Music-Enhanced Exercise for Seniors

(iSTEP Trial)

Recruiting at 1 trial location

Overseen By Shin Park, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Greensboro

Must not be taking: Alzheimer's medications, others

Disqualifiers: Neurological disorder, Cancer treatment, Stroke, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 6 months

50 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are using medication for Alzheimer's disease or have changed the dosage of anxiety or depression medications in the last 6 months, you may not be eligible to participate.

What data supports the effectiveness of the treatment Beat-accented music stimulation (BMS) for seniors?

Research shows that rhythmic auditory music stimulation can improve walking ability in people with gait issues, like those with neurological conditions. Additionally, using music that people enjoy during exercise can boost performance and motivation, suggesting that music-enhanced exercise could be beneficial for seniors. ^{1 2 3 4 5}

Is music-enhanced exercise safe for seniors?

Research on music-enhanced exercise, including Rhythmic Auditory Stimulation, shows it is generally safe for seniors, with no reported adverse events in studies involving older adults. It can improve exercise enjoyment and performance without increasing the risk of harm. ^{3 4 6 7 8}

How is Beat-accented music stimulation (BMS) different from other treatments for seniors?

Beat-accented music stimulation (BMS) is unique because it uses rhythmic music to enhance exercise performance and enjoyment, which can improve physical endurance and walking ability, especially in seniors. Unlike other treatments, BMS focuses on the rhythm and tempo of music to stimulate movement and coordination, making it a novel approach for enhancing physical activity in older adults. ^{1 4 6 9 10}

What is the purpose of this trial?

The goal of this clinical trial is to test the benefits of beat-accented music stimulation (BMS) for behavioral changes of physical activity (PA) in older adults. Specific Aims are to determine (1) whether BMS beneficially influences PA behaviors and psychological responses to PA in older adults for 6 months, and (2) whether exercising with BMS differently influences physical and cognitive functioning as well as quality of life in older adults. To test the effects of BMS on PA, participants will be randomly assigned to an exercise intervention that either includes BMS or does not include BMS. Participants will attend a supervised group strength training (ST) (30 min/day) and aerobic exercise (AE) (30-50 min/day) session for 3 days/week for the first 2 months, 1 day/week for the next 2 months (while encouraging participants to independently perform both AE and ST on other days), and independently for the final 2 months (always with a goal of performing \>150min/week AE and 3 days/week of ST for 30 min/day.

Research Team

Kyoungshin Park, PhD

Principal Investigator

Emory University

Jennifer L Etnier, PhD

Principal Investigator

University of North Carolina, Greensboro

Eligibility Criteria

This trial is for cognitively normal older adults who are interested in improving their physical activity. Participants will engage in supervised group strength and aerobic exercises, with some sessions incorporating beat-accented music stimulation (BMS).

Inclusion Criteria

Having a reliable means of transportation

Having a safe place (at least 6 feet by 6 feet of open space) at home for unsupervised exercise training

Having no self-perceived memory complaints

Exclusion Criteria

I have been diagnosed with clinical depression.

I have hearing or vision problems that haven't been corrected.

One of the household members is participating in this study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a supervised group strength training and aerobic exercise program with or without beat-accented music stimulation for 6 months

6 months

3 visits/week for 2 months, 1 visit/week for 2 months, independent for 2 months

Follow-up

Participants are monitored for changes in physical activity behaviors, psychological responses, and cognitive functioning

4 weeks

Treatment Details

Interventions

• Beat-accented music stimulation (BMS)

Trial Overview The study aims to see if BMS can positively affect exercise behavior and psychological responses over a 6-month period. It also looks at how exercising with BMS might impact physical and cognitive functions, as well as quality of life.

Participant Groups

Group I: Exercise and music stimulation Experimental Treatment 2 Interventions

Participants are given an aerobic and strength training program with faded supervision across 6 months. For aerobic exercise (AE), participants will be instructed to walk at moderate intensity with duration increasing up to an ultimate goal of 150 min/week. Participants will be trained to walk in synchrony with the beats of their personalized playlists. The strength training (ST) incorporates single-leg exercises for balance training and training with resistance bands and body weight. During the ST, participants will be asked to synchronize their concentric and eccentric muscle contractions in time with the tempo of BMS playlists at a specific beats-per-minute rhythm.

Group II: Exercise only Active Control 1 Intervention

Participants are given an aerobic and strength training program with faded supervision across 6 months. The ST incorporates single-leg exercises for balance training and training with resistance bands and body weight. For aerobic exercise (AE), participants will be instructed to walk at moderate intensity with duration increasing up to an ultimate goal of 150 min/week.

Who Is Running the Clinical Trial?

University of North Carolina, Greensboro

Lead Sponsor

Trials

33

Recruited

16,700+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

In a study of 14 patients with claudication, rhythmic auditory music stimulation significantly increased total walking distance by an average of 22.1 meters compared to no music, indicating its potential as an effective intervention for improving walking ability.

The use of rhythmically enhanced music also improved functional claudication distance by 40.0 meters, suggesting that this approach could motivate patients and enhance adherence to exercise rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rhythmic Auditory Music Stimulation Enhances Walking Distance in Patients With Claudication: A FEASIBILITY STUDY. Bronas, UG., Everett, S., Steffen, A., et al.[2020]

Listening to preferred warm-up music significantly improved exercise performance, leading to higher relative power output and faster rowing times compared to no music, based on a study with 12 participants.

