The Music Activity INTervention for Adherence Improvement Through Neurological Entrainment

NCT01752595 | Completed

• 1 other identifier: 12-035
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

Auditory motor-coupling has been shown to induce neural-entrainment that can synchronize walking-pace with sonic tempo. The extent to which acoustical-motor entrainment can induce longer-term changes to physical activity behaviours remains unclear. Cardiac rehabilitation is essential and is associated with irrefutable mortality benefits for patients following an acute cardiac event. Randomized clinical trials have demonstrated a 25-50% improvement in survival as compared to controls; however, as many as 50% of patients will dropout of such programs prior to completion, which undermines these morbidity and mortality benefits (37; 54). Research exploring ways to improve compliance to such programs has suggested that the incorporation of music and other such holistic, patient-centered interventions into a rehabilitation/exercise program is associated with improved motivation, endurance and satisfaction amongst cardiac rehabilitation participants. The MAINTAIN study has been designed to conduct a feasibility evaluation on the effects of a preference-based music intervention on adherence to the cardiac rehabilitation program at Toronto Rehabilitation Institute. The primary objective of the trial is to evaluate the feasibility of the implementation of such a protocol within the context of the program. This is a two-arm, block 2:1 randomized trial. 35 patients participating in cardiac rehabilitation at Toronto Rehabilitation: Cardiac Rehabilitation and Secondary Prevention Program will be recruited and participants will be randomized into: 1) control (standard, usual care); and, 2) music intervention. The randomization process employed will be a blocked 2:1 strategy, whereby subjects are randomized to the music treatment arms 2:1. All those patients randomized into arm 2 will be equally randomized into either (2) preference-based music intervention, (3) preference-based music enhanced with RAS. The primary outcome measure will be weekly physical activity over a 3 month duration as measured using tri-axial accelerometers. We will also analyze the impact of a preference-based music intervention based on audio playlist utilization, self-reported sitting times ,exercise-times, on-site attendance to the cardiac rehabilitation program (attendance), peak oxygen uptake (VO2) (stress-test), and self-efficacy levels (self-efficacy questionnaires). These measures will be collected and analyzed throughout the course of the intervention (3 months).

Conditions

Myocardial Infarction; Compliance Behavior; Patient Compliance

Outcome Measures

Primary Outcomes (1)

• Duration of physical activity

  The primary outcome will be the total weekly physical activity volume as determined using triaxial accelerometers.

  3 months

Secondary Outcomes (5)

• On-site program attendance

  3 months

• Change in Cardio Pulmonary Assessment Score

  Baseline, 3 months

• Changes in Stafford Self-Efficacy Questionnaire/Cardiac Self-Efficacy Questionnaire Scores

  Baseline, 3 months

• Audio-play list use

  3 months

• Study recruitment and drop-out

  3 months

Other Outcomes (1)

• Interview and Focus Group

  3 months

Study Arms (3)

Standard

NO INTERVENTION

Subjects randomized to this group will receive standard, usual care with no intervention.

Preference Based Music Intervention

ACTIVE COMPARATOR

Subjects randomized to this arm will receive an iPod player and an activity monitoring device. The iPod will be loaded with patient indicated music preferences that is synched to the patients pace prescription. Subjects will be asked to use their iPod player during off-site exercise periods.

Other: Preference Based Music Intervention

Preference Based Rhythmic Auditory Stimulation Music

ACTIVE COMPARATOR

Subjects randomized to this arm will receive an iPod player and an activity monitoring device. The iPod will be loaded with patient indicated music preferences that is synched to the patients pace prescription. Subjects will be asked to use their iPod player during off-site exercise periods. Rhythmic Auditory Stimulation (accentuation of beats, frequencies) will be added to the music subliminally.

Behavioral: Preference Based Rhythmic Auditory Stimulation Music

Interventions

Preference Based Rhythmic Auditory Stimulation Music BEHAVIORAL

Patients that have been randomized into arms 2 and 3 will be blinded to the intervention they are receiving (i.e. preference-based playlist vs. preference-based playlist that has been edited to include Rhythmic Auditory Stimulation (RAS). RAS drives synchronous neural oscillation (entrainment) and functions in two ways: (1) facilitates pace and heart-rate synchrony and (2) facilitates brain state dominance (getting into the zone). RAS will be accomplished through: (1) sequencing of subject self-selected music based on tempo, (2) accentuation of the rhythmic driving pulse with added percussive-type sounds, (3) addition of binaurally detuned pitches to follow bass lines at brain-state target frequencies (e.g., 8 Hz alpha, or 16 Hz beta), and (4) the addition of binaurally detuned "background" sounds (e.g., low frequency hum) at target Hz frequencies. RAS is implemented as inherent and natural to the music and may remain imperceptible to most.

Preference Based Rhythmic Auditory Stimulation Music

Preference Based Music Intervention OTHER

Preference Based Music Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• English-speaking patients, who are participating in and have been declared medically stable for out-patient cardiac rehabilitation, will be recruited from the Toronto Rehabilitation Institute's Cardiac Rehabilitation and Secondary Prevention Program.

You may not qualify if:

• Participants who are unable to wear the MP3 device or the activity monitoring device due to medical or non-medical issues will be excluded from this study.
• Subjects that have a medical history of seizure disorders, previous neurosurgery, or known head trauma will be excluded from this study.
• Subjects that have received a bicycle-based exercise prescription.

Sponsors & Collaborators

• Toronto Rehabilitation Institute: lead
• Ontario Centres of Excellence: collaborator
• University of Toronto: collaborator

Study Sites (1)

Toronto Cardiac Rehabilitation Institute

Toronto, Ontario, M4G 1R7, Canada

Location

Related Publications (39)

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  PMID: 26284164 DERIVED

MeSH Terms

Conditions

Myocardial Infarction; Patient Compliance

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Dr. David Alter

  Toronto Rehabilitation Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. David Alter, MD, PhD, FRCPC

Study Record Dates

• First Submitted: December 3, 2012
• First Posted: December 19, 2012
• Study Start: November 1, 2012
• Primary Completion: December 1, 2013
• Study Completion: December 1, 2013
• Last Updated: October 9, 2020

Record last verified: 2020-10

Locations

CA (1)