Background: Music intervention (MI) is a promising complementary therapy for alleviating psychological distress in patients with cancer undergoing radiotherapy. This systematic review and meta-analysis assessed the efficacy of MI in reducing anxiety, depression, and fatigue in these patients. Methods: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the International Clinical Trials Registry Platform from inception to 9 January 2025. We included randomized controlled trials (RCTs) and cohort studies investigating MI’s impact on psychological outcomes in patients with cancer receiving radiotherapy in this review. The study quality was appraised using the Cochrane Risk of Bias 2.0 for RCTs and the ROBINS-I tool for cohort studies. A meta-analysis was performed using a random-effects model in Review Manager 5.4. Results: A total of 13 studies (11 RCTs and 2 cohort studies) with 1073 participants were included. The pooled analysis revealed a significant reduction in anxiety (mean difference [MD]: −3.53, 95% confidence interval [CI]: −5.98 to −1.07, p = 0.003), a non-significant effect on depression (MD: −1.12, 95% CI: −3.25 to 1.01, p = 0.29), and a significant improvement in fatigue (MD: −15.88, 95% CI: −28.19 to −3.57, p = 0.01). A subgroup analysis based on intervention type indicated that music medicine (MM) was more effective in reducing anxiety compared to music therapy (MT). Conclusions: The findings of this study suggest that MI, particularly MM, may be beneficial in alleviating anxiety and fatigue in patients with cancer undergoing radiotherapy, but its impact on depression remains inconclusive. Future studies should employ standardized methodologies and rigorous RCT designs to validate these findings.

The direct observation of procedural skills for knee joint mobilization (DOPSknee) tool requires validation to ensure its reliability and validity for providing immediate feedback and assessing its applicability in off-site settings. We aimed to describe the implementation and clinimetric properties of DOPSkneein both on-site and off-site environments and to evaluate the preclinical competencies of physical therapy (PT) students. Following the development of DOPSknee, 42 preclinical PT students were filmed performing knee joint mobilization. Their performance was assessed by two clinical instructors using DOPSknee, in on-site and off-site conditions, with an interval of 1.5-4.5 months between assessments. DOPSknee exhibited good on-site inter-rater reliability (ICC = 0.78). However, it had poor off-site inter-rater reliability (ICC = 0.37) and intra-rater reliability differed substantially between on- and off-site evaluations (evaluator 1: ICC = 0.42; evaluator 2: ICC = 0.88). Nevertheless, DOPSknee exhibited good reliability for average measures from on- and off-site evaluations (ICC = 0.84). Average total DOPSknee scores were significantly correlated with average global rating scores in both on-site (σ = 0.47) and off-site conditions (σ = 0.75), as well as in cross-over conditions (σ = 0.54 and 0.71). The cutoff score for DOPSknee was determined to be 14 points. Construct validity analysis of both on- and off-site evaluations revealed that students who passed the DOPSknee evaluation had significantly higher average global rating scores (p < 0.05). DOPSknee exhibited good validity and reliability for assessing student performance in on‑site conditions, while average measures may improve reliability in off‑site assessments. These findings highlight its potential as a structured procedural assessment tool in physical therapy education.