Neurological music therapy for poststroke depression, activity of daily living and cognitive function: A pilot randomized controlled study

Abstract

ABSTRACT Introduction Music therapy (MT) has been adapted to post-stroke rehabilitation for years and there were several theories of treatment methods. Our music therapist utilized neurological MT to design a treatment program for stroke survivors. We aimed to compare the effects of a low-dose neurological MT with no MT on outcomes measuring depression, activity of daily living and cognitive function amongst stroke survivors. Method A single masked, randomized controlled study was designed and patients with subacute stroke were recruited. The patients were assigned to a MT group or a conventional therapy (CT) group. Both groups received CT including physical therapy and occupational therapy. Patients with aphasia also received speech therapy. The MT group underwent an additional hour of neurological MT per week for a total duration of 4 weeks. Our MT method comprised therapeutic singing, therapeutic instrument music playing, melodic intonation therapy, and rhythmic speech cueing. The primary outcome measure was the Beck Depression Inventory-II (BDI-II). Secondary outcomes were the Mini-Mental State Examination (MMSE), modified Rankin Scale (MRS) and Barthel Index (BI). Result Eighty-two patients were recruited. No significant differences were found at baseline. There was significant post-treatment effect among both groups for the BI (p < 0.001, Mdiff = 13.96, 95%CI = (11.64,16.29)), MMSE (p < 0.001, Mdiff = 1.04, 95%CI = (0.51,1.57)) and MRS (p < 0.001, Mdiff = −0.45, 95%CI = (−0.57,−0.34)). Additionally, a significant difference was observed between the groups for the MRS (p = 0.033, Mdiff = −0.24, 95%CI = (−0.03,0.52)). No significant between-group effect was found regarding the BI and MMSE. Discussion This study highlights the added value of MT in improving MRS, while requiring relatively less therapeutic time.