The effect of music therapy on language recovery in patients with aphasia after stroke: a systematic review and meta-analysis

Effects of repetitive transcranial magnetic stimulation combined with music therapy in non-fluent aphasia after stroke: A randomised controlled study

BACKGROUND

Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non-fluent aphasia, the efficacy of the combination of these two methods remains to be investigated.

AIMS

To investigate the clinical efficacy of low-frequency rTMS combined with music therapy on language function and depression in patients with non-fluent aphasia after stroke.

METHODS & PROCEDURES

A single-blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non-fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1 Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale.

OUTCOMES & RESULTS

The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest.

CONCLUSIONS & IMPLICATIONS

Our preliminary randomised controlled study indicates that low-frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non-fluent aphasia patients after stroke.

WHAT THIS PAPER ADDS

What is already known on this subject Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non-fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge This is one of the first randomised control trials to investigate whether the clinical efficacy of low-frequency rTMS combined music therapy for non-fluent aphasia is better. The findings show that low-frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work? Low-frequency rTMS combined music therapy may be a better method for treatment of non-fluent aphasia.

Effects of Music Therapy on Aphasia and Cognition of Patients with Post-stroke: A Systematic Review and Meta-analysis

PURPOSE

This investigation sought to systematically assess music therapy's impact on aphasia and cognition in patients with post-stroke.

METHODS

Comprehensive searches were performed across major databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and Vip Chinese sci-tech periodicals (VIP), covering publications up to December 2023. After screening and extracting data from the retrieved literature, its quality was appraised, which was followed by a meta-analysis using RevMan software (version 5.4, Cochrane Collaboration, Oxford, UK).

RESULTS

Nine articles, which were published from 2008 to 2022, were covered in this investigation, comprising 309 stroke patients in total. Meta-analysis results from these variations were found to be not statistically significant in the degree of functional communication improvement between the experimental group and the control group (standardized mean difference [SMD] = 0.23, 95% confidence interval [CI] (-0.19; 0.77), P > 0.05). These variations were found to be not statistically significant in the improvement of understanding ability in the experimental group compared with that in the control group (SMD = 0.21, 95% CI [-0.66; 1.09], P > 0.05). The degree of improvement in repetitive ability of the experimental group was considerably greater than that of the control group (SMD = 0.37, 95% CI [0.01; 0.76], P < 0.05). These variations were found to be not statistically significant in the improvement of naming ability in the experimental group compared with that in the control group (SMD = 0.30, 95% CI [-0.19; 0.80], P > 0.05). The cognitive score of the experimental group was considerably greater than that of the control group (SMD = 0.75, 95% CI [0.44; 1.06], P < 0.05).

CONCLUSION

Music therapy can effectively ameliorate the repetition ability of patients with aphasia after stroke. It can also improve the cognitive ability of patients. Thus, music therapy could be further applied to treat this type of patients.

Exploring the usability and feasibility of a mobile music listening application for people living in the community with post-stroke aphasia

PURPOSE

Language and communication disorders can inhibit participation in activities that have potential therapeutic benefits for recovery. This exploratory research examined the usability and feasibility of a purpose-built music listening mobile application for people living in the community with post-stroke aphasia, and examined relationships between useability and participant age, aphasia severity and time post-stroke.

METHODS

Nineteen participants with chronic aphasia tested the application for two weeks. Prior to use, music preferences, technology use and confidence, self-efficacy and music engagement questionnaires were completed. System usability scale, music listening data and a satisfaction rating were completed following use.

RESULTS

Overall, the application was perceived as being usable and feasible with a high system usability rating and moderate effectiveness, efficiency and satisfaction. The system usability scores were not associated with aphasia severity, age, years post-stroke, self-efficacy or music engagement. Technology confidence was positively associated with system usability.

