Yoo Ga Eul, Kim Soo Ji
Ewha Womans University Ewha Womans University.
Ewha Womans University Ewha Womans University
J Music Ther. 2016 Summer;53(2):149-77. doi: 10.1093/jmt/thw003. Epub 2016 Apr 15.
Given the increasing evidence demonstrating the effects of rhythmic auditory cueing for motor rehabilitation of stroke patients, this synthesized analysis is needed in order to improve rehabilitative practice and maximize clinical effectiveness.
This study aimed to systematically analyze the literature on rhythmic auditory cueing for motor rehabilitation of stroke patients by highlighting the outcome variables, type of cueing, and stage of stroke.
A systematic review with meta-analysis of randomized controlled or clinically controlled trials was conducted. Electronic databases and music therapy journals were searched for studies including stroke, the use of rhythmic auditory cueing, and motor outcomes, such as gait and upper-extremity function.
A total of 10 studies (RCT or CCT) with 356 individuals were included for meta-analysis. There were large effect sizes (Hedges's g = 0.984 for walking velocity; Hedges's g = 0.840 for cadence; Hedges's g = 0.760 for stride length; and Hedges's g = 0.456 for Fugl-Meyer test scores) in the use of rhythmic auditory cueing. Additional subgroup analysis demonstrated that although the type of rhythmic cueing and stage of stroke did not lead to statistically substantial group differences, the effect sizes and heterogeneity values in each subgroup implied possible differences in treatment effect.
This study corroborates the beneficial effects of rhythmic auditory cueing, supporting its expanded application to broadened areas of rehabilitation for stroke patients. Also, it suggests the future investigation of the differential outcomes depending on how rhythmic auditory cueing is provided in terms of type and intensity implemented.
鉴于越来越多的证据表明节奏性听觉提示对中风患者运动康复的作用，需要进行这项综合分析以改善康复实践并最大化临床效果。
本研究旨在通过突出结果变量、提示类型和中风阶段，系统分析关于节奏性听觉提示用于中风患者运动康复的文献。
进行了一项对随机对照试验或临床对照试验的系统评价及荟萃分析。检索电子数据库和音乐治疗期刊，查找包括中风、节奏性听觉提示的使用以及运动结果（如步态和上肢功能）的研究。
共纳入10项研究（随机对照试验或临床对照试验），涉及356名个体进行荟萃分析。使用节奏性听觉提示有较大的效应量（步行速度的Hedges's g = 0.984；步频的Hedges's g = 0.840；步长的Hedges's g = 0.760；Fugl-Meyer测试评分的Hedges's g = 0.456）。额外的亚组分析表明，尽管节奏性提示类型和中风阶段未导致统计学上的显著组间差异，但每个亚组的效应量和异质性值暗示了治疗效果可能存在差异。
本研究证实了节奏性听觉提示的有益效果，支持将其扩大应用于中风患者更广泛的康复领域。此外，它还建议未来根据节奏性听觉提示在类型和实施强度方面的提供方式，对不同结果进行调查。
