Monitoring the Autonomic Nervous Activity as the Objective Evaluation of Music Therapy for Severely and Multiply Disabled Children
Monitoring the Autonomic Nervous Activity as the Objective Evaluation of Music Therapy for Severely and Multiply Disabled Children
复制标题
DOI：
10.1620/tjem.227.185
复制
发表时间：
2012-07-01
影响因子：
2.2
通讯作者：
Takamura, Noboru
中科院分区：
文献类型：
--
作者：
Orita, Makiko;Hayashida, Naomi;Takamura, Noboru
严重和多重残疾儿童经常在多个发展领域受到影响，导致多重残疾。本研究的目的是通过心率变异性的频域分析，通过监测自主神经系统的变化来评估音乐疗法在SMDC中的疗效。我们研究了6例SMDC患者，其中脑性瘫痪3例，颅脑损伤后创伤后综合征1例，疱疹脑炎后遗症1例，Lennox-Gastaut综合征1例，表现为频发癫痫、发育迟缓和心理行为问题)，年龄18~26岁，平均22.5±3.5岁。采用频域心电图法，测量代表副交感神经活动的高频(HF；0.15~0.4 Hz)、交感与副交感神经活动之间的交感神经活动的低频/高频比值和心率。音乐治疗师通过钢琴演奏对所有患者进行治疗，时间为50min。我们对每位研究参与者进行治疗前150分钟、治疗中50分钟和治疗后10分钟的监测。有趣的是，6名患者中有4名患者在音乐治疗期间的HF成分显著低于治疗前，这表明这4名患者可能通过抑制副交感神经活动而对音乐治疗产生反应。因此，音乐疗法可以抑制部分SMDC患者的副交感神经活动。自主神经活动监测可作为客观评价SMDC患者音乐治疗效果的有力工具。
Severely and multiply disabled children (SMDC) are frequently affected in more than one area of development, resulting in multiple disabilities. The aim of the study was to evaluate the efficacy of music therapy in SMDC using monitoring changes in the autonomic nervous system, by the frequency domain analysis of heart rate variability. We studied six patients with SMDC (3 patients with cerebral palsy, 1 patient with posttraumatic syndrome after head injury, 1 patient with herpes encephalitis sequelae, and 1 patient with Lennox-Gastaut syndrome characterized by frequent seizures, developmental delay and psychological and behavioral problems), aged 18-26 (mean 22.5 +/- 3.5). By frequency domain method using electrocardiography, we measured the high frequency (HF; with a frequency ranging from 0.15 to 0.4 Hz), which represents parasympathetic activity, the low frequency/high frequency ratio, which represents sympathetic activity between the sympathetic and parasympathetic activities, and heart rate. A music therapist performed therapy to all patients through the piano playing for 50 min. We monitored each study participant for 150 min before therapy, 50 min during therapy, and 10 min after therapy. Interestingly, four of 6 patients showed significantly lower HF components during music therapy than before therapy, suggesting that these four patients might react to music therapy through the suppression of parasympathetic nervous activities. Thus, music therapy can suppress parasympathetic nervous activities in some patients with SMDC. The monitoring changes in the autonomic nervous activities could be a powerful tool for the objective evaluation of music therapy in patients with SMDC.