UČINAK MUZIKOTERAPIJE NA SIMPTOME DEPRESIVNOSTI I ANKSIOZNOSTI I SUBJEKTIVNO BLAGOSTANJE KOD KORISNIKA DOMOVA ZA STARIJE I NEMOĆNE OSOBE

Elderly people are faced with the usual consequences of aging, but also with the onset of difficulties and diseases related to mental health that are more common in older age. Evidence is beginning to emerge that music therapy can improve mental health. This study aimed to determine the effects of music therapy on certain components of mental health in nursing home residents. The study sample consisted of 26 elderly persons (5 men, 21 women), average age 81.96 years (SD = 7.40), who were living in a nursing home. The participants were subjected to a music therapy treatment for six weeks. The mental health aspects such as depression and anxiety symptoms, the level of perceived stress and subjective well-being were measured at baseline and after the end of intervention. The data were collected using the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Short Subjective Well-being Scale. The results have shown that there is a significant decrease in the level of depression, anxiety and perceived stress after music therapy treatment (t = 4.08, t = 4.28, t = 5.56, p < 0,01, respectively). Accordingly, the subjective well-being increased after the intervention period in the study group (t = -2.85, p < 0.01). Findings suggest that music therapy may decrease depression and anxiety symptoms and the level of stress in nursing home residents. The study results imply that music therapy may be an effective treatment strategy for mental health of the elderly in institutional care.Starije se osobe suočavaju s uobičajenim posljedicama starenja, ali i s poteškoćama i bolestima vezanim za mentalno zdravlje koje su češće u starijoj dobi. Počinju se pojavljivati dokazi da muzikoterapija može poboljšati mentalno zdravlje. Cilj ovog istraživanja je utvrditi učinke muzikoterapije na određene komponente mentalnog zdravlja osoba starije životne dobi smještenih u domu za starije i nemoćne. U istraživanju je sudjelovalo 26 ispitanika (5 muškaraca i 21 žena), prosječne dobi 81,96 godina (SD = 7,40). Ispitanici su bili uključeni u program muzikoterapije dva dana u tjednu, tijekom šest tjedana. Aspekti mentalnog zdravlja poput depresije, anksioznosti, percipiranog stresa i subjektivnog blagostanja mjereni su neposredno prije i nakon završetka intervencije. Podaci su prikupljeni pomoću Skale bolničke anksioznosti i depresije, Skale percipiranog stresa i Kratke skale subjektivnog blagostanja. Rezultati su pokazali kako postoji značajno smanjenje razine depresije, tjeskobe i percipiranog stresa nakon primjene muzikoterapije (t = 4,08, t = 4,28, t = 5,56, p<0,01). U skladu s tim, utvrđeno je značajno poboljšanje subjektivnog blagostanja kod ispitanika (t = -2,85, p < 0,01). Rezultati upućuju kako muzikoterapija može umanjiti simptome depresije i anksioznosti te razinu stresa kod korisnika doma za starije osobe. Ishodi istraživanja sugeriraju kako muzikoterapija može biti učinkovita strategija u očuvanju i poboljšanju mentalnog zdravlja osoba starije životne dobi u okviru okruženja institucionalne skrbi

UČINAK MUZIKOTERAPIJE NA SIMPTOME DEPRESIVNOSTI I ANKSIOZNOSTI I SUBJEKTIVNO BLAGOSTANJE KOD KORISNIKA DOMOVA ZA STARIJE I NEMOĆNE OSOBE

