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音乐辅助疗法对慢性中风患者运动、认知及心理社会功能的影响

The effects of music-supported therapy on motor, cognitive, and psychosocial functions in chronic stroke.

作者信息

Fujioka Takako, Dawson Deirdre R, Wright Rebecca, Honjo Kie, Chen Joyce L, Chen J Jean, Black Sandra E, Stuss Donald T, Ross Bernhard

机构信息

Center for Computer Research in Music and Acoustics, Department of Music, Stanford University, Stanford, California.

Stanford Neurosciences Institute, Stanford University, Stanford, California.

出版信息

Ann N Y Acad Sci. 2018 May 24. doi: 10.1111/nyas.13706.

Abstract

Neuroplasticity accompanying learning is a key mediator of stroke rehabilitation. Training in playing music in healthy populations and patients with movement disorders requires resources within motor, sensory, cognitive, and affective systems, and coordination among these systems. We investigated effects of music-supported therapy (MST) in chronic stroke on motor, cognitive, and psychosocial functions compared to conventional physical training (GRASP). Twenty-eight adults with unilateral arm and hand impairment were randomly assigned to MST (n = 14) and GRASP (n = 14) and received 30 h of training over a 10-week period. The assessment was conducted at four time points: before intervention, after 5 weeks, after 10 weeks, and 3 months after training completion. As for two of our three primary outcome measures concerning motor function, all patients slightly improved in Chedoke-McMaster Stroke Assessment hand score, while the time to complete Action Research Arm Test became shorter in the MST group. The third primary outcome measure for well-being, Stroke Impact Scale, was improved for emotion and social communication earlier in MST and coincided with the improved executive function for task switching and music rhythm perception. The results confirmed previous findings and expanded the potential usage of MST for enhancing quality of life in community-dwelling chronic-stage survivors.

摘要

伴随学习的神经可塑性是中风康复的关键调节因素。在健康人群和患有运动障碍的患者中进行音乐演奏训练需要运动、感觉、认知和情感系统的资源,以及这些系统之间的协调。我们研究了与传统体育训练(GRASP)相比,音乐辅助疗法(MST)对慢性中风患者运动、认知和心理社会功能的影响。28名单侧手臂和手部受损的成年人被随机分配到MST组(n = 14)和GRASP组(n = 14),并在10周内接受30小时的训练。评估在四个时间点进行:干预前、5周后、10周后以及训练完成后3个月。在我们关于运动功能的三项主要结局指标中的两项上,所有患者的Chedoke-McMaster中风评估手部评分均略有改善,而MST组完成动作研究臂测试的时间缩短。关于幸福感的第三项主要结局指标,即中风影响量表,MST组在情绪和社交沟通方面的改善更早,并且与任务切换和音乐节奏感知方面的执行功能改善相一致。研究结果证实了先前的发现,并扩展了MST在提高社区居住的慢性期幸存者生活质量方面的潜在用途。

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