title: Live music is beneficial to preterm infants in the neonatal intensive care unit environment.
abstract: BACKGROUND
  Music stimulation has been shown to provide significant benefits to preterm infants. We hypothesized that live music therapy was more beneficial than recorded music and might improve physiological and behavioral parameters of stable preterm infants in the neonatal intensive care unit.
  
  
  METHODS
  Thirty-one stable infants randomly received live music, recorded music, and no music therapy over 3 consecutive days. A control of the environment noise level was imposed. Each therapy was delivered for 30 minutes. Inclusion criteria were postconceptional age > or = 32 weeks, weight > or = 1,500 g, hearing confirmed by distortion product otoacoustic emissions (DPOAEs), and no active illness or documentation of hyperresponsiveness to the music. Heart rate, respiratory rate, oxygen saturation, and a behavioral assessment were recorded, every 5 minutes, before, during, and after therapy, allowing 30 minutes for each interval. The infant's state was given a numerical score as follows: 1, deep sleep; 2, light sleep; 3, drowsy; 4, quiet awake or alert; 5, actively awake and aroused; 6, highly aroused, upset, or crying; and 7, prolonged respiratory pause > 8 seconds. The volume range of both music therapies was from 55 to 70 dB. Parents and medical personnel completed a brief questionnaire indicating the effect of the three therapies.
  
  
  RESULTS
  Live music therapy had no significant effect on physiological and behavioral parameters during the 30-minute therapy; however, at the 30-minute interval after the therapy ended, it significantly reduced heart rate (150 +/- 3.3 beats/min before therapy vs 127 +/- 6.5 beats/min after therapy) and improved the behavioral score (3.1 +/- 0.8 before therapy vs 1.3 +/- 0.6 after therapy, p < 0.001). Recorded music and no music therapies had no significant effect on any of the tested parameters during all intervals. Both medical personnel and parents preferred live music therapy to recorded music and no music therapies; however, parents considered live music therapy significantly more effective than the other therapies.
  
  
  CONCLUSIONS
  Compared with recorded music or no music therapy, live music therapy is associated with a reduced heart rate and a deeper sleep at 30 minutes after therapy in stable preterm infants. Both recorded and no music therapies had no significant effect on the tested physiological and behavioral parameters.
authors.affiliation: Department of Neonatology, Meir Medical Center, Kfar-Saba, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.forename: Anat
authors.initials: A
authors.lastname: Shapsa
authors.forename: Liat
authors.initials: L
authors.lastname: Forman
authors.forename: Rivka
authors.initials: R
authors.lastname: Regev
authors.forename: Sofia
authors.initials: S
authors.lastname: Bauer
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
authors.forename: Tzipora
authors.initials: T
authors.lastname: Dolfin
mesh_terms: D000704:Analysis of Variance; D001143:Arousal / Q000502:physiology*; D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D005260:Female; D006272:Health Facility Environment; D006339:Heart Rate; D006801:Humans; D018730:Infant Behavior; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology*; D007363:Intensive Care Units, Neonatal; D007557:Israel; D008297:Male; D009147:Music Therapy / Q000379:methods*; D010290:Parents; D012890:Sleep