Hunter SM1, Chow CC2
1Keele University, School of Health and Rehabilitation, Staffordshire, United Kingdom, 2Keele University, School of Health and Rehabilitation, Keele, United Kingdom
Background: Stroke is one of the leading causes of disability and death worldwide. Over half of the stroke population experience ongoing residual motor disability, potentially including the upper limb. As a result of impaired physical and cognitive capability induced by stroke, patients also experience from psychological deterioration. Studies showed temporary plastic changes of the brain were still possible in adult brains through intensive and repetitive motor learning. Music making requires robust communication between different areas of the brain, and participants will receive auditory feedback to the limbic system in return. Stroke survivors may not only experience improvements in mood, they may also be more motivated to engage in music-making rehabilitation than conventional rehabilitation.
Purpose: Currently, there are studies and experiments on how music-supported therapy may promote motor plasticity and mood in stroke patients. However, findings amongst studies are inconsistent, especially with regards to motor plasticity. Moreover, there has yet to be a review to look into the holistic effects of music-therapy on stroke patients, as in motor function, mood, and cognition. The purpose of this paper, therefore, is to review the effectiveness of participating in musical activity on motor function, mood, and cognition after stroke.
Methods: A systematic search of databases (AMED, CINAHL, MEDLINE) was performed on 7th January 2017 using search terms Stroke/Cerebrovascular Accident/CVA; Music; Mood/Cognition/Function/Motor, and PICOS to structure inclusion/exclusion criteria. Intervention was active music-making, with any comparison intervention. Analysis: narrative synthesis of findings and quality assessment of included studies (PEDro).
Results: A total of 189 citations from all included databases; 9 experimental studies (8 RCTs, 1 controlled clinical trial) remained after screening. Studies on motor function and mood presented with heterogeneity of stroke chronicity, interventions and outcomes, with small sample sizes. No studies with outcomes of cognition were identified.
Motor function: All studies reported positive effects on general motor outcomes. Manual dexterity required specific and repetitive music-supported rehabilitation to achieve significant improvements. Outcomes further improved if adjuncts were incorporated into the programme.
Mood: All studies reported positive effects in mood alongside improved social interaction. Group singing improvement in mood was attributed to physiological changes caused by the aesthetics of music produced, and to enhanced social well-being and self-image through group fulfilment. Some studies incorporated non-music-making elements (e.g. body-movement, thoughts-sharing), likely also to enhance psychological and social well-being.
Conclusion(s): Music activity induces significant benefits on predominantly upper limb motor function and mood post-stroke. Incorporating different elements could further enhance benefits of music-making. The significant improvement in social well-being also suggested this intervention was greatly beneficial to participants psychologically.
Implications: Physiotherapists should consider including music-making as part of stroke rehabilitation programme. Future studies will have to include a larger sample size and interventions that only involves music-making. More controlled experimental studies are needed on the cognition aspect of music making on stroke patients, and more qualitative studies are needed to explore stroke survivors´ experience from the intervention.
Keywords: Stroke, Music, Activity
Funding acknowledgements: Project is not funded.
Purpose: Currently, there are studies and experiments on how music-supported therapy may promote motor plasticity and mood in stroke patients. However, findings amongst studies are inconsistent, especially with regards to motor plasticity. Moreover, there has yet to be a review to look into the holistic effects of music-therapy on stroke patients, as in motor function, mood, and cognition. The purpose of this paper, therefore, is to review the effectiveness of participating in musical activity on motor function, mood, and cognition after stroke.
Methods: A systematic search of databases (AMED, CINAHL, MEDLINE) was performed on 7th January 2017 using search terms Stroke/Cerebrovascular Accident/CVA; Music; Mood/Cognition/Function/Motor, and PICOS to structure inclusion/exclusion criteria. Intervention was active music-making, with any comparison intervention. Analysis: narrative synthesis of findings and quality assessment of included studies (PEDro).
Results: A total of 189 citations from all included databases; 9 experimental studies (8 RCTs, 1 controlled clinical trial) remained after screening. Studies on motor function and mood presented with heterogeneity of stroke chronicity, interventions and outcomes, with small sample sizes. No studies with outcomes of cognition were identified.
Motor function: All studies reported positive effects on general motor outcomes. Manual dexterity required specific and repetitive music-supported rehabilitation to achieve significant improvements. Outcomes further improved if adjuncts were incorporated into the programme.
Mood: All studies reported positive effects in mood alongside improved social interaction. Group singing improvement in mood was attributed to physiological changes caused by the aesthetics of music produced, and to enhanced social well-being and self-image through group fulfilment. Some studies incorporated non-music-making elements (e.g. body-movement, thoughts-sharing), likely also to enhance psychological and social well-being.
Conclusion(s): Music activity induces significant benefits on predominantly upper limb motor function and mood post-stroke. Incorporating different elements could further enhance benefits of music-making. The significant improvement in social well-being also suggested this intervention was greatly beneficial to participants psychologically.
Implications: Physiotherapists should consider including music-making as part of stroke rehabilitation programme. Future studies will have to include a larger sample size and interventions that only involves music-making. More controlled experimental studies are needed on the cognition aspect of music making on stroke patients, and more qualitative studies are needed to explore stroke survivors´ experience from the intervention.
Keywords: Stroke, Music, Activity
Funding acknowledgements: Project is not funded.
Topic: Neurology: stroke
Ethics approval required: No
Institution: Keele University
Ethics committee: School of Health and Rehabilitation Student Project Ethics Committee
Reason not required: This project is a systematic review
All authors, affiliations and abstracts have been published as submitted.
