Music Boosts Exercise Capacity During Cardiac Stress Test

Megan Brooks

March 12, 2018

ORLANDO — Listening to upbeat music during standard treadmill cardiac stress test may improve exercise time and intensity, hint results of a randomized controlled trial.

People who listened to music during the test were able to exercise for nearly 1 minute longer than those who didn't, and there was a trend toward an increase in metabolic equivalents (METs). 

Waseem Shami, MD, cardiology fellow at Texas Tech University Health Sciences in El Paso, presented the study here at the American College of Cardiology (ACC) 2018 Scientific Session.

"The impetus for the study was that I found patients on the treadmill tests stopping somewhat prematurely for no obvious reason," Shami told | Medscape Cardiology

"The potential clinical implications could be a cost savings because if patients don't reach a certain target on the stress test, an additional test usually has to be done by default. It can also possibly create better exercise endurance, which of course is more heart healthy," said Shami.

Rocking Out

The study included 127 patients (mean age, 53 years; 46 male) scheduled for routine cardiovascular electrocardiography (ECG) treadmill stress test by Bruce protocol; 67 were randomly assigned to wear headphones playing up-tempo music and 60 to wear the same headphones with no music playing during the test.

The research team members were unaware of which patients had music playing and which did not. There were no marked between-group differences in baseline characteristics, including resting heart rate, obesity, diabetes, and hypertension.

With music, there was a significant 50-second improvement in exercise time and a trend toward higher METs, the researchers found.

Table. Exercise Time With and Without Music During Stress Testing

Variable No Music Music P Value
Exercise time (sec) 455.2 505.8 .045
METS 8.67 9.45 .94


"At least on a small scale, this study provides some evidence that music may help serve as an extra tool to help motivate someone to exercise more, which is critical to heart health," Shami said in a conference statement.

There were no between-group differences in how often patients were able to reach their maximal heart rate goal. Shami said a larger study with greater diversity is needed to determine whether offering music during stress testing can help people achieve their target heart rate and whether it should be recommended routinely.

In his experience, he told | Medscape Cardiology, "music is rarely used during stress tests. It's really up to the testing staff to allow it or not. I think it's a great idea to make the patient comfortable and also create motivation just as if they were in the gym," Shami said.

Clever Study

Reached for comment, Jessica Peña, MD, a cardiologist at Weill Cornell Medicine and New York-Presbyterian, confirmed that listening to music during stress testing is not a common practice. "I believe this is one of the reasons the investigators performed this clever study," she told | Medscape Cardiology

This study is "interesting," said Peña, and points to a "potential low-cost way to improve performance during stress testing."

Peña agrees that a study would be helpful to determine whether listening to music helps more people achieve their target heart rate or increase the number of METs achieved. She said she'd also "be curious about whether listening to music improves the patient's experience with diagnostic testing."

"One cautionary note," said Peña, is that during stress testing, an exercise physiologist interacts with patients, asking them periodically about the presence of symptoms, such as chest pain or shortness of breath, and letting them know what to expect.

"Before widespread implementation of this practice, I'd want to be certain that listening to music did not interfere with ascertainment of symptoms or monitoring of the patient in any way," she said.

American College of Cardiology (ACC) 2018 Scientific Session. Session 1182, Abstract 006. Presented March 11, 2018.

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