Elderly people are faced with the usual consequences of aging, but also with the onset of difficulties and diseases related to mental health that are more common in older age. Evidence is beginning to emerge that music therapy can improve mental health. This study aimed to determine the effects of music therapy on certain components of mental health in nursing home residents. The study sample consisted of 26 elderly persons (5 men, 21 women), average age 81.96 years (SD = 7.40), who were living in a nursing home. The participants were subjected to a music therapy treatment for six weeks. The mental health aspects such as depression and anxiety symptoms, the level of perceived stress and subjective well-being were measured at baseline and after the end of intervention. The data were collected using the Hospital Anxiety and Depression Scale, the Perceived Stress Scale and the Short Subjective Well-being Scale. The results have shown that there is a significant decrease in the level of depression, anxiety and perceived stress after music therapy treatment (t = 4.08, t = 4.28, t = 5.56, p < 0,01, respectively). Accordingly, the subjective well-being increased after the intervention period in the study group (t = -2.85, p < 0.01). Findings suggest that music therapy may decrease depression and anxiety symptoms and the level of stress in nursing home residents. The study results imply that music therapy may be an effective treatment strategy for mental health of the elderly in institutional care.Starije se osobe suočavaju s uobičajenim posljedicama starenja, ali i s poteškoćama i bolestima vezanim za mentalno zdravlje koje su češće u starijoj dobi. Počinju se pojavljivati dokazi da muzikoterapija može poboljšati mentalno zdravlje. Cilj ovog istraživanja je utvrditi učinke muzikoterapije na određene komponente mentalnog zdravlja osoba starije životne dobi smještenih u domu za starije i nemoćne. U istraživanju je sudjelovalo 26 ispitanika (5 muškaraca i 21 žena), prosječne dobi 81,96 godina (SD = 7,40). Ispitanici su bili uključeni u program muzikoterapije dva dana u tjednu, tijekom šest tjedana. Aspekti mentalnog zdravlja poput depresije, anksioznosti, percipiranog stresa i subjektivnog blagostanja mjereni su neposredno prije i nakon završetka intervencije. Podaci su prikupljeni pomoću Skale bolničke anksioznosti i depresije, Skale percipiranog stresa i Kratke skale subjektivnog blagostanja. Rezultati su pokazali kako postoji značajno smanjenje razine depresije, tjeskobe i percipiranog stresa nakon primjene muzikoterapije (t = 4,08, t = 4,28, t = 5,56, p<0,01). U skladu s tim, utvrđeno je značajno poboljšanje subjektivnog blagostanja kod ispitanika (t = -2,85, p < 0,01). Rezultati upućuju kako muzikoterapija može umanjiti simptome depresije i anksioznosti te razinu stresa kod korisnika doma za starije osobe. Ishodi istraživanja sugeriraju kako muzikoterapija može biti učinkovita strategija u očuvanju i poboljšanju mentalnog zdravlja osoba starije životne dobi u okviru okruženja institucionalne skrbi

Effects of Vibrotactile Stimulation on the Control of Muscle Tone and Movement Facilitation in Children with Cerebral Injury

Afferent signals from the muscle’s proprioceptors play important role in the control of muscle tone and in the facilitation of movements. Peripheral afferent pathway enables the restoration of connections with supraspinal structures and so includes mechanism of synaptic inhibition in the performance of normal movement. Different sensory stimuli, as vibrotactile stimulation, excite muscle’s proprioceptors which then send sensorimotor information via spinal cord. In this way afferent signals promote cortical control and modulation of movements. The goal of this study is to evaluate the effects of vibrotactile stimulation on the spasticity and motor performance in children with cerebral injury. Subjects included in this study were 13 children who were developing the classification of spastic cerebral palsy. For all children perinatal brain damage was documented by medical reports and neonatal brain ultrasound scan. At the mean age of 3 years and 6 months subject underwent the assessment of motor development by Gross Motor Function Measurement (GMFM-88). Gross Motor Classification System (GMFCS) has been used to classify functions of lower extremities. Therapeutic intervention was conducted once a week during 3 months. All subjects were stimulated with vibrotactile stimuli of 40Hz in duration of 20 minutes in order to reduce spasticity. After the ending of the treatment subjects underwent second assessment of motor performance and the classification of lower extremities functions. The results have shown that there was a significant improvement in motor performance, what has been seen in the facilitation of rotations, better postural trunk stability and head control and in greater selectivity of movements. Further randomized, control trial investigations with bigger sample and included spasm scale are needed to gain better insight in the role of vibrotactile stimulation in the facilitation of normal movements

