DOI QR코드

DOI QR Code

An Analysis of Research Using the Rhythmic Auditory Stimulation Technique: A Comparison of Music Therapy and Physical Therapy Approaches

국내 리듬청각자극(RAS) 기법 활용 연구 분석: 음악치료와 물리치료 비교를 중심으로

  • Lee, Jiyeon (Gyeonggi Provincial Medical Center Paju Hospital)
  • Received : 2020.04.06
  • Accepted : 2020.05.22
  • Published : 2020.05.30

Abstract

The purpose of this study was to identify research that included the rhythmic auditory stimulation (RAS) technique and to compare this body of research within the field of music therapy with that in physical therapy. Forty-five studies were identified that were published from January 1999 through November 2018, and these were analyzed in terms of intervention procedure, type of rhythmic cueing, and therapeutic basis described by the researcher. While research in both fields used rhythmic cueing as the primary therapeutic agent, differences were found in the area targeted by training and specific type of rhythmic cueing used. Research conducted in the field of music therapy focused primarily on gait function, while research in the field of physical therapy tended to address gait-related physical issues, such as balance, muscle strength, and proprioceptive sensation as well as gait. While all of the identified studies from the field of music therapy used music for cueing, a metronome was used more often for cueing in physical therapy research. In terms of description of theoretical basis, theory of entrainment was more sufficiently described in music therapy research. These results indicate that while music therapy research maximized the role of various elements of music in intervening in gait function, physical therapy research addressed gait in relation to other physical functions. Considering that both aspects are essential for gait training, this study supports the need for a multidisciplinary approach to neurological rehabilitation with RAS.

본 연구는 국내 음악치료 및 물리치료 분야에서 리듬청각자극(RAS)을 적용하여 수행된 연구를 비교분석하였다. 이를 위해 1999년부터 2018년 11월까지 발표된 학위 논문과 학술지 게재 연구 중 RAS 및 보행기능 관련 주제어를 검색하여 기준에 부합한 45개의 연구를 선정하였고, 세부중재방법과 리듬자극의 유형, 기술된 치료 원리의 측면에서 분석하였다. 분석 결과, 두 영역에서의 연구 모두 일정한 간격의 리듬을 핵심적인 치료 자극으로 사용하고 RAS의 기본 절차를 따른 점에서는 공통적이었지만, 목표기능이나 구체적인 리듬제공방법에 있어서는 차이가 있었다. 음악치료 연구에서는 모두 보행기능이 목표 변인이었던 데 비해, 물리치료 연구에서는 균형이나 근력, 고유수용성감각 등 관련 신체기능이 목표에 포함되었다. 또한 음악치료 연구에서는 다양한 요소를 포함한 '음악'이 리듬자극으로 활용된 반면, 물리치료 연구에서는 메트로놈을 리듬자극으로 활용한 연구가 음악을 활용한 연구보다 많았다. RAS 원리와 관련하여 단순한 기법 설명 외에 동조화와 같이 치료의 원리가 충분히 기술된 연구는 물리치료보다는 음악치료 분야에서 많이 확인되었다. 이러한 결과는 음악치료 연구에서는 리듬과 더불어 음악의 다양한 요소가 보행에 미칠 수 있는 영향이 고려되어 음악의 역할이 적극적으로 활용된 반면, 물리치료 연구에서는 보행에 영향을 미치는 다양한 신체기능에 대한 개입이 포함된 경향이 있음을 보여준다. 두 가지 측면 모두 재활에 있어 중요한 부분임을 고려할 때, 본 연구는 다학제간 연구를 기반으로 한 RAS 연구의 기법의 확장 적용에 대한 시사점을 제시한다고 할 수 있다.

