音乐治疗对脑卒中后认知障碍的效果

doi:10.3969/j.issn.1006-9771.2023.06.013

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 714-719.doi: 10.3969/j.issn.1006-9771.2023.06.013

音乐治疗对脑卒中后认知障碍的效果

林煜凡¹^,^2a, 韦添元¹^,^2a, 张晓颖¹^,^2b, 李晁金子¹^,^2a, 何静杰¹^,^2a, 杜晓霞¹^,^2a()

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院，a.神经康复科；b.音乐治疗中心，北京市 100068

收稿日期:2023-03-20 修回日期:2023-05-29 出版日期:2023-06-25 发布日期:2023-07-14
通讯作者: 杜晓霞(1975-)，女，汉族，陕西延安市人，博士，主任医师，主要研究方向：神经康复。E-mail： 364906784@qq.com
作者简介:林煜凡(1998-)，女，汉族，福建福鼎市人，硕士研究生，主要研究方向：认知康复。
基金资助:
1.国家重点研发计划项目(2022YFC3600305);2.国家重点研发计划项目(2020YFC2004105);3.中国残联研究课题(2022CDPFHS-10)

Effect of music therapy on post-stroke cognitive impairment

LIN Yufan¹^,^2a, WEI Tianyuan¹^,^2a, ZHANG Xiaoying¹^,^2b, LI Chaojinzi¹^,^2a, HE Jingjie¹^,^2a, DU Xiaoxia¹^,^2a()

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. a. Department of Neurorehabilitation; b. Music Therapy Center, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2023-03-20 Revised:2023-05-29 Published:2023-06-25 Online:2023-07-14
Contact: E-mail: 364906784@qq.com
Supported by:
National Key Research and Development Program(2022YFC3600305);National Key Research and Development Program(2020YFC2004105);Scientific Research Project of China Disabled Persons' Federation(2022CDPFHS-10)

摘要/Abstract

摘要：

目的观察音乐治疗对脑卒中后认知障碍患者认知功能、运动功能和日常生活活动能力的影响。
方法选取2020年12月至2022年7月北京博爱医院脑卒中后认知障碍的患者48例，随机分为对照组(n = 24)和试验组(n = 24)。两组均给予神经内科常规药物治疗、护理和康复治疗，试验组在此基础上增加音乐治疗，共8周。干预前后采用洛文斯顿作业疗法认知评定成套测验(LOTCA)分析认知功能的变化，采用Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)评价运动功能和日常生活活动能力。
结果对照组脱落6例。治疗前后，试验组LOTCA总分和FMA评分差值均大于对照组(t > 2.665, P < 0.05)；两组MBI评分差值无显著性差异(P > 0.05)。
结论音乐治疗可以提高脑卒中后认知障碍患者认知功能和运动功能。

关键词: 脑卒中, 卒中后认知障碍, 音乐治疗, 运动功能, 日常生活活动能力

Abstract:

Objective To observe the effect of music therapy on cognitive function, motor function, and activities of daily living (ADL) of patients with post-stroke cognitive impairment.
Methods From December, 2020 to July, 2022, 48 patients with post-stroke cognitive impairment in Beijing Bo'ai Hospital were enrolled and randomly divided into control group (n = 24) and experimental group (n = 24). Both groups received conventional medication, nursing, and conventional rehabilitation, while the experimental group received music therapy additionally, for eight weeks. Before and after intervention, the cognitive function was assessed by Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and motor function and ADL were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI), respectively.
Results Six cases in the control group dropped down. The increase in the scores of LOTCA and FMA was more in the experimental group than in the control group (t > 2.665, P < 0.05), however, no significant difference was found in the increase of MBI score between two groups.
Conclusion Music therapy could improve the cognitive function and motor function of patients with post-stroke cognitive impairment.

Key words: stroke, post-stroke cognitive impairment, music therapy, motor function, activities of daily living

中图分类号:

R743.3

林煜凡, 韦添元, 张晓颖, 李晁金子, 何静杰, 杜晓霞. 音乐治疗对脑卒中后认知障碍的效果[J]. 《中国康复理论与实践》, 2023, 29(6): 714-719.

LIN Yufan, WEI Tianyuan, ZHANG Xiaoying, LI Chaojinzi, HE Jingjie, DU Xiaoxia. Effect of music therapy on post-stroke cognitive impairment[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 714-719.

图/表 5

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组别	n	性别(男/女)/n	年龄/岁	受教育程度/年	卒中类型(缺血/出血)/n	病程/ d	病灶部位(左/右)/n
对照组	18	13/5	57.33±12.94	13.50±2.96	10/8	44.72±36.56	15/3
试验组	24	18/6	57.38±11.80	12.83±3.41	14/10	49.04±32.91	20/4
χ²/t值		0.041	0.011	-0.663	0.032	0.401	0.000
P值		0.839	0.991	0.511	0.857	0.690	1.000

项目	对照组 (n = 18)		试验组 (n = 24)		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
项目	治疗前	治疗后	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
定向	5.50±2.73	7.61±2.17	5.92±2.28	7.96±2.27	0.538	0.593	-7.007	< 0.001	-11.017	< 0.001
视知觉	8.44±1.58	10.28±1.53	8.67±1.24	11.54±1.72	0.511	0.612	-11.000	< 0.001	-12.625	< 0.001
空间知觉	6.61±1.98	8.50±1.76	6.88±1.36	10.08±1.59	0.513	0.611	-13.746	< 0.001	-16.086	< 0.001
动作运用	8.72±2.35	10.22±2.65	9.38±1.69	10.29±1.65	1.049	0.300	-6.101	< 0.001	-5.100	< 0.001
视运动组织	13.39±3.70	15.06±3.59	14.54±3.11	16.17±3.64	1.097	0.279	-9.220	< 0.001	-7.855	< 0.001
思维操作	6.61±2.20	9.78±2.51	6.79±1.50	12.79±2.48	0.316	0.754	-21.727	< 0.001	-19.936	< 0.001
总分	49.28±13.93	61.44±13.02	52.17±10.38	68.83±11.73	0.771	0.445	-18.631	< 0.001	-21.257	< 0.001

组别	n	定向	视知觉	空间知觉	动作运用	视运动组织	思维操作	总分
对照组	18	2.11±1.28	1.83±0.71	1.89±0.58	1.50±1.04	1.67±0.77	3.17±0.62	12.17±2.77
试验组	24	2.04±0.91	2.88±1.12	3.21±0.98	0.92±0.88	1.63±1.01	6.00±1.47	16.67±3.84
t值		-0.206	3.691	5.448	-1.963	-0.146	8.473	4.211
P值		0.838	0.001	< 0.001	0.057	0.885	< 0.001	< 0.001

组别	n	治疗前	治疗后	治疗前后差值	t值	P值
对照组	18	46.00±43.30	51.11±40.88	5.11±4.30	-5.041	< 0.001
试验组	24	25.04±21.67	39.83±27.24	14.79±17.09	-4.241	< 0.001
t值		-1.884		2.665
P值		0.072		0.013

组别	n	治疗前	治疗后	治疗前后差值	t值	P值
对照组	18	44.72±29.23	61.11±28.62	16.39±12.46	-5.041	< 0.001
试验组	24	31.67±21.55	50.63±21.18	18.96±13.27	-4.241	< 0.001
t值		-1.668		0.637
P值		0.103		0.528

音乐治疗对脑卒中后认知障碍的效果

Effect of music therapy on post-stroke cognitive impairment

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