CONCLUSION

The music listening application is a feasible and usable option for listening to music in people with chronic post-stroke aphasia. This study provides a foundation for the rigorous examination of the usability of music listening technology for people with post-stroke aphasia and the potential investigation of use in acute care facilities and other clinical populations.IMPLICATIONS FOR REHABILITATIONMusic listening has potential therapeutic benefits for people with post-stroke aphasia.Applications for music listening require customisation to enable people with post-stroke aphasia opportunity to listen to their preferred music.Music listening applications that are perceived as usable and feasible by people with post-stroke aphasia may have potential application within rehabilitation and community settings.

Music Therapy in Global Aphasia: A Case Report

Patients affected by global aphasia are no longer able to understand, produce, name objects, write and read. It occurs as a result of functional damage of ischemic or hemorrhagic origin affecting the entire peri-silvan region and frontal operculum. Rehabilitation training aims to promote an early intervention in the acute phase. We described a case of a 57-year-old female patient with left intraparenchymal fronto-temporo-parietal cerebral hemorrhage and right hemiplegia. After admission to clinical rehabilitative center, the patient was not able to perform simple orders and she presented a severe impairment of auditory and written comprehension. Eloquence was characterized by stereotypical emission of monosyllabic sounds and showed compromised praxis-constructive abilities. Rehabilitation included a program of Neurologic Music Therapy (NMT), specifically Symbolic Communication Training Through Music (SYCOM) and Musical Speech Stimulation (MUSTIM). Rehabilitative treatment was measured by improved cognitive and language performance of the patient from T0 to T1. Music rehabilitative interventions and continuous speech therapy improve visual attention and communicative intentionality. In order to confirm the effectiveness of data presented, further extensive studies of the sample would be necessary, to assess the real role of music therapy in post-stroke global aphasia.

Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: a randomized controlled crossover trial

The ability to produce words through singing can be preserved in severe aphasia, but the benefits of group-based singing rehabilitation in aphasia are largely unknown. Our aim was to determine the efficacy of a multicomponent singing intervention on communication and speech production, emotional-social functioning and caregiver well-being in aphasia. Fifty-four patients with acquired brain injury and chronic aphasia and their family caregivers (n = 43) were recruited. Using a crossover randomized controlled trial design, participants were randomized to two groups who received a 4-month singing intervention either during the first or second half of the study in addition to standard care. The intervention comprised weekly group-based training (including choir singing and group-level melodic intonation therapy) and tablet-assisted singing training at home. At baseline, 5- and 9-month stages, patients were assessed with tests and questionnaires on communication and speech production, mood, social functioning, and quality of life and family caregivers with questionnaires on caregiver burden. All participants who participated in the baseline measurement (n = 50) were included in linear mixed model analyses. Compared with standard care, the singing intervention improved everyday communication and responsive speech production from baseline to 5-month stage, and these changes were sustained also longitudinally (baseline to 9-month stage). Additionally, the intervention enhanced patients' social participation and reduced caregiver burden. This study provides novel evidence that group-based multicomponent singing training can enhance communication and spoken language production in chronic aphasia as well as improve psychosocial wellbeing in patients and caregivers. https://www.clinicaltrials.gov, Unique identifier: NCT03501797.

Potential Benefits of Music Therapy on Stroke Rehabilitation

Stroke is associated with a high rate of disability and mortality, and survivors are usually accompanied with dysphagia, aphasia, motor dysfunction, cognitive impairment, depression, and other complications. In the past decades, many studies have been conducted to reveal the pathogenesis and pathological mechanisms of stroke. Furthermore, treatment methods have been developed that contribute to the elevated survival rate of stroke patients. Early rehabilitation poststroke is starting to be recognized as important and has been receiving increasing attention in order to further improve the quality of life of the patients. As an emerging method of poststroke rehabilitation, music therapy can help attenuate dysphagia and aphasia, improve cognition and motor function, alleviate negative moods, and accelerate neurological recovery in stroke patients. This review helps summarize the recent progress that has been made using music therapy in stroke rehabilitation and is aimed at providing clinical evidence for the treatment of stroke patients.