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JKM > Volume 43(3); 2022 > Article
Lee, Kwon, and Lee: The effects of music therapy program with the hand manipulation on the depression and cognition in elderly women with mild depression

Abstract

Objectives

The purpose of this study is to investigate the effect of music therapy combined with hand manipulation on depression and cognition in elderly women with mild depression.

Methods

In order to investigate the effects of a music therapy program through hand, 20 elderly women with a GDS-K score of 14–18 were selected among women aged 65 to 84 living in Busan. The 10 subjects in the experimental group were given the music therapy program 3 times a week for 4 weeks, 12 sessions, and the 10 subjects in the control group were not given it. GDS-K and K-MoCA were performed before and after the experiment, and data analysis was performed through Wilcoxon’s test using the SPSS 24.0 statistical package program.

Results

The music therapy program through hand manipulation is effective in reducing depression in elderly women with mild depression, and there was a significant decrease. The sub-domains of depression, such as tension and depressive emotions, life dissatisfaction, lethargy, cognitive difficulties, low energy, and loss of motivation, were significantly reduced. In addition, it has an effect on cognition, and it significantly increased in attention, delayed recall ability, which are sub-domains of cognition. There is a significant difference in depression between the experimental group and the control group, and there is a significant difference in cognition between the two groups.

Conclusions

The music therapy program with hand manipulation has a positive effect on depression and cognition in elderly women with mild depression.

Fig. 1
Contents of hand manipulation
jkm-43-3-181f1.gif
Fig. 2
Pre- and Post-test Results for GDS-K Scores
jkm-43-3-181f2.gif
Fig. 3
Pre- and Post-test Results for K-MoCA Scores
jkm-43-3-181f3.gif
Table 1
Information of this Study Subjects
N Experimental group N Control group
Gender Age Years of education Presence of spouse Gender Age Years of education Presence of spouse
1 Female 66 12 Presence 11 Female 68 16 Absence
2 Female 67 12 Presence 12 Female 70 12 Presence
3 Female 68 12 Absence 13 Female 72 6 Absence
4 Female 72 12 Presence 14 Female 72 12 Absence
5 Female 72 12 Presence 15 Female 73 6 Presence
6 Female 72 16 Presence 16 Female 73 12 Presence
7 Female 75 6 Absence 17 Female 73 6 Absence
8 Female 75 12 Presence 18 Female 75 6 Absence
9 Female 75 12 Presence 19 Female 75 12 Presence
10 Female 77 6 Absence 20 Female 76 6 Presence

Information of subjects obtained through records. The questionnaire was recorded in a question-and-answer format to the subjects, and basic information of the subjects was collected.

Table 2
Composition of music therapy program for each session through hand manipulation
Activity progress Time Content
intro 5 minutes Hello song
Move with music 20 minutes Homunculus hand play – Musical activity through hand manipulation such as bending, extension, spread, put together, and rotation of fingers and wrists
Playing an instrument 20 minutes Playing musical instruments with hand manipulations such as grabbing, manipulation, stretch, moving, hitting, pronation and supination
Outro 5 minutes Goodbye song

Each session begins with a “Hello song”, and main activity includes music, homunculus hand play, and musical instrument performance. Each session ends with a “Goodbye song”

Table 3
Treatment Application Plan
Session 1st treatment application plan
Subject Elderly women with mild depression
purpose Formation of a relationship
goal Play rhythm pattern 1 in a send-and-receive format
Stage Content Instrument Time
Intro Sing Hello song with group members Sheet music, piano 5 minutes
Main activity 1. Homunculus hand play
1) Health clap
Clapping health to the song “Cha Cha Cha Cha, together”.
Music, speakers, sheet music, hand acupressure ball walnut, Nanta drum 40 minutes
jkm-43-3-181f4.gif
2) Pass the hand acupressure balls and walnuts on the person next to you to the song “Cha Cha Cha, together”.
2. Playing an instrument
1) Play the Nanta drum
jkm-43-3-181f5.gif
• Rhythm pattern 1
Division rhythm sheet music
Rhythm jkm-43-3-181f6.gif jkm-43-3-181f7.gif jkm-43-3-181f6.gif jkm-43-3-181f7.gif jkm-43-3-181f6.gif jkm-43-3-181f7.gif jkm-43-3-181f6.gif jkm-43-3-181f7.gif
Hand R L R L R L R L
2) Play rhythm pattern 1 as “ send-and-receive format” jkm-43-3-181f8.gif
3) Play the basic beat with the tempo ♩ = 60~80 to the Korean traditional song “Arirang”.
Outro Sing Goodbye song with group members and promise to meet in the next session Sheet music, piano 5 minutes

