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帕金森治疗：击鼓是首选的音乐疗法
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目前对于帕金森病的治疗方案，除了药物治疗和手术治疗之外，还有其他一些辅助治疗方法，例如运动疗法和音乐疗法。
以前我曾在 Parkinsonism.net 上翻译了一篇有关运动疗法的文章——帕金森病的运动疗法 - Exercise for People with Parkinsons Disease( http://www.parkinsonism.net/news/1/298.html)。 而音乐疗法，目前在欧美处于领先地们，欧美在对于音乐疗法的研究和治疗的应用方面非常普及， 而美国则是最早将音乐治疗作为一门独立的学科建立起来的。《美国音乐治疗协会》是领导世界音乐治疗的重要组织，它们对音乐治疗下了个定义： 音乐治疗是一个系统干预的过程，在这个过程中，治疗师利用音乐体验的各种形式，以及在治疗过程中发展起来的， 作为治疗的动力的治疗关系来帮助治疗者达到健康的目的。
在 livejournal的网站上有一篇 2005 年由 JOSéE ROSE 写的文章《With Drum Therapy, Patients Tap Into the Brain》,非常专业地描述了音乐治疗中，击鼓疗法的重要作用。
这篇文章在国内已经有中文翻译，我将全中英文版本收集整理如下：
With Drum Therapy, Patients Tap Into the Brain
来源：livejournal.com 引用：http://www.parkinsonism.net/pathology/1/33.html
By JOSéE ROSE
Staff Reporter of THE WALL STREET JOURNAL
January 4, 2005; Page D4
Walter Smith, now 66 years old, had a stroke in 1994 and was diagnosed with multiple sclerosis in 1999. For 10 years he's been a resident at Beth Abraham, a skilled nursing and rehabilitation facility in the Bronx, N.Y.
But that hasn't kept him from being in the band. Indeed, he credits the institution's therapeutic-drumming program with helping him to regain the use of his left arm and hand.
"It was gradual and then I noticed how much I could move my left hand," says Mr. Smith, who participates in three drum groups each week: a rumming circle, a rock band for the hospital called the Rejuvenators, and a music therapy group where the instruments are adjusted in a particular way to build strength and flexibility. He plays on both the electronic and acoustic drums.
Since ancient times, drumming has been a part of ritual healing, used in social ceremonies and simply to relieve stress. Today, advocates say therapeutic rhythm techniques can help treat medical conditions including autism and Alzheimer's disease, and facilitate an individual's recovery of motor skills. Anecdotal evidence also points to benefits such as lowering stress levels, boosting the immune system, and allowing for emotional expression.
Drums are a popular instrument in music therapy because people without prior music experience can immediately grasp the concept of drumming. It also can complement more-standard forms of music therapy.
Music therapy is becoming more accepted in the medical field. "There are more than 500 health-care individuals that have been trained, and it is used in hospitals, rehabilitation centers, drug and alcohol centers, clinics and support groups," says Barry Bittman, a neurologist who is chief executive officer and medical director of the Mind-Body Wellness Center in Meadville, Pa., which provides programs to help individuals actively participate in their well-being or healing. Dr. Bittman attributes the popularity of music therapy to affordability, effectiveness and its accessibility -- "people without prior music experience can engage in an expressive activity that is nonverbal."
Music therapy is used to improve physical and mental abilities through structured activities such as singing, listening, playing instruments, composition, and music and imagery exercises. There are 71 college and universities in the U.S. that offer an approved music-therapy degree program.
Proponents say that some of the benefits of drumming come from the orderliness involved, particularly for brains that don't have the standard ability to process information. "Rhythm can be predictable and provides a mechanism for timing, an area that these people have trouble with," says Connie Tomaino, director of the Institute for Music and Neurological Function at Beth Abraham, where Mr. Smith lives. The institute integrates neurological, rehabilitative and music-brain research to understand and apply the power of music to promote health and wellness.
For example, a person may not be able to lift his hand to pick something up because he can't organize his thoughts to carry out the action. "Just because people can't do a movement on their own doesn't mean that the physical ability is damaged -- they just can't organize internally what to do," Dr. Tomaino explains. "Paying attention to the rhythm allows individuals [such as those with Parkinson's disease or recovering from a stroke] to have increased movement."
According to Eric Hall, CEO of the Alzheimer's Foundation of America, drum therapy can produce a positive response in patients suffering from the brain-wasting disease. Since rhythm requires little mental processing and because it influences the motor center of the brain, patients often can respond to rhythmic cues.
"Drum therapy gets them to participate once again in life," Mr. Hall says. "It fosters some type of communication, and there is some type of power in the rhythm that promotes cognitive functions. To see an individual in the late stages of Alzheimer's disease participate in life is incredibly monumental."Group drumming sessions also can break through the mental isolation that comes with conditions such as Alzheimer's and autism. "By giving them a drum and drumming with them, I found a new way to interact with those who normally do not engage with others and are not aware of their environment," says Dr. Tomaino.
Dr. Bittman says he's seen drumming benefit elderly individuals with dementia and children with autism. "I was fascinated to see those who seemed in one sense very disconnected with the environment to interact with each other, not only by drumming together but also by doing a 'call-response' activity where one person banged out a rhythm and everyone else followed that same rhythm," he says.
Individuals with learning disabilities or a neurological impairment who listen to music also experience reduced anxiety levels, allowing them to concentrate on the task at hand since they're not thinking about the task, but about the music instead.
