Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson's Disease - A Pilot Study.
Neurologic Music Therapy Training for Mobility and Stability Rehabilitation with Parkinson's Disease - A Pilot Study.
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DOI：
10.3389/fnhum.2015.00710
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发表时间：
2015
影响因子：
2.9
通讯作者：
Marchewka A
中科院分区：
文献类型：
--
作者：
Bukowska AA;Krężałek P;Mirek E;Bujas P;Marchewka A
特发性帕金森病（PD）是一种以步态障碍和平衡障碍为主要症状的进行性疾病。以往的研究主要集中在节律性听觉刺激（RAS）在PD步态康复中的应用。然而，这项初步研究的关键假设，假设所有三种神经音乐治疗（NMT）感觉运动技术的组合在改善时空步态参数和姿势稳定性的PD过程中的主要作用。被邀请参加研究的55名PD诊断受试者被分为两组：30名实验组和25名对照组。入选标准包括Hoehn和Yahr 2或3级，在实验期间无需任何帮助独立行走的能力和稳定的药物治疗。为了评价所选治疗程序的有效性，采用了以下措施：光电3D运动分析、用于步态的系统BTS Smart和用于稳定性和平衡的计算机化动态姿势描记术CQ Stab。在治疗周期之前和之后进行所有测量。实验组受试者每周参加4次音乐治疗，共4周。治疗性器乐表演（TIMP），模式感觉增强（PSE）和RAS用于练习日常生活活动，平衡，步态前和步态模式，在每45分钟的会议。打击乐器、节拍器和节奏音乐是每节课的基础。对照组的受试者被要求在两次测量之间保持活跃并进行日常生活活动。研究表明，NMT三种感觉运动技术的结合可以用于改善PD康复中的步态和其他节律活动。结果表明，与对照组相比，实验组的大多数时空步态参数有显着改善。在闭上眼睛的稳定性测试中，显示出实质性的差异，表明本体感觉（身体位置和运动的感觉）的改善。这些研究结果表明，通过使用听觉系统的运动和姿势控制的新的补偿策略。
Idiopathic Parkinson’s Disease (PD) is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS) in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT) sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn and Yahr stages 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis, System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance. All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions four times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP), Pattern Sensory Enhancement (PSE) and RAS were used in every 45-min session for practicing daily life activities, balance, pre-gait, and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation. The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control group. In the stability tests with eyes closed, substantial differences were revealed, indicating improvement of proprioception (the sense of body position and movement). These findings suggest a new compensatory strategy for movement and postural control through the use of the auditory system.