Teirich (1959), a physician, inspired by one of his patients, who was a deaf-mute, undertook a study on music and vibration. He noticed that his 59-year old patient had discovered a certain ability to enjoy ‘his’ music as he could explain how with his back as the main “receiving station”, he had got into the mode of receiving sound waves through “an inner sense of vibration”. Teirich, as a result, built a couch which contained loud speakers that could transfer vibration from J.S. Bach’s D Minor Toccata and Fugue straight to the solar plexus of the patient. He also used his fellow physicians and doctors as a subject group. They reported their reactions: immediate warmth in the solar plexus, a feeling of complete relaxation in the stomach and a very pleasant dream-like state.
Teirich’s pioneering work in the development of vibroacoustic (VA) therapy was followed by researchers like Olav Skille (1982), a Norwegian music educator, who took forward the practice of VA therapy further.
The process of vibroacoustics is the use of sinusoidal, low frequency sound pressure waves between 30-120 Hz blended with music for use with therapeutic goals. Skille’s interests on the physical effect of sound vibration on the mentally handicapped children led him to ascertain whether sound vibration would relax severely physically and mentally handicapped people and whether it could help reduce muscle tone. He encouraged relaxation by playing music through loudspeakers pressed against bean-bags on which the children were made to lie on. His work culminated later with the manufacture and marketing of what is called the Vibroacoustic chair (VA100) and Vibroacoustic bed (VB500) by a Norwegian company (VibroAcoustics AS) in the late eighties.
Vibroacoustic Chair and Bed
The chair and the bed (VA100 and VB500 respectively) were constructed with stereophonic tapes. A musical form consisting of a single low frequency rhythmically pulsed sinusoidal low-frequency sound wave, proactive for relaxation was zeroed in. A pulsed effect was created by placing close together two sinusoidal tones (for example, 40 Hz and 40.5 Hz).
The stimulus through sound vibration was applied to different areas of the body by six 20-1500Hz loudspeakers positioned within the chair. It was done through a control unit (SU200), which performed three functions: a) allowing the intensity of the stimulus to be adapted for each area of the body b) controlling the balance between the music and pulsed tones so that a patient, if they wished, could listen to music alone and c) controlling the volume at which a patient would experience the music component of the treatment through headphones.
This equipment could produce an effect by which physical vibrations could be felt by the body when connected to a sound source. They could vibrate at a variety of speeds at the same time, due to different vibrational frequencies of each note in a piece of music. The idea was that the soothing vibrations could not only relax muscles but also enhance blood circulation, thanks to the sound waves travelling through the entire body.
For vibroacoustic effect, music is administered through the loud-speakers built into a pad, bed, recliner, table, chair and the like. In this way the music is both perceived by the ears and also felt by the body. These, no doubt, form the theoretical basis for the application of selected music as an auditory, as well as a vibratory, stimulus in VA therapy.
The method aims at stimulating the relaxation response in the patients/clients. In recent times this method has become popular in hospitals and other care facilities. What makes it popular is the ease with which such music could be administered without any invasion and with an assurance on the part of the therapist on its overall pleasing effects?
In VA therapy, the therapist has to choose audible frequencies only. The therapy is based on the belief that exposure to soft, low frequency and non-rhythmic music could act as a ‘sedative’ input for a listener and as a result, it can have the potentiality to induce certain physiological changes in the body conducive for relaxation. The research literature of recent years seems to suggest that ‘sedative’ music encourages relaxation (Maranto, 1993a; Bartlett, 1996; Dileo, 1997).
This VA therapeutic concept recognises the physical effects of sound. In particular the growing endorsements to the idea that subjects are sensitive to differing levels of mechanical vibration when these are applied to the body seem to confirm this approach. It is worth focusing here on the research work of Skoglund and Knutsson, 1985 and Skoglund, 1989 who have noted that the changes in skin temperature can be dependent on the amplitude of vibrations.
It is such stray pieces of scientific evidence and the subjective experience of a huge number of enthusiasts which has confirmed the relaxing role of ‘sedative’ music and the vibratory sensitivity of subjects.
In a way, vibro-acoustic therapy is a ‘passive’ intervention. It is concerned with the transmission of pre-recorded music into the body of the patient/client through speakers built into a chair, table or bed unit. The book published to date on this intervention, Music Vibration and Health (1997) is a valuable source of information on VA therapy. It has documented a variety of clinical and research studies, and has discussed treatment procedures, ethical practice and contraindications.
VA therapy is reported to have benefited patients with cystic fibrosis and reduced the severity of asthma attacks. According to Wigram (1995), the therapy could generate a vibration into the lungs and shifted mucus on the bed of the lung which caused a cough reflex to occur.
The results of yet another study, carried out with cardiac patients, have endorsed the role of Psychoacoustic therapy. It reveals that this could be used to improve cardiac input instead of adding or increasing heart support medicine (Butler and Butler, 1997).
Skille (1992) described a very positive response to the inclusion of VibroAcoustics as part of a rehabilitation programme in hearing-impaired subjects. Darrow and Goll (1989) and Darrow (1992) provided evidence that the Somatron improved rhythm identification and pitch discrimination respectively in such patients.
