Effect Of TOMATIS Auditory Training On Stroke Patients With Memory And Executive Function

Objectives To explore the effects of TOMATIS auditory training on the memory and executive functions in patients with cognitive impairment after stroke,with an aim to provide scientific basis for developing more innovative and effective rehabilitation therapy.Methods 120 patients with cognitive impairment after stroke meeting the inclusion criteria were recruited from Tangshan Rehabilitation Medical Center from June 2015 to December 2016 as the objects of study.The patients were divided into three groups based on random table method,which were experiment group,control group and blank control group,with 40 cases in each group.Patients in blank control group received conventional rehabilitation training from Monday to Friday,including occupational therapy(OT),traditional Chinese medicine(TCM)physiotherapy,physical therapy(PT),balance training and limb functional exercises.Meanwhile,conventional nursing was also conducted,such as basic nursing,medication nursing,health guidance and psychological nursing.The control group was given TOMATIS conventional music(music without audio frequency adjustment)on the basis of blank control group,while the experiment group was given TOMATIS auditory training(music with audio processing)on the basis of blank control group too.It included 2 hosts equipped with touch control panel(green label was host with audio processing,while red label was host without audio processing),2 wireless signal transmitters that were matched with hosts,20 wireless headphones possessing bone conduction and air conduction technology,and several corresponding chargers.It allowed for auditory training on numerous people at the same time.The music program was programmed by the Doctor of Neurology from University of Marseille in France for this experiment.It included Mozart series of music and Gregoria hymns.The operator changed the music program in accordance with the preset order.Both groups were intervened at the same time for once a day for 60-90 minutes.A total of two intervention cycles were set,the first cycle T(procedure)was 14 days and the second cycle F(program)was 10 days after an interval of 30 days.Therefore,altogether 54 days were needed for the two cycles.The Rivermead behavioral memory test-second edition(RBMT-II)and Behavioral Assessment of Dysexecutive Syndrome(BADS)were adopted to evaluate patients before and after intervention,and the intervention effects were observed.All data were input into Excel and the results were analyzed by SPSS 17.0 statistical software after verification.The measurement data were expressed as mean±standard deviation((?)±s).All experimental data were compared by t test and variance test before and after intervention.Difference with P<0.05 was deemed as statistically significant.Results 1.Results of memory function evaluation of three groups.1)There was no significant difference in RBMT-II score among the three groups before intervention(P>0.05).2)Comparison of difference in RBMT-II scores among three groups before and after intervention:(1)Differences in RBMT-II scores in the name recall,hidden items recall,appointment recall,picture recognition,face recognition,story delayed recall,immediate route recall,delayed route recall,delayed information recall and total standard scores were higher in experiment group than those in blank control group(P<0.05);(2)Differences in RBMT-II scores in picture recognition and total standard scores were higher in control group than those in blank control group(P<0.05);(3)Differences in RBMT-II scores in name recall,hidden items recall,appointment recall,delayed information recall and total standard scores in experimental group were higher than those in control group(P<0.05).3)Intragroup comparison of RBMT-II scores in three groups before and after intervention:(1)RBMT-II scores in name recall,hidden items recall,appointment recall,picture recognition,face recognition,immediate story recall,delayed story recall,date,immediate route recall,delayed route recall,delayed information recall and total standard scores in experiment group had elevated after intervention compared with those before intervention,with the differences being of statistical significance(P<0.05);(2)RBMT-II scores in picture recognition,delayed story recall,date,delayed route recall and total standard scores in control group were higher after intervention than those before intervention,and all differences were statistically significant(P<0.05);(3)RBMT-II scores in appointment recall and total standard scores in blank control group had improved after intervention relative to those before intervention,and the differences were statistically significant(P<0.05).The results showed that the intervention effect in experiment group was better than that in control group and blank control group.2.Results of executive function evaluation of three groups.1)Differences in BADS score among three groups before intervention were not statistically significant(P>0.05).2)Comparison of differences in BADS scores among the three groups before and after intervention:(1)Differences in BADS scores in all sub-experiments and total standard scores in experiment group were all higher than those in blank control group(P<0.05);(2)Differences in BADS scores in Rule Shift Cards Test(RSCT),Temporal Judgment Test(TJT),Zoo Map Test(ZMT),Modified Six Elements Test(MSET)and total standard scores in control group were higher than those in blank control group(P<0.05);(3)Differences in BADS scores in Action Program Test(APT),Key Seek Test(KST),Zoo Map Test(ZMT)and total standard scores in experiment group were higher than those in control group(P<0.05).3)Intragroup comparison of BADS scores in three groups before and after intervention:(1)BADS scores in all sub-experiments and total standard scores in experiment group were all higher after intervention than those before intervention,and the differences were statistically significant(P<0.05);(2)BADS scores in Rule Shift Cards Test(RSCT),Temporal Judgment Test(TJT),Zoo Map Test(ZMT),Modified Six Elements Test(MSET)and total standard scores in control group were higher after intervention than before,with the differences being of statistical significance(P<0.05);(3)BADS scores in Action Program Test(APT),Temporal Judgment Test(TJT),Modified Six Elements Test(MSET)and total standard scores in blank control group were higher after intervention than before,and all differences were of statistical significance(P<0.05).The results demonstrated that TOMATIS auditory training had more influence on executive function than music training and conventional rehabilitation and nursing.Conclusions 1 TOMATIS auditory training can significantly improve the memory function of patients with cognitive impairment after stroke.2 TOMATIS auditory training can remarkably enhance the executive function of patients with cognitive impairment after stroke.TOMATIS auditory training has provided a more innovative and simple treatment for the rehabilitation of patients with stroke in clinic.