Assessment of early motor repertoire in extremely preterm infants

Kvalitativni i kvantitativni aspekti ranog motoričkog ponašanja dojenčeta mogu uputiti na indikacije za kasnija neurološka odstupanja. Procjena motoričkog repertoara u dobi uvijanja i vrpoljenja, uz procjenu spontanih pokreta, jedan je od instrumenata procjene ranog neuromotoričkog razvoja radi utvrđivanja njegovog rizika. Cilj ovog istraživanja odnosio se na ispitivanje optimalnosti motoričkog repertoara i kakvoće spontanih pokreta u izrazito nedonošene dojenčadi bez oštećenja mozga. U istraživanje je uključeno 45-ero dojenčadi rođene prije 28. tjedna gestacije, bez evidentiranih lezija na magnetskoj rezonanciji mozga. Procjena spontanih pokreta prema Prechtlu i optimalnosti motoričkog repertoara obavljena je u terminski očekivanoj dobi te u korigiranoj dobi od tri mjeseca. Medijan gestacijske dobi bio je 25 tjedana i 5 dana. Normalni pokreti uvijanja zabilježeni su kod 13-ero (29%) dojenčadi. Medijan optimalnosti motoričkog repertoara u dobi uvijanja iznosio je 32 (IQR = 20 – 40). Pokreti vrpoljenja uočeni su kod 34-ero (76%) dojenčadi. Medijan optimalnosti motoričkog repertoara u dobi vrpoljenja iznosio je 22 (IQR = 12 - 28). Oskudan repertoar pokreta uvijanja učestalo je obilježje ranog neuromotoričkog razvoja izrazito nedonošene dojenčadi, koje je većinom prolaznog karaktera. Razina motoričke optimalnosti u dobi vrpoljenja niža je od rezultata koji postiže zdrava dojenčad rođena u terminu. Posljedična odsutnost pojedinih kriterija optimalnosti u motoričkom ponašanju izrazito nedonošene dojenčadi može nam poslužiti kao polazište u planiranju ciljanih ranih intervencija.The qualitative and quantitative aspects of an infant’s early motor behaviour may predict later neurological impairments. Assessment of early motor repertoire in the writhing and fidgety age is the evaluation method of early neuromotor development in order to determine neurodevelopmental risk. The aim of this study was to examine and describe the optimality of early motor repertoire and the quality of general movements in extremely preterm infants without evident brain injury. The study included 45 infants born before 28 gestational weeks with no evident brain lesion on magnetic resonance imaging at the term-equivalent age. The Prechtl assessment of general movements and the optimality of the motor repertoire was made at the term-equivalent age and at the corrected age of 3 months. Median gestational age was 25 weeks and 5 days. Normal writhing movements were observed in 13 (29%) infants. The median optimality score of motor repertoire at writhing age was 32 (interquartile range, IQR=20-40). Fidgety movements were observed in 34 (76%) infants. The median optimality score of the motor repertoire at the fidgety age was 22 (IQR=12-28). A poor repertoire of writhing movements is a common feature of early neuromotor development of extremely preterm infants, which is mostly transient in nature. The motor optimality score at fidgety age is lower than the one achieved by healthy termborn infants. The consequent absence of individual optimality criteria in motor behaviour of extremely preterm infants may serve as a starting point for planning targeted early interventions

Application of Music Therapy in Promoting Maternal Attachment and Self-perceived Parental Competence in Mothers at Risk

Rano iskustvo emocionalne komunikacije pridonosi privrženosti između majke i dojenčeta te ima utjecaj na neurološki, socijalni i emocionalni razvoj djeteta. Primjenom muzikoterapijskih aktivnosti koje su usmjerene na interakciju roditelj–dijete moguće je kreirati iskustva u kojem majka i dijete uzajamno dijele ritam, tempo, melodiju i visinu glasa, što su sve intrinzični elementi ranog procesa privrženosti. Cilj ovoga rada odnosi se na ispitivanje mogućnosti primjene muzikoterapije u poticanju majčinske privrženosti i jačanju doživljaja vlastitih roditeljskih kompetencija kod majki u riziku. Istraživanje je provedeno na uzorku od tri majke te njihovom dojenčadi koji su bili uključeni u program muzikoterapije jednom na tjedan tijekom 10 tjedana. Prije i poslije provođenja muzikoterapije majke su ispunile Ljestvicu majčine postnatalne privrženosti i Ljestvicu roditeljskih kompetencija. Dobiveni rezultati ukazuju na pozitivne ishode primjene muzikoterapije u poticanju majčinske privrženosti kod majki u riziku, kao i na razinu percipiranih kompetencija u vlastitoj roditeljskoj ulozi. Muzikoterapijska intervencija može se integrirati kao terapijski pristup usmjeren prema jačanju privrženosti u dijadi majka – dojenče te prema poticanju roditeljskih kompetencija kod majki u riziku.Early experience of emotional communication contributes to the attachment between mother and infant and has an impact on the child’s neurological, social, and emotional development. By applying music therapy activities aimed at parent-child interaction, it is possible to create experiences in which the mother and child share the rhythm, tempo, melody, and pitch of their voices, what are all intrinsic elements of the early attachment process. The aim of this paper was to explore the possibility of applying music therapy in promoting maternal attachment and self-perceived parental competence in mothers at risk. The study was conducted on a sample of three mothers and their infants who were enrolled in a music therapy program once a week for 10 weeks. Before and after conducting music therapy, the mothers completed the Maternal Postnatal Affection Scale and the Parental Sense of Competence Scale. The obtained results indicate the positive outcomes of music therapy in enhancing maternal attachment in mothers at risk as well as the level of selfperceived competence in parental role. Music therapy intervention can be integrated as a therapeutic approach aimed at enhancing attachment in the mother infant dyad and at fostering parental competence in mothers at-risk

