Weigel Megan, Hutchinson Brian, Magee Wendy L, Leong Kevin, Sweitzer Tom, Weiss Jamie L, Su Wendy, Fleming Renée
From First Coast Integrative Medicine, Jacksonville Beach, FL, USA (MW).
MS Achievement Center, Sacramento, CA, USA (BH).
Int J MS Care. 2023 Jul-Aug;25(4):168-175. doi: 10.7224/1537-2073.2021-144. Epub 2023 Feb 22.
Interdisciplinary therapies for the management of people with multiple sclerosis (MS) are underappreciated. There is an urgent need to introduce music therapy (MT), either alone or in combination with physical therapy (PT), into clinical practice to achieve synergy with disease-modifying therapies. A holistic approach to rehabilitation for people with MS may mitigate symptoms and reduce polypharmacy, potentially lowering health care costs.
As MS progresses, patients experience a range of worsening symptoms, and many develop psychosocial comorbidities. As disease-modifying therapies delay disability progression, nonpharmacologic treatments become increasingly important. The main aim of PT is to improve or maintain patients' functional mobility, strength, and flexibility. Because it targets multiple functions, MT can help improve functional and psychosocial domains and may be a valuable intervention to help patients achieve the physical, cognitive, and emotional goals of PT. Exploratory studies showed that MT, alone or in combination with PT, can lead to functional improvements in mobility, balance, gait, and fatigue. Similar to PT, MT also has benefits in improving fine motor skills, cognition, learning, and memory and in providing emotional support.
Both MT and PT have the potential to improve overall well-being and health-related quality of life in physically active patients with MS, and MT can provide added emotional support for those who are less able to engage in physical activity. However, MT is not typically a part of standard of care, and PT visits are limited. Nevertheless, interdisciplinary therapies should be incorporated into clinical practice.
针对多发性硬化症(MS)患者的跨学科治疗未得到充分重视。迫切需要将音乐疗法(MT)单独或与物理疗法(PT)相结合引入临床实践,以与疾病修正疗法产生协同作用。对MS患者采取整体康复方法可能会减轻症状并减少联合用药,从而有可能降低医疗成本。
随着MS病情进展,患者会出现一系列症状恶化情况,许多患者还会出现心理社会合并症。由于疾病修正疗法可延缓残疾进展,非药物治疗变得愈发重要。PT的主要目标是改善或维持患者的功能活动能力、力量和灵活性。由于MT针对多种功能,它可以帮助改善功能和心理社会领域,可能是帮助患者实现PT的身体、认知和情感目标的一项有价值的干预措施。探索性研究表明,MT单独或与PT联合使用,均可使活动能力、平衡、步态和疲劳等功能得到改善。与PT类似,MT在改善精细运动技能、认知、学习和记忆以及提供情感支持方面也有好处。
MT和PT都有潜力改善身体活跃的MS患者的整体幸福感和健康相关生活质量,并且MT可以为那些不太能够参与体育活动的患者提供额外的情感支持。然而,MT通常不是标准治疗的一部分,且PT就诊机会有限。尽管如此,跨学科治疗仍应纳入临床实践。