Effectiveness of music-based interventions on motricity or cognitive functioning in neurological populations: a systematic review

    Publication Date
    Source Authors
    Source Title
    Source Issue
    Publication Date

    2017

    Source Authors

    MoumdJian, L., Sarkamo, T., Leone, C., Leman, M., Feys, P.

    Source Title

    Effectiveness of music-based interventions on motricity or cognitive functioning in neurological populations: a systematic review

    Source Issue

    European Journal of physical and rehabilitation Medicine

    53

    Page Range: 466-482

    Siamo nel contesto della riabilitazione neurologica. Il lavoro va a studiare l’efficacia degli interventi basati sull’uso della musica sulla funzione cognitiva e motoria nei disturbi neurologici.
    Studi eseguiti tramite neuroimaging su soggetti sani, hanno dimostrato l’effetto positivo degli interventi musicali sul miglioramento della neuroplasticità e questa scoperta, ha suscitato sempre maggiore interesse in ambito scientifico.
    Per dimostrare dunque, gli effetti di questi interventi su soggetti affetti da patologie neurologiche, gli autori hanno eseguito una revisione sistematica della letteratura, ricercando studi fino al giugno del 2016 e includendo nell’analisi le seguenti tipologie di studio: studi controllati, studi randomizzati e controllati e studi di coorte con un periodo di intervento di almeno 3 settimane. Sulla base di precisi criteri di inclusione, riportati nell’articolo in questione, sono stati selezionati 19 articoli, di cui 13 studi randomizzati e controllati, 4 studi controllati e 2 studi di coorte.
    Tra questi studi, 14 sono stati eseguiti su soggetti affetti da ictus, 3 su individui affetti da malattia di Parkinson e 2 su una popolazione affetta da sclerosi multipla.
    La peculiarità della revisione, risiede nel fatto che all’interno degli studi selezionati, è stato analizzato il contenuto degli interventi musicali utilizzati, i quali sono stati successivamente suddivisi in 4 gruppi. Dopodiché gli autori hanno esaminato il disegno delle sperimentazioni e le misure utilizzate per la valutazione dei risultati degli studi. Infine, sono stati studiati gli effetti di ciascuna tipologia di interventi musicali utilizzati, sulle funzioni motorie e cognitive.
    L’analisi degli studi selezionati dagli autori, rivela che gli interventi musicali, hanno un elevato potenziale clinico per la riabilitazione e per le funzioni motorie e cognitive, nella popolazione affetta da patologie neurologiche, dimostrando, inoltre, la possibilità di poter applicare specifici interventi a specifici gruppi di patologie.
    Gli autori hanno rilevato variabilità nella tipologia di interventi musicali e nelle misure di esito utilizzate nei vari studi. Per tale motivo, gli interventi sono stati suddivisi in 4 tipologie, facilitandone, in tal modo, l’interpretazione degli effetti.
    Ciononostante , non è stato possibile comparare gli effetti degli interventi musicali tra questi studi. Inoltre, è stato rilevato che gli effetti degli interventi musicali non sono generalizzabili a tutte le tipologie di patologie neurologiche e a tutti i sintomi che ne derivano.
    L’obiettivo specifico degli autori è dunque, quello di fornire una revisione comprensiva, non soltanto degli effetti di questa tipologia di interventi sulle funzioni motorie e cognitive, ma anche quello di offrire dei dettagli sulla tipologia di interventi musicali, in maniera da facilitare la pianificazione di futuri studi e poter anche determinare le misure di esito da utilizzare per gli stessi.
    Anche in questo lavoro, così come indicato dagli stessi autori, ci sono dei limiti. Il primo è che non sono stati calcolati gli effetti in base alla dimensione del campione e non è stata eseguita una meta-analisi che comparasse gli interventi musicali rispetto agli interventi non musicali. Questo a causa della variabilità nelle modalità di intervento musicale, nelle misure di esito utilizzate per determinare gli effetti dell’intervento, nel numero di partecipanti inclusi nello studio e infine perché alcuni studi includono gruppi musicali multipli o hanno più di un gruppo di controllo.
    Ulteriori limiti importanti, sono legati alle piccole dimensioni dei campioni degli studi selezionati.
    Inoltre, a causa della variabilità nelle modalità, dell’inconsistenza nella frequenza, del dosaggio degli interventi ed infine per la variabilità delle patologie investigate, la revisione non ha potuto estrapolare dettagli fondamentali per l’integrazione degli interventi musicali in un programma clinico individualizzato e personalizzato.
    Gli autori sostengono dunque, che gli interventi musicali applicati a pazienti con disturbi neurologici, portano a risultati positivi per le funzioni motorie e cognitive. Ci sono crescenti evidenze che la musica possa direttamente promuovere la neuroplasticità attraverso l’aumento dell’attivazione di circuiti motorio-uditivi, cortico-spinali, mesolimbico e dopaminergico. Interessante sarebbe constatare quest’ultima ipotesi attraverso tecniche di neuroimaging.
    È possibile, inoltre, che la terapia musicale, possa aumentare il benessere psicologico, motivando i pazienti e influenzando positivamente sia l’intensità dell’allenamento che quella della singola sessione.
    Concludendo, anche se gli effetti clinici degli interventi musicali sono promettenti, ulteriori ricerche sono necessarie per comprendere meglio i principi, in base ai quali la musica interagisce sulla motricità e la cognizione.

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