Dr. Bittman says a lot is yet to be learned about how music affects neurological function. "This is just in its infancy," he says. "We're just beginning to understand the mind and music."
下面的中文对应翻译，是我转自 Yahoo 知识堂。
击鼓是首选的音乐疗法
来源：Yahoo 知识堂 引用：http://www.parkinsonism.net/pathology/1/33.html
现年66岁的沃尔特·史密斯(Walter Smith)于1994年患了中风，1999年被诊断出患有多发性硬化症。十年来，他一直住在纽约市布朗克斯区的Beth Abraham看护疗养院里。
但所有这些并不能阻止他加入乐队。事实上，他认为，正是Beth Abraham的治疗性击鼓方案帮助他的左臂和左手恢复了功能。
“这个过程是逐步的，但后来我的确发现自己的左手可以有相当幅度的活动了，”史密斯说。
他每周参加三个击鼓小组活动，一个是鼓圈圈(drum circle)，一个是医院的摇滚乐队The Rejuvenators，还有一个是音乐治疗小组（那里的乐器都经过特殊调整，帮助他们锻炼力量和灵活性）。史密斯演奏电声鼓，也演奏传统原声鼓。
自古以来，击鼓就是仪式医疗(ritual healing)的一部分，常用于典礼或只是为了缓解压力。今天，击鼓的鼓吹人士称，治疗性的节奏乐器练习有助于减轻孤独症和阿兹海默症等患者的病症，有助于个人动作技巧的康复。从一些例子来看，这种疗法也有助于减轻压力、改善免疫系统，并使情绪得到表达等益处。
在音乐疗法中，鼓是一种受欢迎的乐器，因为即使是以前没有乐器经验的人也能很快掌握击鼓的要领。这也能补充更标准的音乐疗法。
医学界正在日益推广音乐疗法。“有500多个接受护理的个人已接受了这种训练，音乐疗法在医院、康复中心、戒毒戒酒中心、诊所以及支持团体中都得到了广泛应用，”Mind-Body Wellness Center的首席执行长、神经科专家巴瑞·比特曼(Barry Bittman)表示。这家位于宾夕法尼亚州的中心提供一些治疗项目，帮助个人积极参与康复过程。比特曼将音乐疗法的流行归因于经济上的可承受性、疗效的明显以及简便易行，“以前没有乐器经验的人也能参与到一项非言语的表达活动中来。”
音乐疗法通过歌唱、听音乐、演奏乐器、谱曲、以及音乐想像练习，改善机体和大脑的活动。在美国有71家大学和学院提供获认可的音乐疗法学位课程。
支持者称，击鼓疗法的益处来自其有规律可循，特别是对于那些缺乏一般信息处理能力的大脑。“节奏可以预测，并提供了一个时机把握机制，这是许多患者薄弱的地方，”Beth Abraham音乐神经功能研究所的所长康尼·塔美诺(Connie Tomaino)表示。该研究所综合神经学、康复学以及音乐-大脑的理论，重点研究音乐促进健康的力量，并加以应用。
比如，一个人无法抬起手来拣东西，可能是因为他无法组织执行这个行为的思维。“一个人无法自己完成一个动作，并不意味著其机体能力已经丧失，可能只是思维中存在问题，”塔美诺解释说，“将注意力放在节奏乐器上，可使他们（比如患有帕金森病的患者或中风康复患者）增加运动。”
美国阿兹海默症基金会的首席执行长埃瑞克·豪尔(Eric Hall)称，击鼓疗法能够激起脑部损伤患者的积极反应。因为节奏乐器所需的思维处理很少，并能影响于大脑的运动神经中枢，患者一般都能对节奏提示作出反应。
“击鼓疗法让他们再次参与到现实生活中来，”豪尔表示，“这培养了某种沟通，节奏乐器可促进认知功能。看到阿兹海默症晚期患者能重新参与到现实生活中来，简直令人难以置信，这具有里程碑式的意义。”
集体性的击鼓活动也能打破阿兹海默症和孤独症患者的封闭思维方式。“给他们一个鼓，然后和他们一起击鼓。我发现，这是与那些通常对周围人和环境视而不见的患者进行互动的一种新方式，”塔美诺表示。
比特曼表示，他看到击鼓疗法让很多老年痴呆症患者和孤独症孩子受益。“看到这些从某种意义上来说思想与外界隔绝的人们开始互动，真是令人兴奋，他们的互动还不仅限于一起击鼓，而且还对提示作出反应，如果有一个人击出一个节奏，其他所有人都会跟上。”
听音乐也能让存在学习障碍或神经损伤的患者减轻焦虑程度，从而集中精力完成手头的任务。
比特曼表示，有关音乐是如何影响神经功能的仍有许多未知，“我们还只是刚刚开始了解思维和音乐。”(via wsj )
与音乐、帕金森病相关的资料
- 六种塑造大脑让你聪明的方法
- 听音乐帮中风老人康复
一般我们都认为人的大脑是天生的，后天没更好的办法去改变，但是研究表明，锻炼能够改善大脑的执行能力，包括规划、组织和多任务处理能力。你的食谱也对大脑的有效运作有所影响，诸如听音乐、玩游戏、沉思等可提高大脑的认知能力。
据法国媒体报道，芬兰2月20日公布的一项研究发现，每天听听自己喜欢的流行歌曲、经典音乐甚至爵士乐，都能加速中风患者的康复。这项研究已经发表在牛津大学出版的《大脑》杂志上。
整理：Golden Pig 最后修改：2007-05-23
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