手控节律音乐治疗对脑卒中后单侧空间忽略的效果

doi:10.3969/j.issn.1006-9771.2023.07.013

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (7): 833-838.doi: 10.3969/j.issn.1006-9771.2023.07.013

手控节律音乐治疗对脑卒中后单侧空间忽略的效果

华玲¹^,², 张一楠¹^,², 郑玉¹^,², 孙俏仪¹^,², 房辉¹^,², 宋达¹^,²()

1.无锡市中心康复医院康复治疗科，江苏无锡市 214151
2.江南大学附属精神卫生中心，江苏无锡市 214151

收稿日期:2023-01-06 修回日期:2023-06-19 出版日期:2023-07-25 发布日期:2023-08-30
通讯作者: 宋达(1986-)，男，汉族，江苏宜兴市人，硕士，副主任技师，主要研究方向：神经系统疾病的物理治疗。E-mail： songda164164@126.com
作者简介:华玲(1985-)，女，汉族，江苏无锡市人，硕士，副主任技师，主要研究方向：老年常见神经系统及心肺疾病的康复治疗。
基金资助:
无锡市太湖人才计划项目(WXTTP2020008)

Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke

HUA Ling¹^,², ZHANG Yi'nan¹^,², ZHENG Yu¹^,², SUN Qiaoyi¹^,², FANG Hui¹^,², SONG Da¹^,²()

1. Department of Rehabilitation Therapy, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China
2. The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi, Jiangsu 214151, China

Received:2023-01-06 Revised:2023-06-19 Published:2023-07-25 Online:2023-08-30
Contact: SONG Da, E-mail: songda164164@126.com
Supported by:
Wuxi Taihu Talent Project(WXTTP2020008)

摘要/Abstract

摘要：

目的观察手控节律音乐治疗对脑卒中后单侧空间忽略的临床疗效。

方法 2020年9月至2022年9月，无锡市中心康复医院52例脑卒中后存在单侧空间忽略的住院患者，随机分为对照组(n = 26)和试验组(n = 26)，两组均行常规康复治疗，试验组加入手控节律音乐治疗。分别于治疗前、治疗8周后采用中国行为性忽略测试-香港版(CBIT-HK)常规测试中的6项(短线划销、字母划销、星星划销、二分线段、抄写图形、代表性绘图)、改良Barthel指数(MBI)进行评估。

结果治疗后，两组CBIT-HK常规测试6项分数和MBI评分均显著改善(|t| > 3.077, P < 0.05)，试验组优于对照组(|t| > 2.639, P < 0.05)。

结论手控节律音乐治疗可以进一步有效改善脑卒中后单侧空间忽略症状，提高患者日常生活活动能力。

关键词: 脑卒中, 单侧空间忽略, 手控节律音乐治疗

Abstract:

Objective To observe the clinical effect of hand controlled rhythm music therapy on unilateral spatial neglect for stroke patients.

Methods From September, 2020 to September, 2022, 52 patients with unilateral spatial neglect after stroke in Wuxi Central Rehabilitation Hospital were randomly divided into control group (n = 26) and observation group (n = 26). Both groups accepted routine rehabilitation, and the observation group accepted hand controlled rhythm music therapy in addition, for eight weeks. Before and after treatment, the patients were assessed with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (line crossing, letter cancellation, star cancellation, line bisection, figure and shape copying, and representational drawing) and modified Barthel Index (MBI).

Results After treatment, six scores of CBIT-HK routine tests and the scores of MBI increased in both groups (|t| > 3.077, P< 0.05), and they were higher in the observation group than in the control group (|t| > 2.639, P< 0.05).

Conclusion Hand controlled rhythm music therapy could effectively alleviate the symptoms of unilateral spatial neglect after stroke, and improve the activities of daily living.

Key words: stroke, unilateral spatial neglect, hand controlled rhythm music therapy

中图分类号:

R743.3

华玲, 张一楠, 郑玉, 孙俏仪, 房辉, 宋达. 手控节律音乐治疗对脑卒中后单侧空间忽略的效果[J]. 《中国康复理论与实践》, 2023, 29(7): 833-838.

HUA Ling, ZHANG Yi'nan, ZHENG Yu, SUN Qiaoyi, FANG Hui, SONG Da. Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 833-838.

