title: 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.
authors.affiliation: a Leopold Mozart Centre for Music and Music Education , Augsburg University , Augsburg , Germany.
authors.forename: Isolde
authors.initials: I
authors.lastname: Binzer
authors.affiliation: a Leopold Mozart Centre for Music and Music Education , Augsburg University , Augsburg , Germany.
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Schmidt
authors.affiliation: a Leopold Mozart Centre for Music and Music Education , Augsburg University , Augsburg , Germany.
authors.forename: Tonius
authors.initials: T
authors.lastname: Timmermann
authors.affiliation: b Therapiezentrum , Burgau , Germany.
authors.forename: Maret
authors.initials: M
authors.lastname: Jochheim
authors.affiliation: c Department of Neurology , University of Munich (LMU) , Munich , Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bender
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009147:Music Therapy; D018458:Persistent Vegetative State / Q000503:physiopathology*; D056152:Respiratory Rate / Q000502:physiology*; D055815:Young Adult
keywords: Music therapy; minimally conscious state; unresponsive wakefulness syndrome; vegetative state