conscious state

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.