Effects of a Music-Assisted Relaxation and Imagery Compact Disc Recording on Health-Related Outcomes in Cardiac Rehabilitation

By the end of the time, you feel very, very calm and just very relaxed. Relaxes physical body. Slows down thinking too. Getting a chance to just stay in one spot and listen to something that's slower and wants you to relax, tries to help you to relax, makes a big difference.George lives with coronary heart disease (CHD) and underwent coronary artery bypass graft surgery prior to his enrollment in cardiac rehabilitation at a local hospital. He spoke these words after listening to a Music-Assisted Relaxation and Imagery (MARI1) compact disc (CD) recording as part of this research study.Literature ReviewGeorge learned to cope with heart disease, while more people have died worldwide from CHD since 1990 than from any other cause (Mackay & Mensah, 2004). CHD is the single largest killer of Americans, accounting for more than one in every five deaths in 2005 (American Heart Association, 2009a). Almost one in three American adults has hypertension (National Heart Lung and Blood Institute, 2009), which is diagnosed when there is a blood pressure reading of 1 40/90 or higher, and is a major risk factor for CHD (American Heart Association, 2009b). Individual stress response may be a contributing risk factor for CHD (American Heart Association, 20090), and many of the tools of integrative medicine, mind-body medicine, and complementary and alternative medicine (CAM) assist patients in managing their stress. Principles of integrative medicine include a patient-centered, individualized health approach that combines evidence-based medicine with a holistic model to treat the whole person - body, mind, and spirit. Edelman et al. (2006) conducted a randomized, controlled trial of 154 patients to study the effect of a personalized health plan on improvement of patients' risk factors for developing cardiovascular disease. The health plan included: mindfulness meditation; relaxation training; stress management; motivational techniques; health education; and coaching. There was a statistically significant difference between conditions in the risk improvement rate (p = .04), suggesting that individuals who participated in a multi-dimensional intervention were less likely to develop CHD over a 10 year period.Benson (1975) has explained that regular elicitation of the relaxation response is an inborn counterbalance to the body's stress response. Evoking the relaxation response is an effective mind-body interaction intervention for stress management (Esch, Fricchione, & Stefano, 2003; Stefano, Fricchione, Slingsby, & Benson, 2001). Relaxation response training alone "has been demonstrated to be as effective as drugs in fighting hypertension under suitable circumstances" (Esch et al., 2003, p. RA27). Healthcare professionals have studied the effects of music on stress. A systematic review of 12 randomized controlled trials of music listening by patients with various cardiovascular diseases (Schmidt & Ernst, 2004) indicated that all measured outcomes were favorably significant for the music listening group in three trials (Guzzetta, 1989; Lueders-Bolwerk, 1990; White, 1999); five trials demonstrated some significant and some non-significant outcomes (Barnason, Zimmerman, & Nieveen, 1995; Cadigan et al., 2001; Hamel, 2001; White, 1992; Zimmerman, Neiveen, Barnason, & Schmaderer, 1996); while three showed no difference between music and control conditions (Blankfield, Zyzanski, Flocke, Alemagno, & Scheurman, 1995; Taylor-Piliae & Molassiotis, 2001; Zimmerman, Pierson, & Marker, 1 988); and one study included no between group analysis (Elliot, 1 994). In one study that compared music listening with rest, anxiety was reduced only in the music group; there were no significant differences between groups in blood pressure (White, 1999). Another study reported that listening to music was as effective as rest in decreasing blood pressure and anxiety (Barnason et al., 1995). Chafin, Roy, Gerin, & Christenfeld (2004) found that 75 students who listened to music were able to decrease their systolic blood pressure upon recovery from stress. …