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

      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. MORE...