主动性音乐疗法对脑损伤后患手运动功能恢复的影响

Effect of Music Therapy on Motor Function of Hand of Patients with Hemiplegia after Brain Injury

目的探讨主动性音乐疗法联合常规药物和康复训练对脑损伤后患者手部运动功能的康复效果。方法将30例脑损伤后偏瘫患者分为有声组(n=15)和无声组(n=15)。两组在常规药物和康复训练基础上分别进行有声乐器(开放声音)训练或无声乐器(关闭声音)训练,每次30 min,每周5次,持续4周。使用简易上肢功能检查(STEF)和改良Barthel指数(MBI)分别评价患者手部运动功能和日常生活活动能力(ADL)。结果与治疗前相比,治疗后两组STEF评分和MBI评分均明显升高(P<0.01);治疗前后STEF评分差值有声组较无声组升高幅度更大(P<0.01),两组治疗前后MBI评分差值无显著性差异(P>0.05)。有声组改善最明显的前三项是拿金属片、拿小球、拿金属小棍;无声组改善最明显的前三项为拿小立方、拿金属小棍和拿人造革片。两组ADL最主要改善项目为穿衣、如厕、修饰。结论主动性音乐疗法联合常规药物和康复训练有利于改善脑损伤后患手精细运动的速度、协调性。

Objective To investigate the effect of music therapy combined with routine medication and rehabilitation training on motor function of hand of patients with brain injury. Methods 30 brain injury patients with hemiplegia were divided into sound group （n=15） and no-sound group （n=15）. Besides routine medication and rehabilitation training, two groups received instrument training, one for open music and the other for closed music, 30 minutes a day for 4 weeks. They were evaluated with Simple Test for Evaluating Hand Function （STEF） and Modified Barthel Index （MBI） before and after training to assess hand function and activities of daily living （ADL） respectively. Re-sults The scores of STEF and MBI improved in both groups after training （P〈0.01）. The score of STEF was better in the sound group than in the no-sound group （P〈0.01） while the score of MBI showed no difference between the two groups （P〉0.05）. The items as taking metal pieces, taking small balls, and taking small metal rod improved most in the sound group while the items as taking small cubic, taking small metal rod, and taking artificial leather improved most in the no-sound group. The items as dressing oneself, cleaning after defecating and uri-nating, and making up improved most in the two groups. Conclusion Music therapy combined with routine medication and rehabilitation training can facilitate to improve fine movement function of hand of hemiplegic patients, such as movement speed, precision.