Western Michigan University, Kalamazoo, MI.
Spectrum Health, Grand Rapids, MI.
J Music Ther. 2020 Dec 8;57(4):432-454. doi: 10.1093/jmt/thaa010.
Prolonged disorders of consciousness (PDOC) following acquired brain injury affect a person's awareness of self and the environment. Motor, communication, sensory, and cognitive deficits challenge assessment. Rigorously tested behavioral assessments, sensitive to detecting awareness, are critical for discerning a prognosis for recovery and access to treatment. The Coma Recovery Scale-Revised (CRS-R) is considered the gold standard in PDOC diagnostic assessments. This study explored preliminary concurrent validity of the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC) with the CRS-R. The MATADOC and CRS-R were administered concurrently to 8 participants utilizing a repeated measures design. Correlations for diagnosis and item functionality were explored between and within the 2 measures. There was an adequate level of agreement between the 2 measures for overall diagnosis. Significant positive correlations were found between measures for all domains utilizing the MATADOC repeated administrations design. Within-measure relationships were significant for each of the auditory and communication domains with diagnosis for both measures, and additionally for each of the visual and arousal domains with diagnosis on the MATADOC. Both measures yielded significant inter-item relationships for auditory-visual domains, communication-visual domains, arousal-auditory domains, and arousal-visual domains. The MATADOC yielded an additional significant correlation for the auditory-communication domains. The findings have positive implications for the MATADOC as a diagnostic measure and companion assessment in cases of questionable diagnosis. Research with a larger sample is warranted. Generally, higher arousal scores on the MATADOC support music as effective in eliciting arousal, giving patients the opportunity to perform at their optimal level of function.
获得性脑损伤后持续的意识障碍 (PDOC) 会影响一个人的自我意识和环境意识。运动、沟通、感觉和认知缺陷会影响评估。经过严格测试的、对意识敏感的行为评估对于辨别预后和获得治疗至关重要。修订后的昏迷恢复量表 (CRS-R) 被认为是 PDOC 诊断评估的金标准。本研究探讨了音乐治疗意识障碍评估工具 (MATADOC) 与 CRS-R 在 PDOC 诊断评估中的初步同时有效性。MATADOC 和 CRS-R 同时应用于 8 名参与者，采用重复测量设计。在这两种措施之间和内部探讨了诊断和项目功能的相关性。这两种措施在整体诊断方面有足够的一致性。利用 MATADOC 重复给药设计，在所有领域中，两种措施之间均存在显著的正相关。在每个听觉和沟通领域中，两种措施的诊断与测量之间都存在显著的关系，在每个视觉和觉醒领域中，MATADOC 的诊断也存在显著的关系。两种措施在听觉-视觉领域、沟通-视觉领域、觉醒-听觉领域和觉醒-视觉领域的听觉-视觉领域都产生了显著的相互关系。MATADOC 还在听觉-沟通领域产生了一个额外的显著相关性。这些发现对 MATADOC 作为诊断性测量工具和在可疑诊断病例中的辅助性评估具有积极意义。需要进行更大样本的研究。一般来说，MATADOC 上较高的觉醒分数支持音乐在引起觉醒方面的有效性，使患者有机会在其最佳功能水平上表现。