图/表 3

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参考文献 34

[1]	BOSMA M S, NIJBOER T, CALJOUW M, et al. Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: a systematic review[J]. Ann Phys Rehabil Med, 2020, 63(4): 344-358. doi: S1877-0657(19)30072-7 pmid: 31200080
[2]	WATANABE J, OGATA T, NONAKA M, et al. Patients' characteristics and outcomes depending on complete or incomplete unilateral spatial neglect[J]. Neurosurg Rev, 2017, 40(4): 643-646. doi: 10.1007/s10143-017-0821-4 pmid: 28130656
[3]	LI K, MALHOTRA P A. Spatial neglect[J]. Pract Neurol, 2015, 15(5): 333-339. doi: 10.1136/practneurol-2015-001115 pmid: 26023203
[4]	RODE G, FOURTASSI M, PAGLIARI C, et al. Complexity vs. unity in unilateral spatial neglect[J]. Rev Neurol, 2017, 173(7-8): 440-450. doi: 10.1016/j.neurol.2017.07.010
[5]	ESPOSITO E, SHEKHTMAN G, CHEN P. Prevalence of spatial neglect post-stroke: a systematic review[J]. Ann Phys Rehabil Med, 2021, 64(5): 101459. doi: 10.1016/j.rehab.2020.10.010
[6]	ZIGIOTTO L, DAMORA A, ALBINI F, et al. Multisensory stimulation for the rehabilitation of unilateral spatial neglect[J]. Neuropsychol Rehabil, 2021, 31(9): 1410-1443. doi: 10.1080/09602011.2020.1779754
[7]	谢军, 韩造木, 尹琬凌. 音乐疗法对脑卒中患者认知和情绪的效果[J]. 中国康复理论与实践, 2019, 25(9): 1075-1078. doi: 10.3969/j.issn.1006-9771.2019.09.016
	XIE J, HAN Z M, YIN W L. Effect of music therapy on cognition and emotion for stroke patients[J]. Chin J Rehabil Theory Pract, 2019, 25(9): 1075-1078.
[8]	中华医学会第四届全国脑血管病会议. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
[9]	CUMMING T B, CHURILOV L, LINDEN T, et al. Montreal cognitive assessment and Mini-Mental State Examination are both valid cognitive tools in stroke[J]. Acta Neurol Scand, 2013, 128(2): 122-129. doi: 10.1111/ane.12084 pmid: 23425001
[10]	KENNETH N K, FONG MARKO K L, CHAN BILL Y B, et al. Reliability and validity of the Chinese Behavioural Inattention Test-Hong Kong version (CBIT-HK) for patients with stroke and unilateral neglect[J]. HK J Occup Ther, 2007, 17(1): 23-33.
[11]	恽晓平. 康复疗法评定学[M]. 北京: 华夏出版社, 2005: 448-461.
	YUN X P. Assessment & Evaluation of Rehabilitation Therapy[M]. Beijing: Huaxia Publishing House, 2005: 448-461.
[12]	MEIDIAN A C, WAHYUDDIN, AMIMOTO K. Rehabilitation interventions of unilateral spatial neglect based on the functional outcome measure: a systematic review and meta-analysis[J]. Neuropsychol Rehabil, 2022, 32(5): 764-793.
[13]	宋苗苗, 李磊, 张洪洋, 等. 脑卒中后单侧空间忽略的研究进展[J]. 中国康复, 2018, 33(1): 60-63.
	SONG M M, LI L, ZHANG H Y, et al. Research progress of unilateral spatial neglect after stroke[J]. Chin J Rehabil, 2018, 33(1): 60-63.
[14]	范星月, 徐若男, 韩露, 等. 强制性使用运动疗法结合电刺激对脑卒中单侧忽略的作用[J]. 中国康复, 2017, 32(4): 281-284.
	FAN X Y, XU R N, HAN L, et al. Effect of constraint-induced movement therapy combined with electrical stimulation on unilateral neglect in stroke patients[J]. Chin J Rehabil, 2017, 32(4): 281-284.
[15]	LIU K P Y, HANLY J, FAHEY P, et al. A systematic review and meta-analysis of rehabilitative interventions for unilateral spatial neglect and hemianopia poststroke from 2006 through 2016[J]. Arch Phys Med Rehabil, 2019, 100(5): 956-979. doi: 10.1016/j.apmr.2018.05.037
[16]	杜晓霞, 宋鲁平, 徐莹, 等. 棱镜适应技术治疗卒中后偏侧空间忽略的临床研究[J]. 中国医学前沿杂志:电子版, 2013(10): 5.
	DU X X, SONG L P, XU Y, et al. Effect of prism adaption on unilateral spatial neglect[J]. Chin J Front Med Sci (Electron Ed), 2013(10): 5.
[17]	申嘉怡, 张通, 胡雪艳, 等. 动作观察疗法对脑卒中后单侧忽略的效果[J]. 中国康复理论与实践, 2018, 24(8): 930-937. doi: 10.3969/j.issn.1006-9771.2018.08.012
	SHEN J Y, ZHANG T, HU X Y, et al. Effect of action observation therapy on unilateral spatial neglect after stroke[J]. Chin J Rehabil Theory Pract, 2018, 24(8): 930-937.
[18]	LONGLEY V, HAZELTON C, HEAL C, et al. Interventions for spatial neglect after stroke or nonprogressive brain injury: a Cochrane systematic review[J]. Stroke, 2021, 52(9): e548-e549. doi: 10.1161/STROKEAHA.121.036590 pmid: 34424737
