Columbus, OH - Listening to music, some classical music at least, during exercise performed as part of a cardiac rehabilitation program may sharpen the patient's capacity for organized thinking, suggests a small prospective study in the November-December 2003 issue of Heart & Lung.1

In 33 patients following a standard treadmill exercise protocol, "listening to music was associated with enhanced performance on a test of verbal fluency, reflecting a greater cognitive ability to organize and sequence information," write Dr Charles F Emery (Ohio State University, Columbus) and colleagues. The benefit was likely temporary, but independent of any cognitive improvement from the exercise itself.

Often in cardiac rehab programs music will be available, but it's not systematically utilized.

About two thirds of the patients had recently undergone CABG surgery, and most of the remainder had undergone PCI. Fifty-five percent were post-acute MI. All had been recruited for the study on completion of a standard 12-week cardiac rehab program.

It makes sense to explore cognition-enhancing measures in such a population, Emery told heartwire, due to their elevated risk of mental deficits from progression of vascular disease or any recent surgery with cardiopulmonary bypass. "Often in cardiac rehab programs, music will be available, but it's not systematically utilized."

The patients completed two treadmill sessions two weeks apart. They listened to Vivaldi's The Four Seasons on a personal tape player during one of the sessions and "listened" to a blank tape during the other. The order of the sessions was random.

The Vivaldi piece was selected for its "moderate tempo and rhythmic presentation and its positive effect in previous research among patients with chronic obstructive pulmonary disease," according to the report. Added Emery, "There's good reason to think that other kinds of music would [also] have a beneficial effect."

A battery of standard tests for depression, anxiety, and verbal fluency were administered before and after each exercise session. The verbal test was considered an accurate gauge of capacity for "problem-solving tasks that require purposive behavior, self-control, and the ability to shift attention."

One might think, at least in theory, that if you [also played music] as an intervention over a longer period of time, there might be a cumulative benefit as well.

Preexercise verbal fluency scores were the same regardless of whether the session included music. But listening to the Vivaldi, as compared with no music, was associated with a significant 3% higher score on the postexercise verbal-fluency test. Listening to music had no effect on depression, anxiety, exercise times, or hemodynamic parameters.

Prior studies of music and cognitive function, said Emery, "have documented that the effect seems to dissipate within 30 minutes or so." Long-term exercise programs in healthy people or those with cardiovascular or pulmonary disease, he said, can gradually improve cognitive performance. "So one might think, at least in theory, that if you [added music] as an intervention over a longer period of time, there might be a cumulative benefit as well."