Tong Yanna, Forreider Brian, Sun Xinting, Geng Xiaokun, Zhang Weidong, Du Huishan, Zhang Tong, Ding Yuchuan
Neurol Res. 2015 May;37(5):434-40. doi: 10.1179/1743132815Y.0000000034. Epub 2015 Apr 27.
Music-supported therapy (MST) is a new approach for motor rehabilitation of stroke patients. Recently, many studies have demonstrated that MST improved the motor functions of post-stroke patients. However, the underlying mechanism for this effect is still unclear. It may result from repeated practice or repeated practice combined with musical stimulation. Currently, few studies have been designed to clarify this discrepancy. In this study, the application of "mute" musical instruments allowed for the study of music as an independent factor.
Thirty-three post-stroke patients with no substantial previous musical training were included. Participants were assigned to either audible music group (MG) or mute music group (CG), permitting observation of music's independent effect. All subjects received the conventional rehabilitation treatments. Patients in MG (n = 15) received 20 extra sessions of audible musical instrument training over 4 weeks. Patients in CG (n = 18) received "mute" musical instrument training of the same protocol as that of MG. Wolf motor function test (WMFT) and Fugl-Meyer assessment (FMA) for upper limbs were utilised to evaluate motor functions of patients in both groups before and after the treatment. Three patients in CG dropped out.
All participants in both groups showed significant improvements in motor functions of upper limbs after 4 weeks' treatment. However, significant differences in the WMFT were found between the two groups (WMFT-quality: P = 0.025; WMFT-time: P = 0.037), but not in the FMA (P = 0.448). In short, all participants showed significant improvement after 4 weeks' treatment, but subjects in MG demonstrated greater improvement than those in CG.
This study supports that MST, when combined with conventional treatment, is effective for the recovery of motor skills in post-stroke patients. Additionally, it suggests that apart from the repetitive practices of MST, music may play a unique role in improving upper-limb motor function for post-stroke patients.
音乐辅助疗法（MST）是一种用于中风患者运动康复的新方法。最近，许多研究表明MST改善了中风后患者的运动功能。然而，这种效果的潜在机制仍不清楚。它可能源于重复练习或重复练习与音乐刺激相结合。目前，很少有研究旨在阐明这种差异。在本研究中，使用“静音”乐器使得能够将音乐作为一个独立因素进行研究。
纳入33名既往无大量音乐训练的中风后患者。参与者被分配到有声音乐组（MG）或静音音乐组（CG），以便观察音乐的独立作用。所有受试者均接受常规康复治疗。MG组（n = 15）的患者在4周内额外接受20次有声乐器训练。CG组（n = 18）的患者接受与MG组相同方案的“静音”乐器训练。使用上肢的Wolf运动功能测试（WMFT）和Fugl-Meyer评估（FMA）来评估两组患者治疗前后的运动功能。CG组有3名患者退出。
两组所有参与者在4周治疗后上肢运动功能均有显著改善。然而，两组之间在WMFT上存在显著差异（WMFT-质量：P = 0.025；WMFT-时间：P = 0.037），但在FMA上无显著差异（P = 0.448）。简而言之，所有参与者在4周治疗后均有显著改善，但MG组的受试者比CG组的受试者改善更大。
本研究支持MST与传统治疗相结合对中风后患者运动技能的恢复有效。此外，这表明除了MST的重复练习外，音乐可能在改善中风后患者的上肢运动功能中发挥独特作用。
