According to systematic reviews of Cochrane library and UpToDate, music therapy or auditory intervention is evaluated as one of useful therapeutic methods for various disorders and clinical conditions despite some limitations. It is important to perform an appropriate music therapy for each patient based on evidence-based references. Such approach seems to improve objectivity, reliability, and prevalence of medical music therapy in the medical as well as general community.

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Occupational therapy is a comprehensive treatment and support system towards reducing symptoms at the earliest time after sustaining an injury or getting a disease and achieving meaningful lives for those with functioning disabilities through therapeutic activities and the group dynamic. And, the music element like the sound and the rhythm, etc. is used with music as one of the activities in occupational therapy. In occupational therapy, we use music and the music element as means of neurological use, image therapy, relaxation, reminiscence therapy, recreation, and an art therapy, etc. In the symposium, I introduced the characteristic of the expression style of music, the origin of music, the therapeutic effects of music, and how to use music in occupational therapy.

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Based on our 10 years of clinical experience, we explored optimal music therapy practices in neurological clinics. Disorders evaluated for music therapy were Parkinson′s disease, motor aphasia, dementia, and amyotrophic lateral sclerosis. Although the methods, frequency, and purpose differed among such diseases, we concluded that the optimal practices at our clinic involved patients with Parkinson′s disease and motor aphasia. The highest utilization rate of music therapy was for the former patients, and, in the latter patients, the duration of music therapy was the longest among our patients. For patients with Parkinson′s disease, group music therapy was effective to improve both motor and non-motor symptoms. In motor aphasia, improvements in the QOL such as emotional stability and motivation, rather than improvements in language ability, were noted in individual music therapy. Thus, music therapy might be effective for QOL improvement in the chronic stage of some neurological diseases, particularly Parkinson′s disease and motor aphasia.

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When one aims to promote the distribution and development of a new kind of medical technology in Japan where universal health insurance coverage has been institutionalized, one must keep in mind the rules governing the process to incorporate a new medical technology into the public health insurance coverage. After introducing the discussions concerning the issue of mixed billing, I will outline the system of “medical care for (further) evaluation” (advanced medical technologies and highly advanced medical technologies in particular), for which mixed billing is permitted as an evaluation stage for inclusion in health insurance coverage, as well as the overall process and rules for the inclusion of individual medical technologies in health insurance coverage. After reviewing relevant documentation regarding the expectations of the general public on the future of the social security system, including health care, I will highlight three elements which point to a growth in music therapy in response to people′s expectation : (1) scientific evaluation of efficacy and safety, etc. and standardization of methods, (2) increased distribution and deepening of understanding by the general public with regard to the value of music therapy, and (3) training of the providers of music therapy.

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We determined the amount of saliva secretion, its pH and of salivary alpha-amylase concentrations in 20 patients with Parkinson′s disease before and after the music therapy performed for 1 hour. Music therapy included passive one by hearing music and active one by singing and playing percussion instruments under the guide of music therapists. Evaluation of mood determined by use of visual analog scale revealed that 80% of participants felt happy after the therapy. Amount of saliva and alpha-amylase concentration did not change significantly after the therapy. In contrast, pH of saliva increased significantly after the therapy. Increased stress and sympathetic nerve predominant state have been reported to reduce saliva secretion, increase amylase concentration and reduce saliva pH. Results of our study suggest that active music therapy makes mood happy and increases saliva pH in patients with Parkinson′s disease.

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Music therapy conferences were held on patients with autistic disorder. Case 1 was an 18-year-old girl and case 2 was a 10-year-old boy. The purpose of music therapy was emotional stability in case 1 and promotion of language development in case 2. We discussed their characteristic behaviors such as reaction to a mirror, imitation, obsessive attitude, self-injury, and the way to react these problems in music therapy sessions.

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