Rhythm of life: Music shows potential in stroke rehabilitation

Music therapy provided by trained music therapists may help to improve movement in stroke patients, according to a new Cochrane Systematic Review. A few small trials also suggest a wider role for music in recovery from brain injury.

More than 20 million people suffer strokes each year. Many patients acquire brain injuries that affect their movement and language abilities, which results in significant loss of quality of life. Music therapists are trained in techniques that stimulate brain functions and aim to improve outcomes for patients. One common technique is rhythmic auditory stimulation (RAS), which relies on the connections between rhythm and movement. Music of a particular tempo is used to stimulate movement in the patient.

Seven small studies, which together involved 184 people, were included in the review. Four focused specifically on stroke patients, with three of these using RAS as the treatment technique. RAS therapy improved walking speed by an average of 14 metres per minute compared to standard movement therapy, and helped patients take longer steps. In one trial, RAS also improved arm movements, as measured by elbow extension angle.

"This review shows encouraging results for the effects of music therapy in stroke patients," said lead researcher Joke Bradt of the Arts and Quality of Life Research Center at Temple University in Philadelphia, US. "As most of the studies we looked at used rhythm-based methods, we suggest that rhythm may be a primary factor in music therapy approaches to treating stroke."

Other music therapy techniques, including listening to live and recorded music, were employed to try to improve speech, behaviour and pain in patients with brain injuries, and although outcomes in some cases were positive, evidence was limited. "Several trials that we identified had less than 20 participants," said Bradt. "It is expected that larger samples sizes will be used in future studies to enable sound recommendations for clinical practice."