Kwak Eunmi Emily
Michigan State University, Michigan, USA.
J Music Ther. 2007 Fall;44(3):198-216. doi: 10.1093/jmt/44.3.198.
The purpose of this study was to use Rhythmic Auditory Stimulation (RAS) for children with spastic cerebral palsy (CP) in a clinical setting in order to determine its effectiveness in gait training for ambulation. RAS has been shown to improve gait performance in patients with significant gait deficits. All 25 participants (6 to 20 years old) had spastic CP and were ambulatory, but needed to stabilize and gain more coordinated movement. Participants were placed in three groups: the control group, the therapist-guided training (TGT) group, and the self-guided training (SGT) group. The TGT group showed a statistically significant difference in stride length, velocity, and symmetry. The analysis of the results in SGT group suggests that the self-guided training might not be as effective as therapist-guided depending on motivation level. The results of this study support three conclusions: (a) RAS does influence gait performance of people with CP; (b) individual characteristics, such as cognitive functioning, support of parents, and physical ability play an important role in designing a training application, the effectiveness of RAS, and expected benefits from the training; and (c) velocity and stride length can be improved by enhancing balance, trajectory, and kinematic stability without increasing cadence.
本研究的目的是在临床环境中对痉挛型脑瘫（CP）儿童使用节律性听觉刺激（RAS），以确定其在步行步态训练中的有效性。RAS已被证明可改善步态严重受损患者的步态表现。所有25名参与者（6至20岁）均患有痉挛型CP且能够行走，但需要稳定并获得更协调的运动。参与者被分为三组：对照组、治疗师指导训练（TGT）组和自我指导训练（SGT）组。TGT组在步幅、速度和对称性方面显示出统计学上的显著差异。对SGT组结果的分析表明，根据动机水平，自我指导训练可能不如治疗师指导训练有效。本研究结果支持三个结论：（a）RAS确实会影响CP患者的步态表现；（b）个体特征，如认知功能、父母的支持和身体能力，在设计训练应用、RAS的有效性以及训练的预期益处方面起着重要作用；（c）通过增强平衡、轨迹和运动稳定性而不增加步频，可以提高速度和步幅。
