TÜRKİYE’DE NÖROLOJİK REHABİLİTASYON KAPSAMINDA BİR MÜZİK TERAPİ PROJESİNİN GELİŞTİRİLMESİ

Öz

Müzik terapi (MT) müzikal aktivitelerle zihinsel, fiziksel ve duygusal sağlığı geliştirmek için kullanılan faydalı bir teröpatik araçtır. Bu projenin amacı, nörolojik rehabilitasyon kapsamında MT ile ilgili klinik araştırma çalışmalarını başlatmak ve bu alanda MT programı geliştirmektir. Bu çalışma kapsamında her bir hasta için rehabilitasyon ekibi tarafından özel hedefler belirlenmiş ve hedeflere ulaşmak için şarkı söyleme-dinleme,enstrüman çalma ve müzik ile dans etme (basit salsa ve temel tango adımlarıyla) gibi müzikal aktiviteler gerçekleştirilmiştir. Müzikal aktiviteler bireysel ve grup terapisi olarak düzenlenmiştir. 24 ay içinde 90 serebral palsili (SP), 98 inmeli hasta MT programına dahil olmuştur. MT’nin SP’li çocukların dikkat, hafıza ve yaşam kaliteleri üzerine, perküsyon enstrümanı çalmanın el fonksiyonlarına etkisi; hemiplejik inmeli hastalarda salsa ve tangonun yürüme ve denge üzerine etkisi ile ilgili başlatılan klinik araştırmalar devam etmektedir. Bu proje nörolojik rehabilitasyon kapsamında Türkiye’de oluşturulan ilk MT programıdır. Prospektif randomize kontrollü çalışmalar ile elde edilecek bilimsel veriler sonrasında MT nörolojik rehabilitasyonda faydalı bir adjuvan tedavi yöntemi olabilir.  

Anahtar Kelimeler

• Serebral Palsi,inme,müzik terapi

TÜRKİYE’DE NÖROLOJİK REHABİLİTASYON KAPSAMINDA BİR MÜZİK TERAPİ PROJESİNİN GELİŞTİRİLMESİ

Abstract

Music therapy (MT) is the skillful use of music as a therapeutic tool to reach specific goals through musical activities in order to improve mental, physical, and emotional health. The aim of this project was to develop a profound MT program in a multimodal neurological rehabilitation setting; and to initiate clinical research studies on MT. Specific objectives are set for each patient and musical activities such as listening, singing, playing instruments (simple percussion instruments like maracas, tambourine, drum, wooden spoons, triangle etc), and moving to music (simple steps to salsa and tango basics) are used to reach these goals. Musical activities were applied both as single and group therapy sessions. 90 patients with cerebral palsy (CP), 98 with stroke received MT within 24 months. Clinical research studies investigating effectiveness of MT on attention, memory, and quality of life; playing percussive instruments on hand functions; and salsa/tango on gait and balance of CP or stroke patients were initiated. This project is the first MT program in a neurological rehabilitation setting in Turkey. MT can be a useful adjunctive treatment modality in neurological rehabilitation which requires scientific proof to be generated by prospective randomized controlled trials. 

Keywords

• Cerebral palsy,stroke,music therapy

Kaynakça

1. Bax, MCO., Flodmark, O., Tydeman, C. (2007) Definition and classification of cerebral palsy. From syndrome toward disease. Dev Med Child Neurol Suppl 109: 39-41
2. Bradt, J., Magee, W.L., Dileo, C., Wheeler, B., McGilloway, E. (2010) Music therapy for acquired brain injury. Editorial Group: Cochrane Stroke Group . Published Online: 7 Jul 2010
3. Dursun, E. ve diğ. (2016) Evaluation of dance therapy effects on gait pattern in patients with previous cerebrovascular events: Randomized study results from a single center. Edorium Journal of Disability Rehabilitation 2016;2:124–130.
4. Dursun, M. ve diğ. (2015) Development of a music therapy Project in a neurological rehabilitation setting in Turkey. INEREM-İstanbul özet kitabı, OP 09, Syf.57
5. Goldbeck, L. ve Ellerkamp, T. (2012) A Randomized Controlled Trial of Multimodal Music Therapy for Children with Anxiety Disorders. Journal of Music Therapy. Vol.49 No:4
6. Gökbel, T. ve diğ. (2015) Treating Stroke Patients with Tango. INEREM-İstanbul özet kitabı, VP 01, Syf.123
7. Herdender, M., Esposito, F., di Salle, F., Boller, C., Hilti, C. C., Habermeyer, B., et al. (2010). Musical training induces functional plasticity in human hippocampus. Journal of Neuroscience, 30(4), 1377–1384.
8. Hürriyet Gazetesi (2015), http://www.hurriyet.com.tr/o-hastaliklar-icin-de-robotlatedavi-mumkun-29211268

9. INEREM-2015 International Neurology and Rehabilitation Meeting, 4-6 haziran 2015. İstanbul, Türkiye.
10. Jess-“Ortaya Konuşalım” TV programı (2015) https://www.youtube.com/watch?v= Ad9tH-wy3YE
11. Kocaeli Gazetesi (2015), http://www.kocaeligazetesi.com.tr/turkiyenin-ilk-muzikoterapitoplulugu-goz-doldurdu-629570h.htm
12. Karacan, Ç. ve diğ. (2015) Is Dance Therapy HElpful on Balance and Gait of Patients with Cerebral Palsy?.
13. INEREM-İstanbul özet kitabı, P 136, Syf.121
14. Lesiuk, T. (2010). The Effect of Preferred Music on Mood and Performance in a HighCognitive Demand
15. Occupation. Journal of Music Therapy, Vol. 47, No. 2,
16. Milliyet gazetesi (2015), http://www.milliyet.com.tr/kocaeli-universitesi-nde-felclihastalara-kocaeli-yerelhaber-638909/
17. Mofredj, A., Alaya, S., Tassaioust, K., Bahloul, H. ve Mrabet, A. (2016) Music therapy, a review of the potential therapeutic benefits for the critically ill. Journal of Critical Care Vol. 35 195–199
18. Nasuruddin, M.G. (2010) The Confluence Between Arts and Medical Science — Music and movement therapy for children with Cerebral Palsy. Malaysian Journal of Medical Sciences. Jul-sep 2010 17(3): 1-4
19. Rosenbaum, P., Paneth, N., Leviton, A., ve diğ.(2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl ;109: 8-14
20. Schellenberg, E. G., & Peretz, I. (2008). Music, language and cognition: Unresolved issues. Trends in Cognitive Sciences, 12(2), 45–46.
21. Scholz, D.S., Rohde, S., Nikmaram N., Brückner H.P, Grobach, M., Rollnik, J.D., Altenmüller, E.O.(2016)
22. Sonification of Arm Movements in Stroke Rehabilitation - A Novel Approach in Neurologic Music Therapy. Frontiers in Neurology. 30;7:106
23. Serrallach, B. Ve diğ. (2016). Neural Biomarkers for Dyslexia, ADHD, and ADD in the Auditory Cortex of Children. Frontiers Neuroscience. V. 10:324
24. Sole, C. Mercadal-Brotons, M., Galati, A., De Castro, M. (2014). Effects of Group Music Therapy on Quality of Life, Affect, and Participation in People with Varying Levels of Dementia. Journal of Music Therapy. Vol. 51, No. 1