中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (5): 1065-1071.doi: 10.4103/1673-5374.324856

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

声乐呼吸训练对颈髓损伤患者呼吸功能及呼吸中枢神经可塑性的影响：随机对照试验

  

  • 出版日期:2022-05-15 发布日期:2021-11-22

Effect of vocal respiratory training on respiratory function and respiratory neural plasticity in patients with cervical spinal cord injury: a randomized controlled trial

Xiao-Ying Zhang1, 2, 3, 4, 5, #, Wei-Yong Yu1, 6, #, Wen-Jia Teng1, 2, 3, 4, Yi-Chuan Song1, 5, De-Gang Yang1, 7, Hong-Wei Liu1, 7, Song-Huai Liu1, 5, Xiao-Bing Li8, Wen-Zhu Wang1, 2, 3, 4, Jian-Jun Li1, 2, 3, 4, *   

  1. 1School of Rehabilitation Medicine, Capital Medical University, Beijing, China; 2China Rehabilitation Science Institute, Beijing, China; 3Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China; 4Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China; 5Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China; 6Department of Imaging, China Rehabilitation Research Center, Beijing, China; 
    7Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China; 8Department of Music Artificial Intelligence and Music Scientific Technology, Central Conservatory of Music, Beijing, China
  • Online:2022-05-15 Published:2021-11-22
  • Contact: Jian-Jun Li, MD, crrclijj@163.com.
  • Supported by:
    This work was supported by Scientific Research Project of Establishment of the Winter Olympics Sports Injury Rehabilitation Diagnosis and Treatment System and Green Channel Demonstration of China, No. 2018YFF0301104 (to JJL);  China Rehabilitation Science Institute, No. 2020cz-10 (to WZW), and Scientific Research Foundation of China Rehabilitation Research Center, No. 2017zx-32 (to XYZ).

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摘要：

既往有研究将唱歌用于改善脊髓损伤患者的呼吸功能，但未见以特定音乐训练影响脊髓损伤患者呼吸中枢神经可塑性的研究。声乐呼吸训练作为音乐疗法中与声带肌肉相关的治疗方法，是一种侧重于呼吸肌和肺功能改善的训练。此次随机对照临床试验分析了这种方法对颈髓损伤3个月后出现呼吸功能障碍患者的治疗效果。在收集的37例患者中26例完成了每节30min，每周5节，持续12周的试验，其中干预组（n=13）由专业认证音乐治疗师培训，对照组（n=13）由专业物理治疗师培训。结果显示，12周后，与物理治疗的患者相比，声乐呼吸训练可使患者呼吸功能指标明显改善，且其延髓内呼吸中枢的神经纤维束在上下、左右、前后三个维度有明显多样化走形的趋势，神经纤维束的数量、厚度和密度也增加，同时神经纤维长度也明显延长。上述结果为音乐治疗中声乐呼吸训练对神经纤维束的再生和重塑提供了有力的证据。研究于2020年4月1日经中国康复研究中心伦理委员会批准（批准号2020-013-1），并于2020年9月2日在中国临床试验注册中心注册（注册号ChiCTR2000037871）。

https://orcid.org/0000-0002-8441-7537 (Jian-Jun Li); https://orcid.org/0000-0002-6329-2958 (Xiao-Ying Zhang)

关键词: 颈髓损伤, 声乐呼吸训练, 神经可塑性, 呼吸功能, 音乐疗法, 呼吸中枢, 神经可塑性

Abstract: In previous studies, researchers have used singing to treat respiratory function in patients with spinal cord injury. However, few studies have examined the way in which vocal training affects respiratory neural plasticity in patients with spinal cord injury. Vocal respiratory training (VRT) is a type of vocal muscle-related treatment that is often a component of music therapy (MT) and focuses on strengthening respiratory muscles and improving lung function. In this randomized controlled study, we analyzed the therapeutic effects of VRT on respiratory dysfunction at 3 months after cervical spinal cord injury. Of an initial group of 37 patients, 26 completed the music therapy intervention, which comprised five 30-minute sessions per week for 12 weeks. The intervention group (n = 13) received VRT training delivered by professional certified music therapists. The control group (n = 13) received respiratory physical therapy delivered by professional physical therapists. Compared with the control group, we observed a substantial increase in respiratory function in the intervention group after the 12-week intervention. Further, the nerve fiber bundles in the respiratory center in the medulla exhibited a trend towards increased diversification, with an increased number, path length, thickness, and density of nerve fiber bundles. These findings provide strong evidence for the effect of music therapeutic VRT on neural plasticity. This study was approved by the Ethics Committee of China Rehabilitation Research Center (approval No. 2020-013-1) on April 1, 2020, and was registered with the Chinese Clinical Trial Registry (registration No. ChiCTR2000037871) on September 2, 2020. 

Key words: cervical spinal cord injury, music therapy, neural plasticity, respiratory center, respiratory function, vocal respiratory training

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