Background: Given the increasing evidence demonstrating the effects of rhythmic auditory cueing for motor rehabilitation of stroke patients, this synthesized analysis is needed in order to improve rehabilitative practice and maximize clinical effectiveness. Objective: This study aimed to systematically analyze the literature on rhythmic auditory cueing for motor rehabilitation of stroke patients by highlighting the outcome variables, type of cueing, and stage of stroke. Methods: A systematic review with meta-analysis of randomized controlled or clinically controlled trials was conducted. Electronic databases and music therapy journals were searched for studies including stroke, the use of rhythmic auditory cueing, and motor outcomes, such as gait and upper-extremity function. Results: A total of 10 studies (RCT or CCT) with 356 individuals were included for meta-analysis. There were large effect sizes (Hedges’s g = 0.984 for walking velocity; Hedges’s g = 0.840 for cadence; Hedges’s g = 0.760 for stride length; and Hedges’s g = 0.456 for Fugl-Meyer test scores) in the use of rhythmic auditory cueing. Additional subgroup analysis demonstrated that although the type of rhythmic cueing and stage of stroke did not lead to statistically substantial group differences, the effect sizes and heterogeneity values in each subgroup implied possible differences in treatment effect. Conclusions: This study corroborates the beneficial effects of rhythmic auditory cueing, supporting its expanded application to broadened areas of rehabilitation for stroke patients. Also, it suggests the future investigation of the differential outcomes depending on how rhythmic auditory cueing is provided in terms of type and intensity implemented.

Current perspectives on social skills development of individuals with autism spectrum disorder (ASD) emphasize the interplay between motor and social skills. Given the evidence supporting this relationship, studies are needed to explore the potential benefit of rhythmic behaviors to improve social skills in children with ASD. The purpose of this two-part study was to confirm the relationship between dyadic drum playing and social skills and to further develop a rhythm-mediated music therapy intervention for improving the social skills of children with ASD. In Study 1, we conducted a factor analysis to examine whether dyadic drum playing was related to social skills in 42 children with typical development and 10 children with high-functioning ASD. In Study 2, we conducted a preliminary pilot of a rhythm-mediated music therapy intervention with eight children with ASD and measured changes in social skills (e.g., imitation and engagement in joint action with others) and dyadic drum playing behaviors. Study 1 findings included identification of four factors related to dyadic drum playing. The presence of rhythmic cueing and tempo adjustment correlated with social skills, providing a strong rationale for the use of dyadic drum playing to address social skills. In Study 2, participants showed decreased asynchrony when tapping with a partner at adjusted tempi after the rhythm-mediated intervention. Furthermore, participants showed greater engagement in joint action following the intervention. This study supports potential benefit of the rhythm-mediated intervention using dyadic drum playing and provides preliminary evidence strengthening its use in the social domain for individuals with ASD.

Objectives: To investigate the effects of rhythmic auditory stimulation (RAS) on gait patterns in comparison with changes after neurodevelopmental treatment (NDT/Bobath) in adults with cerebral palsy. Design: A repeated-measures analysis between the pretreatment and posttreatment tests and a comparison study between groups. Setting: Human gait analysis laboratory. Subjects: Twenty-eight cerebral palsy patients with bilateral spasticity participated in this study. The subjects were randomly allocated to either neurodevelopmental treatment (n = 13) or rhythmic auditory stimulation (n = 15). Interventions: Gait training with rhythmic auditory stimulation or neurodevelopmental treatment was performed three sessions per week for three weeks. Temporal and kinematic data were analysed before and after the intervention. Rhythmic auditory stimulation was provided using a combination of a metronome beat set to the individual’s cadence and rhythmic cueing from a live keyboard, while neurodevelopmental treatment was implemented following the traditional method. Main measures: Temporal data, kinematic parameters and gait deviation index as a measure of overall gait pathology were assessed. Results: Temporal gait measures revealed that rhythmic auditory stimulation significantly increased cadence, walking velocity, stride length, and step length (P < 0.05). Kinematic data demonstrated that anterior tilt of the pelvis and hip flexion during a gait cycle was significantly ameliorated after rhythmic auditory stimulation (P < 0.05). Gait deviation index also showed modest improvement in cerebral palsy patients treated with rhythmic auditory stimulation (P < 0.05). However, neurodevelopmental treatment showed that internal and external rotations of hip joints were significantly improved, whereas rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane (P < 0.05). Conclusions: Gait training with rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.

Shin YK, et al. Yonsei Med J. 2015 Nov;56(6):1703-1713. https://doi.org/10.3349/ymj.2015.56.6.1703

Purpose: This study aimed to investigate the effects of patient-directed interactive music on saliva melatonin levels and sleep quality among postoperative elderly patients in the intensive care unit (ICU). Patients and Methods: A total of 133 elderly patients were randomized into three groups: interactive music therapy (IMT), passive listening (PL), and the control group. The control group (n = 45) received routine medical care, while IMT and PL groups received music therapy on ICU day 1. The IMT group received up to 20 mins of interactive music sessions, including relaxation techniques. The PL group received only pre-selected relaxing music-listening for 30 mins. Saliva melatonin and cortisol levels were measured three times at 11 p.m. (preoperative, operation day, and postoperative day [POD] 1). The Richards-Campbell Sleep Questionnaire (RCSQ) and Quality of Recovery-40 questionnaire (QoR40) were administered on the preoperative day, as well as PODs 1 and 2. Results: The RCSQ showed a significant improvement in the IMT group compared to the control group on POD2 (71.50 vs 56.89, p=0.012), but the QoR40 did not show any difference between groups. The quality control of the saliva sample was not available due to the immediate postoperative patient’s condition, resulting in a higher dropout rate. Saliva melatonin levels on POD 1 were elevated in the IMT group compared to the control group (1.45 vs 0.04, p=0.0068). The cortisol level did not show a significant difference between groups. Conclusion: Single IMT intervention improved subjectively assessed short-term sleep quality in postoperative elderly patients. It is difficult to conclude whether music therapy intervention affects the level of melatonin and cortisol. Trial Registration: The study was registered at ClinicalTrials.Gov (number NCT03156205).