[19]	UMEONWUKA C, ROOS R, NTSIEA V. Current trends in the treatment of patients with post-stroke unilateral spatial neglect: a scoping review[J]. Disabil Rehabil, 2022, 44(11): 2158-2185. doi: 10.1080/09638288.2020.1824026
[20]	GUILBERT A, SYLVAIN C, MORONI C, et al. Hearing and music in unilateral spatial neglect neuro-rehabilitation[J]. Front Psychol, 2014, 5:1503. doi: 10.3389/fpsyg.2014.01503 pmid: 25566165
[21]	DEVLIN K, ALSHAIKH J T, PANTELYAT A. Music therapy and music-based interventions for movement disorders[J]. Curr Neurol Neurosci Rep, 2019, 19(11): 83. doi: 10.1007/s11910-019-1005-0
[22]	JANZEN T B, KOSHIMORI Y, RICHARD N M, et al. Rhythm and music-based interventions in motor rehabilitation: current evidence and future perspectives[J]. Front Hum Neurosci, 2021, 15: 789467. doi: 10.3389/fnhum.2021.789467
[23]	王萍, 单春雷, 王健. 单侧空间忽略的康复研究进展[J]. 中国康复理论与实践, 2020, 26(1): 59-61. doi: 10.3969/j.issn.1006-9771.2020.01.010
	WANG P, SHAN C L, WANG J. Advance in rehabilitation therapy for unilateral spatial neglect[J]. Chin J Rehabil Theory Pract, 2020, 26(1): 59-61.
[24]	DAKOS A S, JIANG H, STEIN B E, et al. Using the principles of multisensory integration to reverse hemianopia[J]. Cereb Cortex, 2020, 30(4): 2030-2041. doi: 10.1093/cercor/bhz220 pmid: 31799618
[25]	TINELLI F, CIONI G, PURPURA G. Development and implementation of a new telerehabilitation system for audiovisual stimulation training in hemianopia[J]. Front Neurol, 2017, 8: 621. doi: 10.3389/fneur.2017.00621 pmid: 29209271
[26]	林萌, 王松, 李春林, 等. 空间注意在视听觉信息处理中的调控机制研究[J]. 听力学及言语疾病杂志, 2021, 29(3): 256-261.
	LIN M, WANG S, LI C L, et al. Research on the regulation mechanism of spatial attention in visual and auditory information processing[J]. J Audio Speech Pathol, 2021, 29(3): 256-261.
[27]	CHEN M C, TSAI P L, HUANG Y T, et al. Pleasant music improves visual attention in patients with unilateral neglect after stroke[J]. Brain Inj, 2013, 27(1): 75-82. doi: 10.3109/02699052.2012.722255
[28]	VAN VUGT F T, KAFCZYK T, KUHN W, et al. The role of auditory feedback in music-supported stroke rehabilitation: a single-blinded randomised controlled intervention[J]. Restor Neurol Neurosci, 2016, 34(2): 297-311.
[29]	施伯瀚, 朱燕. 浅谈音乐疗法在神经康复中的应用[J]. 中国康复, 2017, 32(3): 240-244.
	SHI B H, ZHU Y. An introduction to the use of music therapy in neurological rehabilitation[J]. Chin J Rehabil, 2017, 32(3): 240-244.
[30]	AZOUVI P, JACQUIN-COURTOIS S, LUAUTÉ J, et al. Rehabilitation of unilateral neglect: evidence-based medicine[J]. Ann Phys Rehabil Med, 2016, 60(3): 191-197. doi: 10.1016/j.rehab.2016.10.006
[31]	CHOI H S, SHIN W S, BANG D H. Application of digital practice to improve head movement, visual perception and activities of daily living for subacute stroke patients with unilateral spatial neglect: preliminary results of a single-blinded, randomized controlled trial[J]. Medicine (Baltimore), 2021, 100(6): e24637. doi: 10.1097/MD.0000000000024637
[32]	BARRETT A M, BOUKRINA O, SALEH S. Ventral attention and motor network connectivity is relevant to functional impairment in spatial neglect after right brain stroke[J]. Brain Cogn, 2019, 129: 16-24. doi: 10.1016/j.bandc.2018.11.013
[35]	GUILBERT A, SYLVAIN C, MORONI C, et al. A rehabilitation program based on music practice for patients with unilateral spatial neglect: a single-case study[J]. Neurocase, 2016, 23(1): 12-21. doi: 10.1080/13554794.2016.1265652
[36]	LONG J, ZHANG Y, LIU X, et al. Music-based interventions for unilateral spatial neglect: a systematic review[J]. Neuropsychol Rehabil, 2022, 18: 1-26. doi: 10.1080/09602010601082359
[33]	穆景颂, 倪朝民. 单侧空间忽略的神经机制及治疗研究进展[J]. 中国康复医学杂志, 2020, 35(8): 1000-1003.
	MU J S, NI C M. Progress in research on the neural mechanism and treatment of unilateral spatial neglect[J]. Chin J Rehabil Med, 2020, 35(8): 1000-1003.
[34]	GAMMERI R, IACONO C, RICCI R, et al. Unilateral spatial neglect after stroke: current insights[J]. Neuropsychiatr Dis Treat, 2020, 16: 131-152. doi: 10.2147/NDT

