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治疗性歌唱作为帕金森病患者吞咽功能的早期干预措施。

Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

作者信息

Stegemöller E L, Hibbing P, Radig H, Wingate J

机构信息

Department of Kinesiology, Iowa State University, Ames, IA, United States.

Department of Kinesiology, Iowa State University, Ames, IA, United States.

出版信息

Complement Ther Med. 2017 Apr;31:127-133. doi: 10.1016/j.ctim.2017.03.002. Epub 2017 Mar 7.

Abstract

OBJECTIVE

For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms.

DESIGN

Cohort study.

SETTING

University in the United States.

PARTICIPANTS

Twenty-four participants with PD.

INTERVENTION

Eight weeks of group therapeutic singing.

MAIN OUTCOME MEASURES

Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention.

RESULTS

Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL.

CONCLUSION

Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD.

摘要

目的

对于帕金森病(PD)患者,吞咽障碍等继发性运动症状会影响生活质量,并且是导致死亡的主要因素。目前需要针对改善PD早期吞咽功能的治疗干预措施。这项初步研究的目的是检验团体治疗性歌唱干预对无明显吞咽困难症状的PD患者吞咽功能的影响。

设计

队列研究。

地点

美国一所大学。

参与者

24名PD患者。

干预措施

为期八周的团体治疗性歌唱。

主要结局指标

在团体歌唱干预前后,使用肌电图(EMG)评估与吞咽相关的肌肉活动。还在干预前后获取了吞咽生活质量(SWAL-QOL)和统一帕金森病评定量表(UPDRS)。

结果

参与者报告吞咽困难极小,但结果显示EMG结局指标显著增加,UPDRS总分和UPDRS运动评分也有显著改善。SWAL-QOL未显示出显著差异。

结论

EMG时间测量的增加可能表明团体歌唱会导致喉提升时间延长,在吞咽过程中使气道更长时间免受异物侵害。结合UPDRS临床指标的改善,治疗性歌唱可能是一种有吸引力的早期干预策略,可解决口咽吞咽困难,同时也有益于PD的其他临床症状。

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