A Systematic Review of Structured Exercises and Music Therapy on the Functional Status of Stroke Survivors

Abstract

Background: Stroke, a leading cause of disability worldwide, often leaves survivors grappling with functional impairments that significantly impact their daily lives. Enhancing the functional status of stroke survivors is not only a personal achievement but also a critical public health concern. Aim: A systematic review of literature was conducted to identify the various forms of structured exercises and music therapy used in enhancing the functional status of stroke survivors, and the various outcome measures used in measuring the functional status of the stroke survivors. Design: A systematic review Data Sources: A systematic literature search was performed for publications using PubMed, Scopus, Google Scholar, Embase, CINAHL, ISI, and ScienceDirect Databases. Eligibility Criteria: The review included published studies which reported use of structured exercises and Music therapy in enhancing the functional status of stroke survivors aged 18 years and above, and published in English between June 2012 and June 2022. Data Extraction: The titles and abstracts of articles were screened and studies that did not meet the eligibility criteria were excluded. Full texts of eligible studies were further scrutinized. The results were interpreted and reported with respect to their level of evidence, design, sample size, duration, quality appraisal and risk of bias. Result: A total of 2,427 studies were identified through initial search of the databases. Additional 8 records were identified through other sources making it a total of 2,435 records. 2,350 duplicate studies were removed after screening. The remaining 85 full-text articles were screened for eligibility criteria and further reduced to 26. Of these 26 studies, 17 were Randomized Controlled Trials (RCTs), 7 quasi-experimental studies, 1 case series, and 1 case study. Hand function exercise (23.0%) was the most used form of structured exercise while music-supported therapy (29.1%) was the most used music therapy intervention. Motor function (41.6%) was the most investigated construct of functional status. The most used outcome measures were Box and Blocks Test (BBT) (10.4%) and 9 Hole Pegboard Test (9HPT) (10.4%) which were used for measuring motor function of the stroke survivors. Conclusion: Various forms of structured exercises and music therapy were found to improve the functional status of stroke survivors. Also, various outcome measures for measuring the functional status of the stroke survivors were reported as well. Clinicians and researchers should choose the appropriate outcome measures for the right constructs in the course of their practice and research programmes.