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音乐支持的卒中后运动训练并未显示出团体治疗中同步的优越性。

Music-supported motor training after stroke reveals no superiority of synchronization in group therapy.

机构信息

Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media Hanover Hanover, Germany ; Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, University Claude Bernard Lyon-1 Lyon, France.

Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media Hanover Hanover, Germany.

出版信息

Front Hum Neurosci. 2014 May 20;8:315. doi: 10.3389/fnhum.2014.00315. eCollection 2014.

Abstract

BACKGROUND

Music-supported therapy has been shown to be an effective tool for rehabilitation of motor deficits after stroke. A unique feature of music performance is that it is inherently social: music can be played together in synchrony.

AIM

The present study explored the potential of synchronized music playing during therapy, asking whether synchronized playing could improve fine motor rehabilitation and mood.

METHOD

Twenty-eight patients in neurological early rehabilitation after stroke with no substantial previous musical training were included. Patients learned to play simple finger exercises and familiar children's songs on the piano for 10 sessions of half an hour. Patients first received three individual therapy sessions and then continued in pairs. The patient pairs were divided into two groups. Patients in one group played synchronously (together group) whereas the patients in the other group played one after the other (in-turn group). To assess fine motor skill recovery the patients performed standard clinical tests such as the nine-hole-pegboard test (9HPT) and index finger-tapping speed and regularity, and metronome-paced finger tapping. Patients' mood was established using the Profile of Mood States (POMS).

RESULTS

Both groups showed improvements in fine motor control. In metronome-paced finger tapping, patients in both groups improved significantly. Mood tests revealed reductions in depression and fatigue in both groups. During therapy, patients in the in-turn group rated their partner as more sympathetic than the together-group in a visual-analog scale.

CONCLUSIONS

Our results suggest that music-supported stroke rehabilitation can improve fine motor control and mood not only individually but also in patient pairs. Patients who were playing in turn rather than simultaneously tended to reveal greater improvement in fine motor skill. We speculate that patients in the former group may benefit from the opportunity to learn from observation.

摘要

背景

音乐支持的治疗已被证明是中风后运动功能障碍康复的有效工具。音乐表演的一个独特特征是它本质上是社会性的:音乐可以一起同步演奏。

目的

本研究探讨了治疗过程中同步演奏的潜力,即同步演奏是否可以改善精细运动康复和情绪。

方法

28 名处于中风后神经早期康复阶段且无大量先前音乐训练的患者被纳入研究。患者学习用钢琴演奏简单的手指练习和熟悉的儿童歌曲,共进行 10 个半小时的课程。患者首先接受三个个体治疗课程,然后继续进行双人治疗。将患者配对分为两组。一组患者进行同步演奏(一起组),而另一组患者依次演奏(轮流组)。为了评估精细运动技能恢复情况,患者进行了标准的临床测试,如九孔钉板测试(9HPT)、食指敲击速度和规律性以及节拍器引导的手指敲击。使用心境状态问卷(POMS)评估患者的情绪。

结果

两组患者的精细运动控制均有所改善。在节拍器引导的手指敲击中,两组患者的表现均有显著提高。情绪测试显示,两组患者的抑郁和疲劳感均有所减轻。在治疗过程中,在视觉模拟量表上,轮流组患者对其搭档的评价比一起组患者更具同情心。

结论

我们的研究结果表明,音乐支持的中风康复不仅可以单独改善精细运动控制和情绪,还可以在患者配对中改善。与同时演奏相比,轮流演奏的患者精细运动技能的改善更为显著。我们推测,前者组的患者可能受益于观察学习的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cac8/4033001/4d94677b048d/fnhum-08-00315-g0001.jpg

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