Non-preferred music did not provide any performance benefits, and motivation to exercise was notably higher when participants listened to their preferred music before the workout.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Preferred and Nonpreferred Warm-Up Music on Exercise Performance. Karow, MC., Rogers, RR., Pederson, JA., et al.[2021]

High groove music significantly improved gait speed in both younger and older adults during rhythmic auditory stimulation (RAS), with synchronized walking maximizing these benefits.

Older adults with poor beat perception were more adversely affected by unfamiliar music while walking, indicating that familiarity and cognitive demands should be considered when using RAS in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gait in younger and older adults during rhythmic auditory stimulation is influenced by groove, familiarity, beat perception, and synchronization demands. Ready, EA., Holmes, JD., Grahn, JA.[2022]

In a study involving 45 residents from long-term care facilities, both Patterned Sensory Enhanced music (PSE) and big band background music were found to enhance exercise performance and participant enjoyment, with no significant differences in satisfaction levels between the two music types.

While PSE showed consistency in the number of repetitions led during exercises, it did not prove to be more effective than big band music for improving performance in most exercises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative effectiveness of exercise with patterned sensory enhanced music and background music for long-term care residents. O'Konski, M., Bane, C., Hettinga, J., et al.[2019]

In a study of 60 adults with chronic non-malignant pain, both types of music (researcher-provided and subject-preferred) significantly reduced pain, depression, and disability compared to a control group.

The findings suggest that music can enhance the effects of pain relief treatments and empower patients, although there was no significant difference in effectiveness between the two types of music used.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of music on power, pain, depression and disability. Siedliecki, SL., Good, M.[2022]

Older adults using the Jymmin® system, which combines music-making with exercise, were able to work out significantly longer (about 66 seconds more) compared to traditional workouts while maintaining the same level of perceived exertion.

The study suggests that the musical feedback from Jymmin® may enhance physical endurance and encourage better pacing during strength-endurance exercises, potentially leading to improved muscle effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Musical feedback system Jymmin® leads to enhanced physical endurance in the elderly-A feasibility study. Rehfeld, K., Fritz, TH., Prinz, A., et al.[2022]

This pilot study involving 10 participants with traumatic brain injury (TBI) explored the feasibility and potential benefits of rhythmic auditory stimulation (RAS) over a 2-week treatment period, showing improvements in gait parameters without any adverse events.

After the RAS intervention, 50% of participants improved their Functional Gait Assessment scores, indicating they were no longer at high risk of falling, highlighting the potential efficacy of RAS in enhancing mobility in TBI patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study. Thompson, S., Hays, K., Weintraub, A., et al.[2021]

In a study with 27 physically active participants, different types of music significantly reduced perceived exertion during 20 minutes of moderate-intensity exercise compared to exercising without music.

All music conditions (fast upbeat, classical, and self-selected) led to lower ratings of perceived exertion, suggesting that music can effectively distract and enhance the exercise experience without affecting heart rate or exercise intensity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of music on ratings of perceived exertion during 20 minutes of moderate intensity exercise. Potteiger, JA., Schroeder, JM., Goff, KL.[2022]

In a study involving 22 older adults in cardiac rehabilitation, sedative music significantly reduced perceived exertion (RPE) and heart rate (HR), while also improving participants' feeling status during exercise.

Stimulating music, on the other hand, only increased heart rate and did not provide the same benefits for perceived exertion or feeling status as sedative music, indicating that sedative music is more effective for enhancing exercise experience in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Outcomes of Different Tempos of Music During Exercise in Cardiac Rehabilitation Patients. Miller, JS., Terbizan, DJ.[2019]

Listening to high BPM (150-170) music during stationary bike workouts helped 28 female participants reach their target heart rate zone faster compared to exercising without music.

Once participants reached 75% of their maximum heart rate, the presence of rhythmical qualities in music was important to maintain or increase heart rate levels, indicating that both tempo and rhythm play a role in exercise performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of rhythmical and extra-rhythmical qualities of music on heart rate during stationary bike activities. DI Cagno, A., Iuliano, E., Fiorilli, G., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Rhythmic Auditory Music Stimulation Enhances Walking Distance in Patients With Claudication: A FEASIBILITY STUDY. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of Preferred and Nonpreferred Warm-Up Music on Exercise Performance. [2021]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Gait in younger and older adults during rhythmic auditory stimulation is influenced by groove, familiarity, beat perception, and synchronization demands. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Comparative effectiveness of exercise with patterned sensory enhanced music and background music for long-term care residents. [2019]

5. England pubmed.ncbi.nlm.nih.gov

Effect of music on power, pain, depression and disability. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Musical feedback system Jymmin® leads to enhanced physical endurance in the elderly-A feasibility study. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Influence of music on ratings of perceived exertion during 20 minutes of moderate intensity exercise. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Clinical Outcomes of Different Tempos of Music During Exercise in Cardiac Rehabilitation Patients. [2019]

10. Italy pubmed.ncbi.nlm.nih.gov

Effects of rhythmical and extra-rhythmical qualities of music on heart rate during stationary bike activities. [2022]