Music-based therapy in rehabilitation of people with multiple sclerosis: a systematic review of clinical trials

Abstract

Background: Multiple sclerosis (MS) is a major cause of chronic neurological disability in young adults. An increasing number of controlled studies have assessed the potential rehabilitative effects of new drug-free treatments, complementary to the standard care, including music-based therapy (MBT). Objective: To analyze the evidence for the effectiveness of MBT within the therapeutic approaches to individuals diagnosed with MS. Methods: A systematic review of clinical trials was performed with searches in the following databases: BIOSIS, CINAHL, Cochrane, EBSCO, ERIC, Google Scholar, IBECS, LILACS, LISA (ProQuest), Medline, PEDro, PsycINFO (APA), Psychological & Behavioral, PubMed, SciELO, Scopus, SPORTDiscus and Web of Science. Clinical trials comparing MBT versus conventional therapy/no intervention were included. Results: From the 282 studies identified, 10 trials were selected. Among these, the total sample consisted of 429 individuals: 253 were allocated to the experimental group (MBT) and 176 to the control group (conventional therapies or no intervention). All the studies presented high methodological quality. Modalities of MBT were clustered into four groups: (1) Rhythmic auditory; (2) Playing musical instruments; (3) Dance strategy; and (4) Neurological music therapy. Overall, the studies consistently showed that MBT was better than conventional therapy or no intervention, with regard to gait parameters (double support time and walking speed), fatigue level, fatigability, coordination, dexterity, balance, walking endurance, lower extremity functional strength, emotional status and pain. Regarding mental fatigability and memory, the data were conflicting and the evidence was unclear. Conclusion: MBT is a safe and effective approach for clinical rehabilitation of MS patients that leads to positive results regarding both motor and non-motor functions.

RESUMO

Introdução: A esclerose múltipla (EM) é a maior causa de incapacidade neurológica crônica em adultos jovens. Um crescente número de estudos controlados avalia a reabilitação por meio de tratamentos não medicamentosos, cuidados complementares incluindo a terapia baseada na música (TBM). Objetivo: Analisar a evidência de efetividade da TBM na abordagem terapêutica de indivíduos diagnosticados com EM. Métodos: Foi realizada uma revisão sistemática de ensaios clínicos com busca nas bases de dados Biosis, Cinahl, Cochrane, Ebsco, Eric, Google Scholar, Ibecs, Lilacs, Lisa (ProQuest), Medline, PEDro, PsycINFO (APA), Psychological & Behavioral, PubMed, SciELO, Scopus, Sportdiscus e Web of Science. Foram incluídos ensaios clínicos comparando TBM versus terapia convencional/sem intervenção. Resultados: Dentre os 282 estudos identificados, 10 ensaios foram selecionados. Desses, a amostra total consistia em 429 indivíduos (253 alocados no grupo experimental (TBM) e 176 no grupo controle (terapias convencionais ou sem intervenção). Todos os estudos apresentaram elevada qualidade metodológica. Modalidades da TBM foram reunidas em quatro grupos: (1) Audição rítmica; (2) Tocar instrumentos musicais; (3) Dança como estratégia; e (4) Terapia neurofuncional baseada na música. A maioria dos estudos identificou que a TBM é melhor que a terapia convencional ou nenhuma intervenção nos parâmetros da marcha (duplo apoio e velocidade), níveis de fadiga, fatigabilidade, coordenação, destreza, equilíbrio, força de membros inferiores, estado emocional e dor. Os dados sobre fatigabilidade mental e memória foram conflitantes e as evidências são incertas. Conclusão: A TBM é uma abordagem segura na reabilitação clínica de indivíduos com EM e propicia resultados positivos nas funções motoras e não motoras.

Keywords:

Multiple Sclerosis - Music Therapy - Rehabilitation

Palavras-chave:

Esclerose Múltipla - Musicoterapia - Reabilitação

Authors’ contributions:

Both authors did data collection, data analysis and writing and analyses of the final text.

Publication History

Received: 31 July 2020

Accepted: 01 October 2020

Article published online:
04 July 2023

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