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

Abstract

INTRODUCTION: Motor and cognitive symptoms are frequent in persons with neurological disorders and often require extensive long-term rehabilitation. Recently, a variety of musicbased interventions have been introduced into neurological rehabilitation as training tools. AIM: This review aims to a) describe and define music-based intervention modalities and content which are applied in experimental studies, and b) describe the effects of these interventions on motor and/or cognitive symptoms in the neurological population. EVIDENCE ACQUISITIONː The databases PubMed and Web of Science were searched. Cited references of included articles where screened for potential inclusion. A systematic literature search up to 20 th of June 2016 was conducted to include controlled trials and cohort studies that have used music-based interventions for ≥3 weeks in the neurological population (in-and outpatients) targeting motor and/or cognitive symptoms. No limitations to publication date was set. EVIDENCE SYNTHESISː Nineteen articles comprising thirteen randomised controlled trials (total participants Nexp = 241, Nctrl = 269), four controlled trials (Nexp = 59, Nctrl = 53) and two cohort studies (N = 27) were included. Fourteen studies were conducted in stroke, three in Parkinson's disease, and two in multiple sclerosis population. Modalities of musicbased interventions were clustered into four groups: instrument-based, listening-based, rhythm-based, and multicomponent-based music interventions. Overall, studies consistently showed that music-based interventions had similar or larger effects than conventional rehabilitation on upper limb function (N=16; fine motricity, hand and arm capacity, finger and hand tapping velocity/variability), mobility (N=7; gait parameters), and cognition (N = 4; verbal memory and focused attention). CONCLUSIONSː Variety of modalities using music-based interventions has been identified and grouped into four clusters. Effects of interventions demonstrate an improvement in the domains assessed. Evidence is most available for improving motricity in stroke. More studies are warranted to investigate cognition as well as motor and cognition dysfunctions in combination. CLINICAL IMPLICATIONS: Instrument-based music interventions can improve fine motor dexterity and gross motor functions in stroke. Rhythm-based music interventions can improve gait parameters of velocity and cadence in stroke, Parkinson's disease and multiple sclerosis. Cognition in the domains of verbal memory and focused attention can improve after listening-based music interventions in stroke.

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“…Elements that lead to reaching a state of meditation during exercise are known and are as follows: focusing on inhale-exhale breathing rhythm. Nosal mode and oral mode [ 77 ], focusing on cadence (running, biking, hitting) while coordinating bodily movement to the rhythm of the music [ 78 ]. This is especially challenging, for men with more difficulties adjusting the cadence of exercise to a musical rhythm.…”

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“…The subjective perception of fatigue requires a cognitive perspective involving interoception and metacognition (48,50,51). The use of music during therapy for neurological diseases may affect cognitive functions, such as increasing verbal memory, in addition to improving motor performance (52)(53)(54) and providing benefits for the psycho-emotional sphere (55). The rehabilitative effects of music during therapy for neurological disorders appear to be associated with brain neuroplasticity and neural activation changes; however, the specific mechanisms remain unknown (56).…”

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“…Nevertheless, many of these symptoms can deleteriously impact the occupational profile, social participation, selfesteem and quality of life of patients. Over the last 11 years, an increasing number of controlled studies conducted on several neurological disorders have assessed the potential rehabilitative effects of new drug-free treatments that would be complementary to the standard care, including music-based therapy (MBT) 3,14,15,16 . MBT therapeutic techniques have been described 17 , such as rhythmic auditory stimulation, therapeutic instrumental music performance, melodic intonation therapy and musical mnemonic training.…”

“…MBT therapeutic techniques have been described 17 , such as rhythmic auditory stimulation, therapeutic instrumental music performance, melodic intonation therapy and musical mnemonic training. These techniques form the core of neurological music therapy 14 .…”