脳血管障害に対する音楽の療法的利用の現状と課題についての文献レビュー

A literature review of current issues in the therapeutic application of music for people with cerebral vascular disturbance

要旨：2000年以降の医学中央雑誌掲載論文を中心に，国内の脳血管障害に伴う感覚運動機能の障害や精神認知機能の障害に対する音楽の療法的利用についてレビューを行った．歩容，下肢筋力，手指の巧緻性，失語症，構音障害，注意機能，半側空間無視，意識障害，嚥下機能などに対して改善がなされたとの報告があった．しかし，治療的介入手段の作業の一つとして音楽の特性が十分利用されておらず，作業療法士による報告は少なかった．感覚運動領域や認知機能の障害に対する音楽の影響の明示と，治療的ニーズに応じて，知識や技術の養成教育への導入，もしくはそれらをもったそれぞれの専門職種間の連携を可能にする診療システムの構築の必要性が示唆された．

　This paper reviews the therapeutic applications of music in Japan for disturbances of the sensorimotor, mental and cognitive function of people with cerebrovascular disorders after 2000 “Ichushi”. Music therapy has proven to have many positive effects on the improvements of gait, strengthening of the muscles of the lower extremities, hand and finger dexterity, aphasia, dysarthria, unilateral spatial neglect, consciousness disturbance, swallowing and attention. However, there are few reports by occupational therapists, and there are not enough occupational therapists who take advantage of the characteristics of music, and who use music as a tool of therapeutic intervention. It is necessary to clarify the influence of music on sensorimotor and cognitive function of cerebrovascular disorders, and implement the specific knowledge and techniques to an occupational therapy training program, or build up medical care systems which enable interdisciplinary approaches according to therapeutic needs.