Modulation of Pain Perception Through Identifying Emotionally with Music Feedback During Physical Exercise for Patients with Chronic Pain: A Randomized Trial.

BACKGROUND

The emotional modulation of pain can be achieved through interventions in the form of music, which may therefore be valuable in regulating emotions and perceived pain during physical activity.

OBJECTIVES

The present study aimed to investigate the effects of music feedback during physical exercise on chronic pain patients' emotional states, motivation, and pain levels during an acute clinic stay.

STUDY

DESIGN

A crossover design was used to test the effects of music feedback during an ergometer training (active condition) vs. music listening during an ergometer training (passive condition) on 43 patients with different chronic pain conditions during their acute clinical stay.

SETTING

An acute clinic specializing in pain medicine.

METHODS

Patients were recruited by clinical staff and randomly assigned to perform both conditions in different orders. The music was selected from 4 genres, and the same songs were used in the training sessions for both types of conditions.

RESULTS

The results showed that patients' motivation to exercise was stronger during the active condition than during the passive condition, as measured by active engagement during the training interval (t(39) = 3.013, P = 0.006; 95% CI: 0.0104; .0529). Those findings matched with patients' individual ratings of their motivation. For both conditions, anxiety levels decreased significantly from baseline (active condition: Z = -4.213; P < 0.001; passive condition: Z = -3.864; P < 0.001). The pain levels did not differ between conditions (Z = -0.137, P = 0.45). Interestingly, the reported match/congruency of the patients' moods and emotions expressed by the chosen music pieces correlated with changes in pain perception (r = -0.438, P = 0.007), and the match of the patients' own emotional state with the music was significantly higher during the active condition (Mdn = 7.7) than during the passive condition (Mdn = 6.35; Z = -3.429; P < 0.001). No significant correlation between changes in pain intensity and changes in heart rate variability were observed (r = 0.15, P = 0.952).

LIMITATIONS: The rather heterogeneous patient sample limits specific conclusions about effects on certain pain conditions, and the focus on immediate effects precludes conclusions about long-term outcomes.

CONCLUSION

Music feedback during physical exercise may be beneficial in increasing motivation in patients with chronic pain. A stronger match of emotions expressed by music feedback and the patient's own emotional state seems to influence pain perception.