Muzikoterapija u procesu obrazovanja djece s teškoćama u razvoju

Music therapy acts as a separate discipline in the interdisciplinary field of science and art. Unlike music education, music therapy is aimed at developing and enhancing non-musical skills by using music as a symbol of emotional and personal growth. The purpose of this paper is to present an overview of the theoretical foundations of music therapy in the field of human psychology and music pedagogy, as well as the development of music therapy models that have arisen from these theoretical approaches. The most commonly used music therapy models in special education are based on improvisational music therapy techniques, which include free improvisation therapy, creative music therapy known as the Nordoff-Robbins model, and Orff music therapy. Improvisation in these models plays a key role during the acquisition and promotion of skills. Using sounds, playing instruments, making music here and now, allows for expression and exploration, and enables children to acquire skills in different developmental domains. Finally, the paper offers an overview of the use of music therapy in education of children with developmental disabilities, its unique features and connections with the education through music approach, in accordance with the set-up goals of the Individual Education Plan.Muzikoterapija djeluje kao zasebna disciplina u interdisiciplinarnom području znanosti i umjetnosti. Za razliku od glazbenoga obrazovanja, muzikoterapija je usmjerena prema razvoju i jačanju neglazbenih vještina koristeći glazbu kao simbol emocionalnoga i osobnoga rasta. Svrha je ovoga rada prikazati pregled teorijskih osnova muzikoterapije na području humanističke psihologije i glazbene pedagogije, kao i razvoj modela muzikoterapije koji su proizašli iz navedenih teorijskih pravaca. Modeli muzikoterapije koji se najčešće koriste u procesu obrazovanja djece s teškoćama u razvoju zasnivaju se na improvizacijskim tehnikama muzikoterapije, a obuhvaćaju: terapiju slobodnom improvizacijom, kreativnu muzikoterapiju poznata kao Nordoff-Robbins model i Orff muzikoterapiju. Improvizacija u ovim modelima ima ključnu ulogu tijekom usvajanja i poticanja vještina. Korištenje zvukova, sviranje instrumenata, stvaranje glazbe ovdje i sada, omogućava izražavanje i istraživanje, a djeci pruža mogućnost samoostvarenja na različitim razvojnim područjima. Naposljetku u radu se nudi prikaz primjene muzikoterapije u obrazovanju djece s teškoćama u razvoju, njegove jedinstvenosti te poveznice u odnosu na pristup obrazovanja kroz glazbu sukladno postavljenim ciljevima Individualnog edukacijskog plana

The Quality Of Fidgety Movements And Motor Outcome At 2 Years Of Age In Preterm Born Children With Perinatal Brain Injury

Procjena spontanih pokreta valjan je i pouzdan prediktor kod djece s perinatalnom ozljedom mozga za optimalan ili neoptimalan neuromotorički ishod. Kvaliteta spontanih pokreta vrpoljenja ima najveću prediktivnu vrijednost u prepoznavanju neuromotoričkoga razvojnog ishoda. Cilj istraživanja bio je ispitati motorički ishod prijevremeno rođene djece s perinatalnom ozljedom mozga u drugoj godini života u odnosu na kvalitetu spontanih pokreta vrpoljenja. U istraživanje je bilo uključeno 27 prijevremeno rođene djece (medijan gestacijske dobi 29 tj.) s evidentiranom ozljedom mozga u terminski očekivanoj dobi. Procjena kvalitete spontanih pokreta vrpoljenja provedena je prema klasifikaciji Hadders-Algre (medijan korigirane dobi 13 tj.). Neuromotorička procjena provedena je primjenom testa grubih motoričkih funkcija GMFM-66 i klasifikacijskog sustava gruboga motoričkog funkcioniranja GMFCS (medijan korigirane dobi 16 mj.) Abnormalni spontani pokreti vrpoljenja zabilježeni su u 22 djece (81 %). Medijan ukupnog rezultata GMFM-66 u djece s normalnim suboptimalnim spontanim pokretima iznosio je 58,8 % (IQR = 57,7 – 66,4), u djece s blago abnormalnim spontanim pokretima 53,4 % (IQR = 47,5 – 52,7), dok je u djece s definitivno abnormalnim spontanim pokretima iznosio 33,1 % (IQR = 27,3 – 45,5). Djeca s normalnim suboptimalnim spontanim pokre tima su pokazala motoričku izvedbu koja odgovara najvišim razinama gruboga motoričkog funkcioniranja (razine GMFCS-a I i II), dok je motorička izvedba djece s blago i definitivno abnormalnim spontanim pokretima odgovarala svim razinama sustava GMFCS (I – V).Assessment of general movements is a valid and reliable predictor of neuromotor outcome in children with perinatal brain injury. The quality of fidgety movements has the highest predictive value in recognizing the neurological developmental outcome. This study aimed to examine the motor outcome at 2 years of age in preterm born children with perinatal brain injuries in relation to the quality of fidgety movements. The study included 27 preterm born infants (median gestational age = 29 weeks) with evident brain injury at term-equivalent age. Assessment of the quality of fidgety movements was made according to the HaddersAlgra classification (median = 13 weeks corrected age). The neuromotor assessment was performed using the Gross Motor Function Measure (GMFM-66) and the Gross Motor Function Classification System (GMFCS) (median = 16 months corrected age). Abnormal fidgety movements were observed in 22 children (81%). The total median GMFM score in children with normal suboptimal fidgety movements was 58,8% (IQR = 57,7-66,4), in children with mildly abnormal fidgety movements 53,4% (IQR = 47,5 – 52,7 ), and in children with definitively abnormal fidgety movements 33,1% (IQR = 27,3–45,5). Children with normal suboptimal fidgety movements showed motor performance corresponding to the highest levels of gross motor function (GMFCS levels I and II), while the motor performance of children with mild and abnormal fidgety movements corresponded to all levels of the GMFCS system (I-V)

