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Noormohammadi F, Ashayeri H, Afrooz G A, Kamkari K. The Effectiveness of Neurological Music Intervention on Psychological Well-Being of Women With Multiple Sclerosis. jrehab 2019; 20 (1) :74-85
URL: http://rehabilitationj.uswr.ac.ir/article-1-2461-en.html

Objective Multiple Sclerosis (MS) is a chronic autoimmune, demyelinating disorder of the central nervous system. Psychological well-being often declines as a consequence of this impairment. Application of neurological musical intervention to adapt with the limitation of neurological impairments has been under investigation. This study aimed to explore the effectiveness of neurological music intervention on the psychological well-being of women with MS.
Materials & Methods Quasi-experimental study with pretest and posttest design was conducted. A total of 20 women from the Iranian MS Association, with a relapsing-remitting course, aged 20 to 30 years, were selected with the convenience sampling method. After grouping them with respect to variables such as education, age, marital status, occupation, and low Extended Disability Status (EDSS), they were randomly paired and assigned to experimental and control groups after obtaining their consent and taking the pretest. The exclusion criteria for the participants were as follows: psychological symptoms such as depression or taking other musical training during the intervention. Neurological music intervention was designed with the assistance of a musician based on Iranian culture and Musical Executive Function Training (Thaut, 2005) to affect the frontal and prefrontal lobes. The 8 designations of the training program included "executive function", "goal regulation support", "group motivation", "impulsivity control", "inhibition", "responsibility", "problem-solving creativity", and " decision making/creativity". The internal validity of program has been already validated. The experimental group received 30 sessions training, two times a week for three months in MS association center while the control group did not receive any training.  Scores were gathered using Ryff (1995) 42-item psychological well-being scale in the pretest and posttest stages. Also, the Kurtke (1983) extended disability status scale was used to evaluate the physical disabilities of MS participants.
Results The results, analyzed in ANCOVA and MANCOVA, indicated a significant improvement in psychological well-being (P<0.05) and medium effect size (0.38) according to the Cohen Scale. No significant improvement in 6 Ryff subscales was observed but a small effect was noted in self-acceptance (0.02), personal growth (0.02), the purpose of life (0.01), environmental mastery (0.07), autonomy (0.09), and small to medium size effect in positive relation (0.23). 
Conclusion According to experts, there is no cure for multiple sclerosis, there are, however, numerous treatments and rehabilitation interventions to slow down and reduce the physical and psychological symptoms. These findings suggest that neurological music intervention based on "Musical Executive Function Training” has a potential dual effect on cognitive and affective aspects of the brain. This kind of music intervention includes group and individual improvisation and composition exercises which improved the executive function skills such as organizing, problem-solving, decision making, and comprehending. Our results indicate that neurological music intervention improves psychological well-being in women with MS. Although there was no significant effect on the subscale of psychological wellbeing, a small to medium size effect was observed on different subscales of well-being. It appears that this intervention can be applied to clinical and rehabilitation settings.