组别	n	性别(男/女)/n	年龄/岁	病程/d	受教育年限/年	病变性质(梗死/出血)/n	MMSE
对照组	26	14/12	60.35±10.54	44.50±18.33	9.15±3.31	16/10	21.62±3.09
试验组	26	17/9	64.15±8.76	43.27±19.29	9.31±2.90	18/8	20.81±3.32
χ²/t值		0.325	-1.417	0.236	-0.178	0.340	-0.908
P值		0.569	0.163	0.814	0.859	0.560	0.368

项目	对照组(n = 26)		试验组(n = 26)		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d
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	t值^d	P值^d
短线删除	21.85±3.52	24.18±3.98	22.38±4.76	27.73±4.17	-8.830	< 0.001	-18.233	< 0.001	0.463	0.645	-2.639	0.011
字母删除	17.50±3.26	20.19±3.83	16.96±3.25	24.04±4.06	-6.386	< 0.001	-12.515	< 0.001	-0.595	0.554	-3.487	< 0.001
星星删除	22.96±3.48	27.65±2.88	23.83±3.56	33.77±3.69	-10.352	< 0.001	-15.269	< 0.001	0.788	0.435	-6.657	< 0.001
临摹图形	0.65±0.61	1.38±0.57	0.77±0.51	2.00±0.62	-6.985	< 0.001	-12.200	< 0.001	0.724	0.472	-3.682	0.001
二等分线段	2.15±0.94	3.19±0.98	2.35±1.09	4.27±1.31	-8.844	< 0.001	-14.245	< 0.001	0.672	0.505	-3.350	0.002
代表性绘图	0.46±0.43	0.85±0.61	0.54±0.38	1.53±0.50	-3.077	0.005	-10.408	< 0.001	0.508	0.614	-4.434	< 0.001
总分	65.73±8.93	78.15±9.37	66.73±9.15	93.3±10.64	-14.278	< 0.001	-24.483	< 0.001	0.460	0.648	-5.524	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	26	37.19±12.49	56.04±13.30	-15.790	< 0.001
试验组	26	38.58±10.57	68.35±10.09	-17.446	< 0.001
t值		0.431	3.759
P值		0.668	< 0.001

手控节律音乐治疗对脑卒中后单侧空间忽略的效果

Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke

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