The treatment purpose of the 1st session is to form a relationship between the music therapist and group members. The 2nd to 4th sessions are for alleviating depressive emotions, the 5th to 7th sessions are to relieve loss of motivation, the 8th to 9th sessions are to improve attention, and the 10th to 12th sessions are to improve delayed recall.

Table 4
Pre- and Post-test Results for GDS-K Scores
Group Pre-test Post-test Rate of change Z Significance level
M SD M SD
Experimental group (N=10) 15.50 1.65 8.70 2.11 −6.80 −2.842 .004**
Control group (N=10) 15.50 1.78 16.70 1.77 +1.20 −2.807 .005**
Table 5
Pre- and Post-test Results for K-MoCA Scores
Group Pre-test Post-test Rate of change Z Significance level
M SD M SD
Experimental group (N=10) 23.20 2.04 27.00 2.16 +3.8 −2.842 .004**
Control group (N=10) 23.50 1.96 22.90 2.08 −0.6 −1.897 .058
Table 6
The Sub-domains of GDS-K Post-test Results between the Two Groups
Category Group N M SD Mean rank Rank sum U Z p
Tension and depressive emotions Experimental 10 2.20 .632 7.6 76 21.000 −2.320 .029*
Control 10 3.60 1.430 13.4 134

Dissatisfaction with life Experimental 10 1.50 .527 7.25 72.5 17.500 −2.625 .011*
Control 10 3.00 1.333 13.75 137.50

Lethargy Experimental 10 1.90 .738 6.15 61.50 6.500 −3.378 .001**
Control 10 3.80 .919 14.85 148.50

Cognitive difficulty Experimental 10 1.10 .316 6.25 62.50 7.500 −3.469 .001**
Control 10 2.70 1.160 14.75 147.50

Decreased energy Experimental 10 2.00 .667 6.30 63.00 8.000 −3.297 .001**
Control 10 3.60 .843 14.70 147.00

Total Experimental 10 8.70 2.11 5.50 55.00 .000 −3.791 .000**
Control 10 16.70 1.77 15.50 155.00

* p<.05,

** p<.01

The post-test results for GDS-K between the two groups showed a significant difference (p<.01).

Table 7
The Sub-domains of K-MoCA Post-test Results between the Two Groups
Category Group N M SD Mean rank Rank sum U Z p
Visuospatial/ Executive Experimental 10 4.30 .823 11.70 117.00 38.000 −.978 .328
Control 10 4.00 .667 9.30 93.00

Naming Experimental 10 2.60 .516 10.50 105.00 50.000 .000 1.000
Control 10 2.60 .516 10.50 105.00

Attention Experimental 10 5.20 .789 14.80 148.00 7.000 −3.328 .001**
Control 10 3.30 .949 6.20 62.00

Language Experimental 10 2.60 .516 10.50 105.00 50.000 .000 1.000
Control 10 2.60 .516 10.50 105.00

Abstraction Experimental 10 1.80 .422 12.00 120.00 35.000 −1.371 .170
Control 10 1.50 .527 9.00 90.00

Delayed recall Experimental 10 4.50 .707 14.45 144.50 10.500 −3.138 .002**
Control 10 3.20 .632 6.55 65.50

Orientation Experimental 10 5.80 .422 12.50 125.00 30.000 −1.780 .075
Control 10 5.40 .516 8.50 85.00

Total Experimental 10 27.00 2.160 14.55 145.50 9.500 −3.082 .002**
Control 10 22.90 2.080 6.45 64.50

* p<.05,

** p<.01

The Post-test results for K-MoCA between the two groups showed a significant difference (p<.01).

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