Effects Of Brainwave Music On Post-stroke Fatigue In Patients With Acute Ischemic Stroke

Objective:1.To investigate risk factors associated with the occurrence of post-stroke fatigue(PSF)in patients with acute ischemic stroke(AIS).2.To explore the effects of brainwave music on the occurrence of PSF,neurological function,autonomous self-care and anxiety in patients with AIS,in order to provide a clinical practice basis for improving the connotation of chronic disease management.Methods:To provide a reference for developing a targeted intervention by investigating the risk factors of PSF in patients with AIS.Based on the first part of the research,implemented an intervention which explored the effects of brainwave music on occurrence of PSF,neurological function,autonomous self-care and anxiety in patients with AIS.Part Ⅰ:The patients observed in this study are those with AIS who were hospitalized in the Department of Neurology at Sichuan Academy of Medical Sciences-Sichuan Provincial People’s Hospital between February 2020 and July 2020.Patients who met the inclusion criteria were investigated within 48 hours of being hospitalized,through the use of the General Information Questionnaire(GIQ),the Chinese version of the Fatigue Severity Scale(FSS),the National Institutes of Health Stroke Scale(NIHSS),the Barthel Index(BI)and the Self-Rating Anxiety Scale(SAS).General and disease-related information of patients collected by the aforementioned questionnaire was statistically analysed to screen out risk factors for PSF by using chi-square test,t-test,rank sum test,binary logistic regression etc.Part Ⅱ:64 patients with AIS who were hospitalized in the Department of Neurology of the previously mentioned hospital between August 2020 and November 2020 were included.Using random controlled trial,they were divided into control and intervention groups.Both groups started nursing on the first day after hospitalization.The control group were exposed to regular nursing methods,whereas the intervention group,in addition to regular nursing,also underwent a brainwave music intervention which brainwave music of healthy adults in a resting state was delivered to patients for 30 minutes once a day for 7 days.Baseline was collected from both groups using the GIQ.The FSS,NIHSS,BI and SAS were used to assess the severity of fatigue,degree of neurological deficits,autonomous self-care ability and to measure the anxiety level between the two groups both before and after the intervention.Results:Part I:1.70 patients with AIS were included,of whom 3 patients were removed due to automatic discharge,transfer and change of decision during the investigation,thus,the exclusion rate was 4.28%.41 of the 67 patients were male while 26 were female.The mean age was 62.34±13.27 years.The lowest FSS score among all patients was 1 and the highest was 6.11,with a mean score of 3.4 7±1.35.The incidence of PSF in patients with AIS was 46.27%.2.Based on the FSS score,36 patients were divided into the non-PSF group(FSS<4 points)and 31 patients were divided into the PSF group(FSS≥4 points).Spearman correlation analysis was applied.The results of the Spearman correlation indicated that there was a 0.162 positive association between the patients’ FSS scores and NIHSS scores,there was a significant positive association between FSS scores and SAS scores,(rs(67)=.349,P<.01)and there was a 0.087 negative association between the FSS scores and BI scores.3.The study compared the distribution of 26 potential factors such as gender,age,marriage,educational level,occupation,source of medical expenses,site of stroke,past medical history,degree of neurological impairment on hospitalization,autonomous self-care and anxiety level between the non-PSF and PSF groups.The results showed there are significant differences in three factors between the non-PSF and PSF groups:degree of neurological impairment on hospitalization,autonomous self-care ability,and anxiety level.The above 3 factors were then analysed using logistic regression with the results highlighting that degree of neurological impairment on hospitalization and anxiety level were risk factors for PSF.Part II:1.The comparison of general information as a baseline between the two groups,including gender,age,educational level,marriage,occupation and source of medical expenses,as well as the FSS,NIHSS,BI and SAS scores of the two groups before the intervention were statistically analysed;the results indicated that there was no significant difference(P>0.05),thus further analysis can be conducted.2.The FSS,NIHSS,BI and SAS scores after the intervention in the control and the intervention groups were analysed via two independent samplest-test or rank sum tests.The results showed that the fatigue and anxiety scores of the patients were reduced at a statistically significantly level after undergoing the intervention of listening to brainwave music(P<0.05).The FSS,NIHSS,BI and SAS scores before and after the intervention in the two groups were analysed.The results showed that patients of both groups experienced no significant difference in terms of neurological function and autonomous self-care ability either before or after the intervention(P>0.05).Conclusion:1.PSF is at high risk in patients with AIS,which impacts their recovery of neurological function and autonomous self-care ability.It is positively correlated with anxiety,meaning that the more severe a patient’s fatigue,the more severe their anxiety.The risk factors for PSF are the degree of impaired neurological function and anxiety level on hospitalization.2.Brainwave music can alleviate the occurrence of PSF and reduce anxiety levels for patients with AIS,thus improving the patient’s experience of fatigue,quality of life and confidence in recovery.As a combined medical-engineering project,brainwave music serves as an important exploration how stroke patients are treated in the field of neuroscience,laying the foundation for pioneering new intervention attempts and providing a clinical basis for these.