The Effects of VibroAcoustic Therapy on Clinical and Non-Clinical Populations

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THE EFFECTS OF

VIBROACOUSTIC THERAPY

ON CLINICAL AND

NON-CLINICAL POPULATIONS

ANTHONY LEWIS WIGRAM

THESIS SUBMITTED FOR THE DEGREE OF

DOCTOR OF PHILOSOPHY

ST. GEORGES HOSPITAL MEDICAL SCHOOL

LONDON UNIVERSITY

Published: 1996

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ABSTRACT

Vibroacoustic and vibrotactile devices that transmit sound as vibration to the bodyhave developed over the last 15 years, and have been reported anecdotally toproduce relaxation and reductions in muscle tone, blood pressure and heart rate.Vibroacoustic (VA) therapy is used in clinical treatment and involves a stimulus thatis a combination of sedative music and pulsed, sinusoidal low frequency tonesbetween 20Hz and 70Hz, played through a bed or chair containing large speakers.There is limited evidence to support the efficacy of VA therapy in the clinicalsituations in which it is used. The studies in this thesis investigated the clinical effectof VA therapy, and the effect of elements of the stimulus on non-clinical subjects.A study on 10 multiply handicapped adults with high muscle tone and spasmcompared the effect of eight trials of VA therapy with a similar number of trials ofrelaxing music. A significantly greater range of movement was recorded after VAtherapy than relaxing music. No significant difference was found in changes in bloodpressure or heart rate.A second study on non-clinical subjects (n=60) in three groups found that VAtherapy had a significantly greater effect in reducing arousal when compared withrelaxing music, and a control, and heart rate when VA therapy was compared with acontrol. No significant differences were found between the groups in changes inblood pressure.

1.1. ORIGIN OF STUDY

The development of Vibroacoustic (VA) therapy as a form of treatment began in theearly 1980's. VA therapy as defined in the research reported in this thesis is atreatment involving the psychological and physical stimuli of relaxing music andpulsed sinusoidal low frequency tones between 20Hz and 70Hz played throughspeakers built into a bed (Fig.1 and Fig 2). Patients, or subjects involved in theseresearch studies, lie on the bed, and experience a sensation of vibration from themusic and sinusoidal tones, and at the same time hear both of these stimuli.Vibroacoustic units have been developed for both treatment and research, and thedesign and specifications of these units varies. The beds that were constructed to beused in the research documented in this thesis were designed with bass speakersbuilt into the base of the units capable of reproducing music and pulsed, sinusoidallow frequency sound within the range defined above. Figure 1 shows a vibroacousticbed, and Figure 2 demonstrates how the speakers are secured into the base of thebed.The studies and experiments documented in this thesis emerged from a desire toresearch objectively and analyse the effect of VA therapy, both on the clinicalpopulation with whom I have been working as a music therapist for a largeproportion of my professional career, and also with the non-clinical population.There is limited anecdotal material documenting applications of VA or vibrotactile

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devices, very little of which has involved any objective research. The historicaldevelopment of VA therapy is a sequence of apparently unconnected events. It is notconfined to one country, and has emerged in America, Scandinavia, England and oneor two other countries in Europe. It is quite difficult to put VA therapy into a context,which has affected the way it has developed. It includes aspects of music therapy,music in medicine and music psychology. Medical practitioners, paramedical staff,teachers, researchers and commercial organisations have been developingvibroacoustic units and systems for treatment, and have often independently definedprocedures for using equipment, treating patients and monitoring the effect. Theapplication of VA therapy has attracted specific attention within the broadly basedfield of music therapy. This is natural as the treatment involves the use of differentstyles of recorded music, and concerns the physiological and psychological effect ofthe music that is chosen to be used. The simultaneous use of a pulsed low frequencysinusoidal tone together with the vibrational effect of music played through a bed orchair that is designed to transfer a sensation of vibration to the patient does notnormally come within the traditional framework of current treatment practice inmusic therapy. Practitioners in the field of music and medicine, occupationaltherapy, physiotherapy and nursing have more typically embraced these methodsand developed its use. Understanding the relationship between VA therapy andmusic therapy, and VA therapy and practices in music and medicine is relevant inorder to contextualise the research documented in this thesis.The application of a pulsed, sinusoidal low frequency soundwave is a significant partof VA therapy. The research on human response to infrasound and low frequencysound is extensive, although there are very few studies on its benefits as a stimulusused in clinical treatment.Between 1983 and 1985, the Forsvarets Materielverk (FMV) of the Swedish DefenceMaterial Administration collected together a substantial bibliography and summaryof articles on low frequency sound and infrasound (FMV, 1983; FMV, 1985). FMVwere concerned with noise problems generally, and much of the focus for theircollation of articles stemmed from a conference held in 1980 in Aalborg, Denmark,entitled "Low Frequency Noise and Hearing". In the introduction section to theirsummary of interesting articles, it is stated that:

"Infra Sound is of course not at all a new concept within acoustics. According todefinition, this means sounds with frequencies below 20Hz. This is what is usuallyreferred to as 'not audible sound'."

It goes on to say:

"We adopt without any reservation, the opinion that instead of "infra sound" weshould talk of "low frequency sound" (below 100Hz) where human effects areconcerned."

In general infrasound should not be a direct problem for normal people and researchresults support this. This report states that there is not enough research on low