Research, which compared VibroAcoustics and a music intervention, indicated that VA therapy had a greater effect on the anxiety of ten subjects with an intellectual disability (Wigram,. 1993), and, in a separate study with subjects who displayed self-injurious behaviour, resulted in a greater tolerance of staff interactions (Wigram, 1993). It was suggested that VA therapy offered a pleasurable tactile experience which neutralised the element of self-stimulation within unprovoked self-injurious behaviour (Wigram, 1995). This diverting quality also reduced the anxiety of acutely ill children during invasive procedures (Jones, 1997) and encouraged autistic patients to be more open to interaction (Wigram, 1992).
It is also suggested that VA therapy may offer an antidote for stress related conditions (Lehikoinen, 1988; Raudsik, 1997; Patrick, 1999). However, the results should be treated with caution. The experiments were not double-blind trials and hence the researchers could be reporting the effect of positive expectations.
There is anecdotal evidence (Lehikoinen, 1997; Chesky and Michel, 1997) and objective studies (Madsen, Standley and Gregory, 1991; Walters, 1993) which indicate that VA therapy is pleasurable and relaxing. As a consequence, it can be profitably used to address anxiety or anxiety related problems.
Clinical experiments into the effects of VA therapy on pain relief are, however, continuing. Chesky (1992) however, believes that MVT encouraged greater reductions in the pain perception of rheumatoid arthritis sufferers. In another study, MYT was held as a “possible supplemental intervention” for those with the diffuse musculo-skeletal pain of fibromyalgia (Chesky et al 1997). Individual case studies have shown that MVT reduced pain perception following treatment for an ankle strain (Chesky and Michel, 1991). Its value in decreasing the pain perception of post-operative gynaecological patients (Burke, 1997) and knee replacement patients (Burke and Thomas, 1997) is also reported.
When Olav Skille developed VibroAcoustics he believed it had the potential to relax people and reduce muscle tone – the natural tension in the fibres of a muscle. Wigram, who began by describing this response (Wigram and Weekes, 1989), later investigated the use of VibroAcoustics with cerebral palsy patients. He found that, when compared to using music alone; it produced a greater reduction in muscle tone and a greater improvement in the range of movement (Wigram, 1997b). For certain subjects VA therapy reduced the danger of fixed deformity and it was welcomed as a long-term preventive medicine, as well as a treatment intervention (Wigram, 1992). Individual case studies (Skille, 1997; Wigram, Mc Naught et al., 1997) and work with Rett Syndrome (Wigram, 1997c) offered further evidence of this response. There is anecdotal evidence that VibroAcoustics provides relief from the pain caused by conditions including polyarthritis, rheumatism and colic (Wigram, 1992; Skille, Wigram and Weekes, 1989).
VA Therapy: Contraindicated Conditions
Contraindicated conditions in VA therapy are reported to be psychosis, acute inflammation, pregnancy, haemorrhaging, thrombosis, hypertension and the use of pacemakers.
The current situation is that anyone can purchase and use VA equipment. Wigram and Dileo, (1997) voicing their concern about this position, outlined minimum requirements for its use in private practice or institutional settings. They suggested that practitioners should have a professional certification and/or training in basic health care areas and, in addition, specialised training in the use of music for VA therapy. Wigram and Dileo (1997) further suggested that music therapists may be qualified to practice this type of treatment.
Is VA Therapy a Form of Music Therapy?
Music is now widely used as a complementary or supplementary treatment method. Background music is regularly played in wards and in waiting rooms in many medical set-ups around the world, after taking the consent of the patients. Though the music may have a therapeutic effect, it cannot be described as music therapy.
Maranto (1993) has outlined instances where the use of music in medicine may be regarded as music therapy. In each case music meets specific, and often individualised, therapeutic goals and it does so either by supporting a medical treatment, by acting as an adjunct to a primary intervention for a specific medical condition.
We have seen that VA therapy is a very distinct form of treatment as compared to playing therapeutic music. American music therapists seem to feel more comfortable with this method as compared to their European brethren. As the presentation of music is made more as a relaxant (or as a contingent reinforcer), the resulting therapeutic process does not involve much dynamic and evolving musical relationship. In Europe, on the other hand, there is a history of active music making in music therapy.
In keeping with this trend, the experiments of recent years indicate how VA therapy has been used to support the medical treatment of preterm infants (Burke, Walsh, Oehler and Gingras, 1995), as well as gynaecological (Burke, 1997), cardiac (Butler and Butler, 1997) and post-operative patients (Burke and Thomas, 1997). VA therapy has also been provided as a treatment in its own right for high muscle tone (Wigram, 1997b), pain relief (Chesky, 1992) and anxiety (Jones, 1997). In these cases, VA therapy was employed in a result-orientated manner.
A VA therapy session involves introducing the patient to the equipment (bed, mattress etc). The patient is made comfortable by choosing the stimulus levels. Response monitoring is carried out in an unobtrusive way. At the end of the session the patient is offered reassurance, guidance and support. Thus, the therapist is able to build a relationship. It also calls on the skills of a music therapist not just for the selection of music but especially with non-verbal clients, in understanding and interpreting individual responses to the stimuli.
VA therapy offers a unique listening experience. It also applies the fundamental principle that low frequencies have a relaxing effect and does so in a systematic way with the context of a therapeutic relationship. In this way VA therapy can be held as a modified version of music therapy.
This article was published in AYURVEDA AND ALL JANUARY 2009 – Pages 35 to 38
Edited by Geeta Shreedar, July 29, 2021