A randomized prospective study of music therapy for reducing anxiety during cast room procedures

J Pediatr Orthop. 2007 Oct-Nov;27(7):831-3. doi: 10.1097/BPO.0b013e3181558a4e.


Background: Cast room procedures, such as cast application and removal, pin removal, and suture removal can cause significant anxiety in young children. The use of music therapy in the cast room to decrease anxiety has not been previously reported.

Methods: We performed a randomized, prospective study of soft lullaby music compared with no music in 69 children 10 years or younger undergoing cast room procedures. Heart rates (beats per minute) were recorded in the waiting room and cast room using a pulse oximeter.

Results: A total of 28 children were randomized to music and 41 children to no music. The mean rise in heart rate between the waiting room and entering the cast room was -2.7 beats/min in the music group and 4.7 beats/min in the no music group (P = 0.001). The mean difference in heart rate between the waiting room and during the procedure was 15.3 beats/min in the music group and 22.5 beats/min in the no music group (P = 0.05). There were 7 patients in the no music group with heart rate increases of greater than 40 beats/min. No patient in the music group had an increase of this magnitude.

Conclusions: Playing soft music in the cast room is a simple and inexpensive option for decreasing anxiety in young children during cast room procedures.

Level of evidence: Randomized Clinical Trial, Level II.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anxiety / prevention & control*
  • Casts, Surgical*
  • Child, Preschool
  • Female
  • Heart Rate / physiology
  • Humans
  • Infant
  • Male
  • Music Therapy*
  • Prospective Studies
  • Treatment Outcome