Combining Kangaroo Care and Live-Performed Music Therapy: Effects on Physiological Stability and Neurological Functioning in Extremely and Very Preterm Infants

Abstract

Interventions such as kangaroo care (KC) and live-performed music therapy (LPMT), are increasingly used to facilitate stress reduction in neonates. This study aims to investigate the effect of combining the two on physiological responses and neurological functioning in very preterm infants. Infants received six sessions of LPMT. KC was added to one LPMT session. Physiological responses included heart rate, respiratory rate and oxygen saturation. We videotaped infants for 30 min before and after two sessions to assess general movements (GMs). We included 17 infants, gestational age median 26.0 weeks (IQR 25.6–30.6 weeks), of whom six were males. Combined interventions showed a decrease in heart rate from mean 164 bpm before to 157 bpm during therapy, p = 0.001. Oxygen saturation levels increased during combination therapy from median 91.4% to 94.5%, p = 0.044. We found no effects of LPMT or combined interventions on GMs. Infants with a postnatal age (PNA) < 7 days generally seem to display less optimal GMs after therapy compared with infants with a PNA >7 days. In conclusion, combining interventions is equally beneficial for physiological stability and neurological functioning as LPMT alone. Future studies should focus on the effects of this combination on parent-infant bonding.

Impact of Physical Contact on Preterm Infants’ Vital Sign Response to Live Music Therapy

“…Only a few studies compared the effect of kangaroo care or physical contact with and without music therapy [ 20 ], and music therapy with and without kangaroo care [ 21 ], on preterm infants’ vital signs. Combining music therapy with kangaroo care showed stronger declines of heart and respiratory rates and an increase of oxygen saturation compared to kangaroo care alone [ 21 ].…”

“…Combining music therapy with kangaroo care showed stronger declines of heart and respiratory rates and an increase of oxygen saturation compared to kangaroo care alone [ 21 ]. Another study with music therapy by a qualified music therapist who sang and played improvised melodies on an ocean disc and guitar showed decreased heart rates and increased oxygen saturations in infants who received music therapy during kangaroo care, while infants receiving music therapy alone showed no vital sign responses [ 20 ]. Matching the results of these two studies, combining kangaroo care and lullaby music showed stronger effects on heart rate and oxygen saturation compared to an only-lullaby music group and a control group receiving kangaroo care [ 34 ].…”

“…For example, preterm infants with severe brain injury displayed physiological and behavioural instability during the singing of their mother and kangaroo care [ 17 ]. In stable infants with normal hearing, additional live music therapy during kangaroo care to enhance stress reduction showed beneficial effects on heart rate, oxygen saturation [ 18 , 19 , 20 , 21 ], length of hospital stay, and re-hospitalisation rate compared to kangaroo care alone [ 22 ]. The applied study designs included cross-over designs [ 19 ], randomized controlled trials [ 17 , 18 , 21 , 22 ], and analysis of a complete cohort [ 20 ], typically comparing baseline with post-therapy values.…”

The benefits of music therapy on preterm infants in the intensive care unit

“…It is worth noting that music therapy without the voice has the same impact on the patient´s vital signs as other methods of MT, such as lullabies, conversations between parents and children, live music and the combination of other methods that stimulate the connection between parents and neonates. Among the methods of MT explored in other studies, it has been demonstrated that principally the HR shows changes under this adjuvant therapy [6,15,[18][19][20]. It is therefore understood that MT is an alternative therapy with signi cant results and that has the ability to bene t patients in the NICU.…”

Kanguru Bakımı Sırasında Müzik Uygulamasının Prematüre Bebeklerin Davranış Durumu ve Fizyolojik Parametrelerine Etkisi: Bir Sistematik Derleme ve Meta-Analiz Protokolü

“…Literatür incelendiğinde, KB sırasında müzik uygulaması sadece KB uygulaması ile karşılaştırıldığı [19][20][21]24,25 , KB sırasında müzik uygulamasının standart bakım ile karşılaştırıldığı 26,27 , KB sırasında müzik uygulamasının sadece müzik uygulaması ile karşılaştırıldığı görülmektedir. 27,28 Meta-analizler kanıt düzeyi yüksek çalışmalardır. İyi tasarlanan bir meta-analiz ile tüm literatürün gözden geçirilmesi mümkündür.…”