Sustained Effect Of Neurocreative Music Therapy On Upper Limb Abilities, Spasticity, Selective Control And Quality Of Life In Cerebral Palsy: A Case Report

Öz

Abstract This case report, presents the sustained effect of Neurocreative Music Therapy (NCMT) which a uniqe music therapy approach on the upper limb in an individual with cerebral palsy (CP). Our case is a 19-year-old individual with hemiparetic CP and she was included in the 8-week NCMT application program. Before the application, a phenomenological interview was conducted in accordance with the principle of the NCMT approach, which prioritizes the needs and pleasures of the individual. Before and immediately after the 8-week NCMT application, the patient's spasticity was assessed with the Modified Ashwort Scale, selective motor control with the Selective Control of the Upper Extremity Scale, upper limb abilities in daily activities with the ABILHAND-Kids, and quality of life with the Pediatric Quality of Life Inventory CP Module 3.0. As a result of the assessments, an individual-specific music therapy program was planned and implemented. The outcome measurements made immediately after the NCMT application were repeated in the 4th and 8th weeks following the end of the application. According to the results of the scales, it was observed that spasticity decreased, selective motor control increased, upper limb abilities improved, and quality of life increased. The obtained improvements were generally maintained in the 4th week following the end of the therapy. It was observed that there was a decrease in the sustainability of the effect in the 8th week following the end of the therapy in other measurement parameters other than quality of life. As a result, we concluded that NCMT is an effective approach in the rehabilitation of individuals with CP and that its effects may be transferred to the post-rehabilitation period.

Anahtar Kelimeler

• Cerebral palsy
• Music therapy
• Upper extremity

Serebral Palside Nörokreatif Müzik Terapinin Üst Ekstremite Becerileri, Spastisite, Selektif Kontrol ve Yaşam Kalitesi Üzerine Sürdürülebilir Etkisi: Olgu Sunumu

Öz

Bu olgu sunumunda, özgün bir müzik terapi yaklaşımı olan Nörokreatif Müzik Terapi (NKMT) yaklaşımının Serebral Palsili (SP) bir bireyde üst ekstremiteye olan sürdürülebilir etkileri sunulmaktadır. Olgumuz 19 yaşında hemiparetik Serebral Palsili bir bireydir ve 8 haftalık NKMT uygulama programına alınmıştır. Uygulama öncesi bireyin ihtiyaçlarını ve zevklerini önceleyen NKMT yaklaşımı prensibi gereği fenomenolojik görüşme yapılmıştır. 8 haftalık NKMT uygulaması öncesinde ve uygulamanın hemen sonrasında olgunun spastisitesi Modifiye Ashwort Skalası ile, selektif motor kontrolü Üst Ekstremite Selektif Kontrol Skalası ile, günlük aktivitelerdeki üst ekstremite becerisi ABILHAND-Kids ile, yaşam kalitesi ise Çocuklar İçin Yaşam Kalitesi Ölçeği SP modülü 3.0 ile değerlendirilmiştir. Değerlendirmeler sonucunda bireye özgü bir müzik terapi programı planlanmış ve uygulanmıştır. NKMT uygulamasının hemen ardından yapılan sonuç ölçümleri, uygulama bitimini takip eden 4. ve 8. haftalarda tekrarlanmıştır. Ölçeklerin sonuçlarına göre spastisitenin azaldığı, selektif motor kontrolün arttığı, üst ekstremite becerilerinin geliştiği, yaşam kalitesinin arttığı görülmüştür. Elde edilen gelişmeler genel olarak terapi bitimini takiben 4.haftada korunmuştur. Yaşam kalitesi dışındaki diğer ölçüm parametrelerinde ise terapi bitimini takiben 8.haftada etkinin sürdürülebilirliğinde azalma olduğu görülmüştür. Sonuç olarak NKMT'nin SP'li bireylerin rehabilitasyonunda etkili bir yaklaşım olduğu ve etkilerinin rehabilitasyon sonrası döneme de aktarılabileceği düşünülmektedir.

Anahtar Kelimeler

• Serebral Palsi
• Müzik terapisi
• Üst ekstremite

Kaynakça

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