Applying Comfort Theory to an AI-Assisted Group Music Intervention: Psychosocial and Physiological Outcomes and Feasibility in Long-Term Care Residents.

Condition(s) studied

Investigational drug(s) / intervention(s)

Group music intervention: A standardized group music program led by a therapist with music therapy training: 6 sessions, once weekly for 6 weeks, about 60 minutes each, in groups of about 10 residents. Each session includes warm-up and body activation, core music interaction (rhythmic clapping, body movement, small percussion instruments, cooperative group activities), and music-guided relaxation with group feedback. Weekly themes progress from group building to rhythm synchronization, emotional expression, social connection, relaxation, and integration. Intensity is adjusted to residents' physical function and responses.

AI-assisted monitoring system: A multimodal AI monitoring system developed in Stage 1 that analyzes video of residents' facial expressions (positive, neutral, negative) and upper-limb movement (pose estimation of shoulder, elbow, and wrist keypoints) during group music sessions. It shows simplified, low-interference visual trends for individual residents and the group to the music therapist. The system does not diagnose or make decisions; the therapist decides whether and how to adjust the activity based on AI cues, direct observation, and professional judgment.

Study summary

The research design adopts a sequential two-phase framework. The study will be conducted in three residential LTC facilities located in Taichung City or Changhua County, with a total planned enrollment of 60 residents. In Phase 1, 20 residents from one facility will participate in a six-week group music intervention, with one session per week. This phase will focus on multimodal image data construction and AI model development. Facial expression data will be manually annotated to establish reference standards for emotion recognition, while upper-limb movements will be analyzed using pose estimation and skeletal recognition techniques to extract dynamic features. These data will be used to develop and preliminarily validate an AI-based emotion and activity response monitoring model.

In Phase 2, 40 residents who did not participate in Phase 1 will be recruited and divided into four groups to participate in a six-week group music intervention, with one session per week. The AI model developed in Phase 1 will be implemented in the LTC setting to transform residents' facial emotional expressions and upper-limb activity responses into low-interference visual information for the music therapist as an adjunct to activity facilitation and professional judgment. Evaluation indicators include subjective psychosocial measures of loneliness, anxiety, and depression, with heart rate variability (HRV) assessed in Phase 2 as an objective physiological measure.

This study expects to establish a multimodal dataset and an AI-based emotion and activity response monitoring model for group music activities in LTC settings and to preliminarily evaluate the feasibility of a human-AI collaborative approach characterized by "AI-assisted monitoring and human professional decision-making.

Eligibility

Primary outcome measure(s)

• UCLA Loneliness Scale, Version 3 — T0 (pre-intervention): before the first group music session (week 1); T1 (post-intervention): after completion of the sixth group music session (week 6)
  A 20-item self-report scale rated on a 4-point Likert scale (1 = never to 4 = always). Total scores range from 20 to 80, with higher scores indicating greater loneliness. The score ranges are defined as follows: 20-34 points for low loneliness, 35-49 points for moderate loneliness, 50-64 points for high loneliness, and 65-80 points for severe loneliness.
• Chinese version of Beck Anxiety Inventory — T0 (pre-intervention): before the first group music session (week 1); T1 (post-intervention): after completion of the sixth group music session (week 6) Measured in Stage 1 and 2 participants
  A 21-item scale with each item scored from 0 (not at all) to 3 (severely). Total scores range from 0 to 63, with higher scores indicating more severe anxiety.
• Geriatric Depression Scale-15 — T0 (pre-intervention): before the first group music session (week 1); T1 (post-intervention): after completion of the sixth group music session (week 6) Measured in Stage 1 and 2 participants
  A 15-item yes/no scale. Total scores range from 0 to 15, with higher scores indicating more depressive symptoms. Administered with the help of trained research staff.

Trial sites (1)

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