Application of music therapy in children with autistic spectrum disorder

Muzikoterapija je disciplina koja koristi jezik zvukova i glazbe u odnosu klijenta i terapeuta kao sredstvo unutar sistematičnog procesa intervencije s preventivnim, rehabilitacijskim i terapijskim ciljevima. Osnovna struktura terapijskog procesa uključuje definiranje potreba, planiranje intervencija i evaluaciju ishoda. Uzimajući u obzir poteškoće koje nalazimo kod djece s poremećajem iz autističnog spektra, možemo uočiti da disfunkcija središnjeg živčanog sustava onemogućava kodiranje i interpretiranje informacija poput govornog jezika i facijalne ekspresije. Zato su djeci s poremećajem iz autističnog spektra poruke koje primaju nejasne i zbunjujuće, a posljedica toga je njihovo povlačenje iz socijalne interakcije. Stvaranje glazbe kroz kliničku improvizaciju u procesu muzikoterapije predstavlja sredstvo postizanja određene komunikacijske razmjene, koje može potpomoći razvoj komunikacijskih, kognitivnih i socijalno-emocionalnih vještina. Svrha ovog rada je prikazati osnove primjene muzikoterapije kod djece s poremećajem iz autističnog spektra, predstaviti najčešće modele rada s ovom populacijom klijenata, kao i ponuditi pregled dosadašnjih spoznaja o učincima njenih intervencija.Music therapy is a discipline which uses sound musical language in relationship between the client and the therapist or group relationship as a means within a systematic process of intervention with preventive, rehabilitative and therapeutic goals. The basic structure of the therapy process involves defining need, planning interventions, and measuring outcomes. Considering the difficulties found in children with autism spectrum disorders, we can see that the dysfunction of the central nervous system prevents the coding and interpretation of information, such as spoken language and facial expressions. Because of that, children with autism spectrum disorders find the received messages ambiguous and confusing, and consequently they withdraw from social interaction. Creating music through clinical improvisation in the process of music therapy is a mean of achieving certain communication exchange, which may facilitate communication, cognitive and social-emotional skills in these children. The main goal of this review is to present application of music therapy in children with autism spectrum disorder, its most used models with this population of clients and to consider its effects

Measurements of gross motor function for children with cerebral palsy

Procjena u promjeni motoričke funkcije djece s cerebralnom paralizom složen je mjerni zadatak. Iako su razvijeni različiti instrumenti procjene za kvantificiranje specifičnih aspekata motoričkog ponašanja, sustavno mjerenje grubih motoričkih funkcija predstavlja zahtjevan problem u praksi. Ovaj rad kritički prikazuje valjane i klinički utemeljene instrumente procjene koji se koriste u randomiziranim kontroliranim istraživanjima na području cerebralne paralize. Razvijanje i vrednovanje odgovarajućih mjernih instrumenata važno je za procjenu znanstveno utemeljenih pristupa u habilitaciji djece s cerebralnom paralizom.Assessment of changes in motor function in children with cerebral palsy is a complex measurement task. Although a variety of tests have been developed to quantify specific aspects of motor behaviour, systematic measurement of gross motor function is still a challenge. This paper critically reviews valid and clinically based evaluative measures that are used in randomised controlled trials in the field of cerebral palsy. The development and validation of responsive evaluative measures is essential for the assessment of evidence-based approaches in habilitation of children with cerebral palsy