音樂增進物理治療對嚴重慢性阻塞性肺疾病患的復健成效

Effects of Music Enhanced Physical Therapy on Treatment Outcomes of Persons with Severe COPD

10.30171/JYUST.200612.0004

陳譽齡(Yu-Ling Chen)

慢性阻塞性肺疾病 ； 音樂治療 ； 物理治療 ； 節奏式的聽覺刺激 ； Chronic obstructive pulmonary disease COPD ； Music therapy ； Music-enhanced physical therapy ； Pacing

元培學報

13期（2006 / 12 / 01）

35 - 58

繁體中文

慢性阻塞性肺疾病包括慢性支氣管炎與肺氣腫，不僅嚴重危害大眾健康，而且每年因住院、急診、及居家照護所花費的醫療資源，更帶來龐大的社會負擔。在復健過程中，伴隨著運動所產生的呼吸困難症狀，常是阻礙病患繼續參與療程的原因。有鑑於此，本實驗計畫結合音樂與物理治療，利用音樂作為一種節奏式的聽覺刺激，藉以控制及調整病患在療程中的行走速度及呼吸型態，期望能增進復健療效，緩解呼吸不適症狀，提高參與動機，並給予心理上的支持，為病患提供一個更為人性化的復健療程。共有三位嚴重慢性阻塞性肺疾病患者參與此項為期五週的實驗計畫。參加者在第一週和第五週接受傳統式物理治療，在第二、三、四週則接受音樂增進物理治療。實驗結果顯示，在音樂治療的配合下，三位參加者在療程中的步行距離均有所增加，對呼吸困難症狀的適應程度也提升。同時，根據參加者自評之健康狀態問卷調查，參加者的生活品質也獲得改善。本研究結果顯示，音樂增進物理治療在嚴重慢性阻塞性肺疾病患者的呼吸症狀、運動耐力、及健康狀態上都有所助益。音樂結合物理治療的復健方式或許可提供醫療專業人員未來的研究方向，及病患參與復健療程時的選擇。

The purpose of this study was to investigate the effects of music enhanced physical therapy on the rehabilitation of patients with severe chronic obstructive pulmonary disease (COPD). The effects were determined by measures of walking endurance, dyspnea management, and perceived health status. Music was used in this study as a pacing mechanism to facilitate participants' walking, and breathing movements following walking. Three patients, from a nursing home unit of a Veterans Affairs Medical Center in a Midwestern city, participated in the study. All of them were diagnosed with oxygen-dependent advanced COPD. The study was a single-subject research with ABA design. Each participant served as his own control. During the study, individual participants were treated for five weeks in physical therapy five times a week for a total of 25 sessions. They received conventional physical therapy for the first week (baseline phase), music enhanced physical therapy for the following three weeks (treatment phase), and conventional physical therapy again for the last week (return to baseline phase). Results indicated that the music enhanced physical therapy treatment protocol was effective in improving functional abilities in walking endurance and breathing efficiency. All three participants walked significantly longer distances under the music enhanced physical therapy than under the conventional physical therapy alone. Participants' tolerance of dyspnea after walking also increased. Participants did not require additional recovery time following walking as their walking distances increased and did not required increased supplemental oxygen during walking as they walked further distances. The results of improved perceived health status after music enhanced treatment indicated psychological improvements and increased cadences walked following the music enhancement phase implied physical improvements. Observation from the study also showed that participants increased their motivation in treatment participation. It was concluded that the music enhanced physical therapy was effective in increasing functional abilities, treatment engagement, and perceived health status in persons with severe COPD.