Investigation of Factors That Affect the Quality of Life After a Stroke

Reminiscent music therapy combined with robot-assisted rehabilitation for elderly stroke patients: a pilot study

BACKGROUND

Although some studies suggest that robot-assisted technology can significantly improve upper limb function in stroke patients compared to traditional rehabilitation training, it is still necessary to incorporate an auxiliary intervention to alleviate negative emotions, thereby alleviating the post-stroke fatigue and encouraging patients to actively respond to rehabilitation. However, the effect of the auxiliary intervention is unknown.

OBJECTIVE

To evaluate the effect of reminiscent music therapy combined with robot-assisted rehabilitation in elderly patients with upper limb dysfunction.

METHODS

From November 2022 to March 2023, elderly patients with upper limb dysfunction after stroke were assigned to one of three groups, with group A receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, group B receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation, and group C receiving only usual rehabilitation treatment and care. Thirty patients completed this study, with 10 participants in each group. Activities of daily living, self-esteem, rehabilitation self-efficacy, positive emotion and upper limb function were measured before and after the intervention. One-way analysis of variance, paired-sample t-test, Kruskal-Wallis H test, Wilcoxon signed rank sum test and Chi-square test were used to analyze the data.

RESULTS

According to the intragroup comparisons, in the three groups, all outcome measurements were significantly higher than those at baseline (all P < 0.05). After the intervention, the differences in the self-management effectiveness, rehabilitation self-efficacy, and positive emotion score were statistically significant among the three groups (all P < 0.05). In accordance with the results of Bonferroni analysis, the self-management effectiveness score of group A was significantly higher than that of Group B and Group C (all P < 0.05). The rehabilitation self-efficacy score of group A was significantly higher than that of Group B and Group C (P < 0.05). The positive emotion score of group A was significantly higher than that of Group B and Group C (P < 0.05).

CONCLUSION

Reminiscent music therapy combined with robot-assisted rehabilitation is a promising approach to improve rehabilitation self-efficacy and positive emotion, which is evidence that reminiscent music therapy may be an effective auxiliary intervention to improve rehabilitation outcomes.

Mechanisms associated with post-stroke depression and pharmacologic therapy

Stroke is one of the most common cerebrovascular diseases, which is the cause of long-term mental illness and physical disability, Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, and its mechanisms are characterized by complexity, plurality, and diversity, which seriously affects the quality of survival and prognosis of patients. Studies have focused on and recognized neurotransmitter-based mechanisms and selective serotonin-reuptake inhibitors (SSRIs) can be used to treat PSD. Neuroinflammation, neuroendocrinology, neurotrophic factors, and the site of the stroke lesion may affect neurotransmitters. Thus the mechanisms of PSD have been increasingly studied. Pharmacological treatment mainly includes SSRIs, noradrenergic and specific serotonergic antidepressant (NaSSA), anti-inflammatory drugs, vitamin D, ect, which have been confirmed to have better efficacy by clinical studies. Currently, there is an increasing number of studies related to the mechanisms of PSD. However, the mechanisms and pharmacologic treatment of PSD is still unclear. In the future, in-depth research on the mechanisms and treatment of PSD is needed to provide a reference for the prevention and treatment of clinical PSD.