Research in basic and clinical neuroscience of music conducted over the past decades has begun to uncover music’s high potential as a tool for rehabilitation. Advances in our understanding of how music engages parallel brain networks underpinning sensory and motor processes, arousal, reward, and affective regulation, have laid a sound neuroscientific foundation for the development of theory-driven music interventions that have been systematically tested in clinical settings. Of particular significance in the context of motor rehabilitation is the notion that musical rhythms can entrain movement patterns in patients with movement-related disorders, serving as a continuous time reference that can help regulate movement timing and pace. To date, a significant number of clinical and experimental studies have tested the application of rhythm- and music-based interventions to improve motor functions following central nervous injury and/or degeneration. The goal of this review is to appraise the current state of knowledge on the effectiveness of music and rhythm to modulate movement spatiotemporal patterns and restore motor function. By organizing and providing a critical appraisal of a large body of research, we hope to provide a revised framework for future research on the effectiveness of rhythm- and music-based interventions to restore and (re)train motor function.

Objective: To test whether rhythmic auditory stimulation (RAS) training reduces the number of falls in Parkinson’s disease patients with a history of frequent falls. Design: Randomized withdrawal study design. Subjects: A total of 60 participants (aged 62–82 years) diagnosed with idiopathic Parkinson’s disease (Hoehn and Yahr stages III or IV) with at least two falls in the past 12 months. Intervention: Participants were randomly allocated to two groups and completed 30 minutes of daily home-based gait training with metronome click–embedded music. The experimental group completed 24 weeks of RAS training, whereas the control group discontinued RAS training between weeks 8 and 16. Main measures: Changes in clinical and kinematic parameters were assessed at baseline, weeks 8, 16, and 24. Results: Both groups improved significantly at week 8. At week 16—after the control group had discontinued training—significant differences between groups emerged including a rise in the fall index for the control group ( M = 10, SD = 6). Resumption of training reduced the number of falls so that group differences were no longer significant at week 24 ( M_experimental = 3, SD = 2.6; M_control = 5, SD = 4.4; P > 0.05). Bilateral ankle dorsiflexion was significantly correlated with changes in gait, fear of falling, and the fall index, indicating ankle flexion as a potential kinematic mechanism RAS addresses to reduce falls. Conclusion: RAS training significantly reduced the number of falls in Parkinson’s disease and modified key gait parameters, such as velocity and stride length.

Music has played a prominent role in the clinical and research literature on autism spectrum disorder (ASD) in regard to diagnosis, therapy, and behavioral observations of exceptional artistic abilities in this population. Music as therapy for ASD has traditionally focused on social interaction, communication skills, and social-emotional behaviors. However, recently, there has been an increased research focus on the role of motor and attention functions as part of the hallmark features of ASD, which may have significant implications for the role of music as an intervention for individuals with autism. The purpose of this article is to provide a critical appraisal of new research developments for therapists and researchers to potentially reassess the role of music as intervention to support healthy neurodevelopment in individuals with ASD and expand the current clinical scope of practice in music therapy for autism. Our argument is based upon compelling research evidence indicating that motor and attention deficits are deeply implicated in the healthy neurodevelopment of socio-communication skills and may be key indicators of structural and functional brain dysfunction in ASD. In light of this evidence, we suggest that music-based developmental training for attention and motor control may receive a critical new functional role in the treatment of autism due to the significant effect of auditory-motor entrainment on motor and attention functions and brain connectivity.

Background: Humans exhibit a remarkable ability to synchronize their actions with external auditory stimuli through a process called auditory–motor or rhythmic entrainment. Positive effects of rhythmic entrainment have been demonstrated in adults with neurological movement disorders, yet the neural substrates supporting the transformation of auditory input into timed rhythmic motor outputs are not fully understood. We aimed to systematically map and synthesize the research on the neural correlates of auditory–motor entrainment and synchronization. Methods: Following the PRISMA-ScR guidelines for scoping reviews, a systematic search was conducted across four databases (MEDLINE, Embase, PsycInfo, and Scopus) for articles published between 2013 and 2023. Results: From an initial return of 1430 records, 22 studies met the inclusion criteria and were synthesized based on the neuroimaging modality. There is converging evidence that auditory–motor synchronization engages bilateral cortical and subcortical networks, including the supplementary motor area, premotor cortex, ventrolateral prefrontal cortex, basal ganglia, and cerebellum. Specifically, the supplementary motor area and the basal ganglia are essential for beat-based timing and internally guided rhythmic movements, while the cerebellum plays an important role in tracking and processing complex rhythmic patterns and synchronizing to the external beat. Self-paced tapping is associated with additional activations in the prefrontal cortex and the basal ganglia, suggesting that tapping in the absence of auditory cues requires more neural resources. Lastly, existing studies indicate that movement rate and the type of music further modulate the EEG power in the alpha and beta frequency bands. Conclusions: These findings are discussed in the context of clinical implications and rhythm-based therapies.