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3. Participation in active group percussion experiences has physical benefits
including sustained physical activity, relaxation, and use of fine motor
skills.
4. A strong sense of group identity and a feeling of belonging is created
because participants are actively making music together and because the
sustained repetition of the steady beat brings people together physically,
emotionally, and mentally (rhythmic entrainment).
5. Percussion activities can be done with little or no previous musical
background or training, making these experiences accessible to all people.
Although these principles represent
ample rationale for incorporating drumming as a therapeutic intervention
into conventional healthcare, a paucity of scientific data are available
documenting the biological benefits associated with percussion activities.
Therefore, researchers in this study set out to determine measurable biological
effects associated with a group percussion activity using a controlled
experimental design in normal subjects.
The initial working hypothesis was
that group drumming can alter stress-related hormones and neural mediators
with subsequent consequences for immunologic reactivity.
A wide range of stressful environments and psychosocial factors in both
human and experimental animal studies are known to alter immunological
responses. When present for extended periods, such factors have been associated
with adverse consequences to challenges from cancer or infectious diseases./3-5
However, the demonstration of both diminished immunologic reactivity and
increased morbidity or mortality from a tumor or infectious challenge
does not necessarily mean that these observations are related causally.
Such a causal link between immunologic changes and subsequent health consequences
is becoming established for infectious challenge by influenza virus in
mice,/6,7 wound healing in humans,/8
and breast cancer in both experimental animals/9-11 and
humans./12
Not all stressors have an adverse
impact on immune responses, particularly in acute laboratory stress paradigms.
However, chronic stressors such as caregiving for a loved one with Alzheimer's
disease,/13 marital separation and divorce,/14
and examination stress in medical students/14-16 appear
to have a suppressive influence on many measures of immunologic reactivity.
A common pattern of dysfunction emerges
in conditions of chronic or severe stress, including diminished T-cell
prolifera-tion to mitogens, diminished natural killer (NK) cell activity,
diminished cell-mediated immune measures, and reactivation of latent viruses
such as Epstein-Barr virus. A recent report has shown that diminished
cell-mediated immunity in medical stu-dents during examination stress
takes the form of shifted cytokine balance between TH1 (interleukin [IL]
2 and interferon-gamma [IFN-y]) and TH2 (IL-4 and IL-10) toward a humoral
and away from a cell-mediated immune response./17
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This TH1-TH2 cytokine shift away from
cell-mediated responses and toward humoral responses has been noted in
age-associated immunosenescence/18 in patients showing
a degenerating condition with cancer, even cancers normally thought of
as nonimmunogenic,/19 and has been suggested to occur
in individuals with human immunodeficiency virus that is rapidly deteriorating
to acquired immunodeficiency syndrome./20 Positive interventions
that maintain robust cell-mediated responses, reduce perceived stress,
and diminish heightened activation of the hypothalamic-pituitary-adrenal
axis and the sympathetic nervous system may therefore be beneficial to
health maintenance and wellness, even when tumors and infectious agents
are involved.
These positive interventions are sometimes
described as "eustress" paradigms,/21 and include
exercise,/22 mirthful laughter,/21 and
nature's imagery combined with music and positive affirma-tions./23
However, not all hormonal responses in these paradigms are the same, either
in magnitude or direction, nor is cortisol nec-essarily the sole mediator
or even an important mediator of the stress-related immunologic alterations,
especially diminished NK cell activity and diminished cell-mediated immune
responses./24
Based on an established knowledge
base of predictable neuroendocrine and neuroimmune responses described
above, a protocol was established (after preliminary testing of several
group-drumming approaches) to measure the ability of a single group-drumming
session to modulate NK cell activity, lym-phokine-activated killer (LAK)
cell activity, plasma levels of IL-2 and IFN-y, and plasma levels of cortisol,
dehydroepiandrosterone (DHEA), and DHEA-to-cortisol ratios, which the
researchers predicted would change in directions opposite to those expected
with the classic stress response. METHODS
Subjects and Exclusionary Criteria
A total of 111 normal age-and-sex-matched volunteer sub-jects
(55 men and 56 women, with a mean age of 30.4 years) were recruited by
the Mind-Body Wellness Center in Meadville, Pa, through local newspaper
advertising and word of mouth. Initially, 61 subjects were randomly assigned
to 6 preliminary groups (9-11 subjects each) and studied using various
control and experimental paradigms designed to separate drumming components
for the ultimate determination of a single experimental model.
The final experimental design included
60 volunteers: 31 men and 29 women comprising the original composite drumming
group (10 individuals) plus 50 additional subjects who participated in
control or experimental group sessions. Subjects were screened extensively
by phone, age and sex matched, and subsequently assigned randomly to control
and experimental groups. During each telephone interview, it was explained
that the subject would be paid $25 and that venous blood sampling would
occur on 2 occasions. It was further disclosed that each person would
read or participate in a group-drumming exercise during a 1-hour period.
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