Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources and Search Strategy
2.2. Eligibility Criteria
- Participants: Patients of any age, gender, or disease stage who have been diagnosed with PD. However, studies including atypical PD and other diagnoses (e.g., Alzheimer’s Disease) were excluded.
- Interventions and comparisons: The inclusion criteria for the interventions in the experimental group were any music-based intervention or other interventions combined with music, but the studies which used music as a secondary medium were excluded. Other modalities of intervention including dance and movement therapy using music as a secondary medium of treatment were also excluded. Studies which examined the immediate effect of interventions were also excluded. The comparison groups included those who received non-music interventions, usual care, or no intervention. The intervention format (individual/group), setting (clinic/hospital/home), duration, and frequency were not limited.
- Outcomes: There was no limit to the dependent variable that music-based interventions affected. Therefore, the outcomes of interest were both motor (e.g., gait, mobility) and non-motor symptoms (e.g., executive function and quality of life). All outcomes were measured using validated tools including the timed up-and-go test (TUG), the trail making test (TMT) and the Stroop color and word test (SCWT).
- Study design: The study design included in this review were randomized controlled trials (RCTs) and controlled clinical trials (CCTs). This study was limited to articles published in English and peer-reviewed journals. The following types of research were ruled out: master’s theses, doctoral dissertations, conference papers, case studies, descriptive studies, literature research, and any review studies.
2.3. Study Selection and Data Extraction
2.4. Risk-of-Bias Assessment
2.5. Data Synthesis
3. Results
3.1. Study Selection
3.2. Summary of Risk of Bias
3.3. Study Characteristics
3.3.1. Characteristics of Participants
3.3.2. Characteristics of Interventions
3.4. Effects of the Interventions on Motor Outcomes
3.4.1. Cadence
3.4.2. Velocity
3.4.3. Stride Length
3.4.4. Mobility
3.5. Effects of the Intervention on Non-Motor Outcomes
3.5.1. Cognitive Flexibility
3.5.2. Inhibition
3.5.3. Quality of Life
3.6. Sensitivity Analysis
3.7. Publication Bias
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Author | Country | Study | Sample | Age | Gender | Disease Duration (Years) | UPDRS | Hoehn and Yahr Score | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(Year) | Types | Ex | Co | Ex | Co | Ex | Co | Ex | Co | Ex | Co | Ex | Co | |
Bugos (2021) [29] | USA | CCT | 34 | 11 | 65.79 ± 8.38 | 67.55 ± 7.29 | M11/F18 | M6/F5 | N/A | N/A | N/A | N/A | 1 or 2 a | 1 or 2 b |
Bukowska (2016) [27] | Poland | RCT | 30 | 25 | 63.4 ± 10.61 | 63.44 ± 9.67 | M15/F15 | M15/F10 | N/A | N/A | N/A | N/A | 2 or 3 | 2 or 3 |
Calabrò (2019) [26] | Italy | RCT | 25 | 25 | 70 ± 8 | 73 ± 8 | M11/F9 | M14/F6 | 10 ± 3 | 9.3 ± 3 | 29 ± 3 | 31 ± 5 | 3 ± 1 | 3 ± 1 |
Chaiwanichsiri (2011) [56] | Thailand | RCT | 10 | 10/ 10 | 67.1 ± 4.0 | 67.9 ± 6.3/ 68.6 ± 5.2 | N/A | N/A | 3.7 ± 4.1 | 7.4 ± 3.4 4.4 ± 2.3 | N/A | N/A | 2, 2.5, 3 | 2, 2.5, 3 |
Chomiak (2017) [28] | Canada | CCT | 5 | 6 | 70.8 ± 5.6 | 69.0 ± 5.7 | M5/F0 | M4/F2 | 15.4 ± 5.4 | 11.2 ± 5.0 | 18.2 ± 6.4 (Part III) | 20.3 ± 4.7 (Part III) | 2.5 ± 0.50 | 2.7 ± 0.41 |
De Luca (2020) [54] | Italy | RCT | 20 | 20 | 63.2 ± 8.4 | 66.5 ± 6.2 | M10/F10 | M7/F13 | N/A | N/A | N/A | N/A | 1.5 ± 0.53 | 1.7 ± 0.59 |
Fodor (2021) [36] | Romania | RCT | 16 | 16 | 67.1 ± 5.9 | 65.6 ± 5.5 | M4/F12 | M6/F10 | N/A | N/A | N/A | N/A | 1~3 | 1~3 |
Pacchetti (2000) [16] | Italy | RCT | 16 | 16 | 62.5 ± 5 | 63.2 ± 5 | M12/F4 | M11/F5 | 4.8 ± 3 | 5.2 ± 2 | 40.2 ± 7.7 (Part III) | 40.7 ± 7 (Part III) | 2 or 3 | 2 or 3 |
Pantelyat (2016) [37] | USA | CCT | 8 | 10 | 72 ± 8 | 71 ± 7 | F% 63 | F% 60 | N/A | N/A | 22 ± 6 (MDS Part III) | 25 ± 11 (MDS Part III) | 2.2 ± 0.46 | 2.2 ± 0.24 |
Park (2021) [57] | Korea | RCT | 6 | 6 | 61.6 ± 4.9 | 63.1 ± 10.1 | N/A | N/A | 5.6 ± 3.1 | 4.8 ± 1.4 | N/A | N/A | 2 or 3 | 2 or 3 |
Shah (2020) [39] | India | RCT | 15 | 15 | 66.98 ± 5.4 | 68.78 ± 4.76 | M11/F4 | M12/F3 | 2 ± 1.51 | 3 ± 1.58 | N/A | N/A | 2, 2.5, 3 (modified) | 2, 2.5, 3 (modified) |
Spina (2016) [30] | Italy | RCT | 10 | 15 | 68.3 ± 8.1 | 61.9 ± 6.8 | N/A | N/A | 79.2 ± 39.2 (months) | 80 ± 53.4 (months) | 18.5 ± 8.1 (MDS Part III) | 17.7 ± 8.3 (MDS Part III) | N/A | N/A |
