Patient Care Vignette
Sylvia was a 63-year-old woman diagnosed with pneumonia complicated by renal failure. When the music therapy research team met her, she had been transferred to a clinical unit after being in the ICU for 11 days. She was resting quietly in bed, with a fall alert bracelet on her left wrist, wearing no-slip yellow hospital socks, with a blanket covering her petite body frame. The television was on, and she was staring at the screen.
Upon seeing the research team, Sylvia turned her head and smiled softly. She shared that she was doing okay and was just waiting to see the doctors; she also mentioned that she missed being home. Her speech was soft and her gestures were minimal. Everything about her movement was slow. The research team asked Sylvia if she would be interested in participating in a research study testing a music and exercise program. She said yes, as she felt that she was not strong and wanted to improve muscle strength.
On the first day of the intervention, Sylvia was provided with instructions: The intervention involved listening to a music playlist that guides patients in completing five exercises: two lower extremity exercises (feet and legs) and three upper extremity exercises (hands, arms, and shoulders), each completed 10 times. In consultation with music therapists, each exercise was facilitated by musical melodies and verbal cues to direct how and when to move the body (e.g., “and down and up”). The intervention was personalized by asking patients to indicate their instrumental sound preferences. (Sylvia preferred the wood and piano sounds.) The intervention took about 10 minutes. Patients were advised to perform the music-guided exercises at least twice daily for 5 days, with more repetitions allowed if desired. Patients were given an MP3 player preloaded with their playlist and a speaker to use while in the hospital and to take home for further exercise.
It was evident from the first day and throughout the study period that Sylvia was motivated and engaged in the music and exercise program. When the research team entered her room, her face would light up, and she would say she was “ready to exercise.” During the first couple of days, she occasionally checked with the team to confirm that she was doing the exercises correctly, especially the bicep curls. After coaching to only move her forearm and not her whole upper arm, Sylvia would occasionally look at her arms while doing the exercise.
In the final days of the study period, Sylvia often listened to the playlist and completed the exercises with her eyes closed. Sometimes she did not want to stop after the tenth time, and would continue to do one or two more repetitions. After each exercise, she smiled and was so proud of herself for doing the movements. At the end of the entire 10-minute set, Sylvia would say, “I feel good,” and state how much she looked forward to the ...