Keywords

References

  1. Bayat, R., Barbeau, H., & Lamontagne, A. (2005). Speed and temporal-distance adaptations during treadmill and overground walking following stroke. Neurorehabilitation and Neural Repair, 19(2), 115-124. https://doi.org/10.1177/1545968305275286
  2. Cho, H. Y. (2017). Effect of balance and gait in stroke patient with action observation using audiovisual (Unpublished master's thesis). Daegu University, Gyeongbuk.
  3. Clark, I. N., Baker, F., & Taylor, N. F. (2012). The effects of live patterned sensory enhancement on group exercise participation and mood in older adults in rehabilitation. Journal of Music Therapy, 49(2), 180-204. https://doi.org/10.1093/jmt/49.2.180
  4. Cooper, H., Carlisle, C., Gibbs, T., & Watkins, C. (2001). Developing an evidence base for interdisciplinary learning: A systematic review. Journal of Advanced Nursing, 35(2), 228-237. https://doi.org/10.1046/j.1365-2648.2001.01840.x
  5. Dalla-Bella, S., Dotov, D., Bardy, B., & de Cock, V. C. (2018). Individualization of music-based rhythmic auditory cueing in Parkinson's disease. Annals of the New York Academy of Sciences, 1423(1), 308-317. https://doi.org/10.1111/nyas.13859
  6. Dobkin, B. H. (2004). Strategies for stroke rehabilitation. The Lancet Neurology, 3(9), 528-536. https://doi.org/10.1016/S1474-4422(04)00851-8
  7. Ghai, S., Ghai, I., Schmitz, G. & Effenberg, A. O. (2018). Effect of rhythmic auditory cueing on parkinsonian gait: A systematic review and meta-analysis. Scientific Reports, 8(1), 1-19.
  8. Jeong, S. H. (2013). Systematic review of the literatures on music intervention for neurological patients in Korea. Journal of Korean Biological Nursing Science, 15(2), 65-73. https://doi.org/10.7586/jkbns.2013.15.2.65
  9. Johansson, B. B. (2011). Current trends in stroke rehabilitation. A review with focus on brain plasticity. Acta Neurologica Scandinavica, 123(3), 147-159. https://doi.org/10.1111/j.1600-0404.2010.01417.x
  10. Kim, S. J., Cho, S. R., Oh, S. J., & Kwak, E. M. (2010). Case study of gait training using rhythmic auditory stimulation(RAS) for a pediatric patient with cerebellar astrocytomas. Journal of Music and Human Behavior, 7(2), 65-81.
  11. Kim, S. J., Yoo, G. E., Shin, Y. K., & Cho, S. R. (2020). Gait training for adults with cerebral palsy following harmonic modification in rhythmic auditory stimulation. Annals of the New York Academy of Sciences. Advance online publication. doi.org/10.1111/nyas.14306
  12. Magee, W. L., Brumfitt, S. M., Freeman M., & Davidson, J. W. (2006). The role of music therapy in an interdisciplinary approach to address functional communication in complex neuro-communication disorders: A case report. Disability and Rehabilitation, 28(19), 1221-1229. https://doi.org/10.1080/09638280600630999
  13. Magee, W. L., Clark, I., Tamplin, J., & Bradt, J. (2017). Music interventions for acquired brain injury. Cochrane Database of Systematic Reviews, 2017(1), 1-117. doi: 10.1002/14651858.CD006787.pub3
  14. Magee, W. L., & Stewart, L. (2015). The challenges and benefits of a genuine partnership between music therapy and neuroscience: A dialog between scientist and therapist. Frontiers in Human Neuroscience, 9, 223. https://doi.org/10.3389/fnhum.2015.00223
  15. Nombela, C., Hughes, L. E., Owen, A. M., & Grahn, J. A. (2013). Into the groove: Can rhythm influence Parkinson's disease? Neuroscience & Biobehavioral Reviews, 37(10), 2564-2570. https://doi.org/10.1016/j.neubiorev.2013.08.003
  16. Oh, S. J., Kim, S. J., Cho, S. R., & Kwak, E. M. (2010). Case study of gait training with rhythmic auditory stimulation (RAS) in hemiplegia adults with spastic cerebral palsy. Journal of Exercise Rehabilitation, 6(1), 119-130.
  17. Park, H. J. (2015). Exploring the use of melody during RAS gait training for adolescents with traumatic brain injury: A case study. Journal of Music and Human Behavior, 12(2), 19-36. https://doi.org/10.21187/JMHB.2015.12.2.019
  18. Park, J., Kim, B. R., & Kim, T. H. (2018). Effects of visual feedback and rhythmic auditory stimulation on walking of stroke patients induced by treadmill walking training. Physical Therapy Korea, 25(2), 53-61. https://doi.org/10.12674/ptk.2018.25.2.053
  19. Repko, A. F., & Szostak, R. (2016). Interdisciplinary research: Process and theory (3rd ed.). NY: Sage Publications.
  20. Song, S. Y., Song, Y. H., & Lee, H. M. (2018). The effects of action observational physical training with rhythmic auditory stimulation on muscle activity of the lower extremity and gait ability in patients with chronic stroke. Journal of the Korean Society of Physical Medicine, 13(2), 137-145. https://doi.org/10.13066/kspm.2018.13.2.137
  21. Thaut, M. H. (2003). Neural basis of rhythmic timing networks in the human brain. Annals of the New York Academy of Sciences, 999(1), 364-373. https://doi.org/10.1196/annals.1284.044
  22. Thaut, M. H. (2005). Rhythm, music, and the brain. NY: Routledge.
  23. Thaut, M. H., & Abiru, M. (2010). Rhythmic auditory stimulation in rehabilitation of movement disorders: A review of current research. Music Perception: An Interdisciplinary Journal, 27(4), 263-269. https://doi.org/10.1525/mp.2010.27.4.263
  24. Thaut, M. H., Rice, R. R., Braun Janzen, T., Hurt-Thaut, C. P., & McIntosh, G. C. (2019). Rhythmic auditory stimulation for reduction of falls in Parkinson's disease: A randomized controlled study. Clinical Rehabilitation, 33(1), 34-43. https://doi.org/10.1177/0269215518788615
  25. Yoo, G. E., & Kim, S. J. (2016). Rhythmic auditory cueing in motor rehabilitation for stroke patients: Systematic review and meta-analysis. Journal of Music Therapy, 53(2), 149-177. https://doi.org/10.1093/jmt/thw003
  26. Yoon, S. K., & Kang, S. H. (2015). Effects of inclined treadmill walking training with rhythmic auditory stimulation on balance and gait in stroke patients: A pilot study. Journal of Korean Society of Integrative Medicine, 3(4), 69-78. https://doi.org/10.15268/ksim.2015.3.4.069