Thaut (1996) [55] | U.S.A. | RCT | 15 | 11/ 11 | 69 ± 8 | 74 ± 3/ 71 ± 8 | M10/F5 | M8/F3 M8/F3 | 7.2 ± 4 | 5.4 ± 3/ 8.5 ± 4 | N/A | N/A | 2, 2.5, 3 (modified) | 2, 2.5, 3 (modified) |
First Author (Year) | Contents | Intervention | Control | Outcomes | Evaluation Methods | |
---|---|---|---|---|---|---|
Intensity (Duration; Frequency; Time) | Type | |||||
Bugos (2021) [29] | Intensive piano training | 10 days; daily each morning; 3 h/session | Group | No treatment | ⑦⑨⑩ | PASAT, cued color–word Stroop, digit coding, symbol search, TMT part B, D-KEFS: verbal fluency subtest; PDQ-39; GSE |
Bukowska (2016) [27] | The combination of three NMT sensorimotor techniques: TIMP, PSE, and RAS for daily life activities, balance, pre-gait, and gait pattern | 4 weeks; 4 times/week; 45 min/session | Individual | Stay active and perform daily life activities b/t measures | ①② | Computerized dynamic posturography CQ stab; optoelectric 3D movement analysis, system BTS Smart |
Calabrò (2019) [26] | Treadmill gait training using GaitTrainer3 with RAS | 8 weeks; 5 times/week; 20 min/session | Individual | Treadmill gait training using GaitTrainer3 without RAS (same intensity) | ①②⑩ | UPDRS, BBS, TUG; A single wireless inertial sensor (GSensor, BTS Bioengineering), 10 m walking test, FGA, gait quality index; Tinetti FES |
Chaiwanichsiri (2011) [56] | Treadmill with music cue 3 days/week and home walking program 3 days/week | 8 weeks; 6 days/week; 30 min/session | Individual | Control 1. Treadmill training 3 days/week and home walking program 3 days/week Control 2. Home walking program 6 days/week | ①② | TUG, single leg stance test; expanded TUG, six-minute walk test |
Chomiak (2017) [28] | In-home music-contingent stepping-in-place training | 4 weeks; minimum of 3/week; 10 to 20 min/session | Individual | In-home auditory-contingent stepping-in-place training using a podcast (auditory feedback) (same intensity) | ①⑧⑩ | FOG-Q; MoCA; FES-International |
De Luca (2020) [54] | Gait training via a treadmill and RAS | 8 weeks; 3 times/week; about 30 min/session | Individual | Traditional over-ground gait training (same intensity) | ①②⑧ ⑨⑩ | FIM: motor, TUG; 10 m walking test; FIM: cognitive; PGWBI; Brief COPE |
Fodor (2021) [36] | A multimodal rehabilitation program centered on physical therapy combined with listening to music | 14 days; daily; 2.5 h | Group | A multimodal rehabilitation program centered on physical therapy (same intensity) | ⑨ | PDQ-39 |
Pacchetti (2000) [16] | Music therapy, choral singing, voice exercise, rhythmic and free body movements, and improvisation | 13 weeks; weekly; 2 h/session | Group | PT, stretching exercises, specific motor tasks, and balance and gait training (intensity: 13 weeks; weekly; 1.5 h/session) | ①⑨⑩ | UPDRS-ADL, UPDRS-MS; PDQL; happiness measure |
Pantelyat (2016) [37] | West African drum circle | 6 weeks; twice-weekly; 45–60 min/session | Group | No treatment | ⑧⑨⑩ | MoCA; PDQ-39; GDS-15 |
Park (2021) [57] | Drum playing with rhythmic cueing (DPRC intervention) | 12 weeks; weekly; 50 min/session | Group | Regular program: gait rehabilitation and speech therapy | ①③⑦ | Nine-hole peg test; K-TMT-e: part A; K-TMT-e: part B, Korean Stroop test |
Shah (2020) [39] | PT with MT: standing and marching activity, gait training, tap dance, and balance training | 6 weeks; 4 times per week; 60 min/session | Group | Conventional PT | ①②⑨ | TUG; dynamic gait index; PDQ-39 |
Spina (2016) [30] | Active music therapy—production of music, singing, and dancing | 24 weeks; once a week; 90 min/session | Group | No treatment | ①③④⑤⑥⑦⑨ | New FOG-Q, TUG, MDS-UPDRS; TMT part A; Rey immediate recall, Rey delayed recall; clock drawing test; names denomination, verbal denomination; FAB, phonemic verbal fluency, Raven test, TMT part B, Stroop test; PDQ-39 |
Thaut (1996) [55] | RAS; home-based training | 3 weeks; daily; 30 min/session | Individual | Control 1. Self (internally)-paced group: same exercise program but without the aid of RAS Control 2. No-training group: normal daily activities | ①② | EMG; computerized foot-switch recording system |
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Lee, H.; Ko, B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2023, 20, 1046. https://doi.org/10.3390/ijerph20021046
Lee H, Ko B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2023; 20(2):1046. https://doi.org/10.3390/ijerph20021046
Chicago/Turabian StyleLee, Hyunjung, and Bumsuk Ko. 2023. "Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 20, no. 2: 1046. https://doi.org/10.3390/ijerph20021046