Exploring Music-Based Interventions for Executive Functioning and Emotional Well-Being in Stroke Rehabilitation: A Scoping Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Review report:

1. Basic Reporting

1.1. Clarity and Language:

In general, the manuscript is well-written and demonstrates proficiency in professional English. However, some sections could be made clearer. For instance, on page 3, the criteria for including studies in the meta-analysis could be outlined more clearly.

1.2. Literature and Context:

The authors provide a comprehensive overview of the literature pertinent to the meta-analysis, effectively framing the research question. There is, however, a need to include more recent studies in the literature review, particularly those published in the last two years (e.g., page 8), which would emphasize the research's relevance and timeliness.

1.3. Structure, Figures, and Tables:

The manuscript follows a logical structure, moving smoothly from the introduction to the analysis and conclusion. The figures and tables are generally well presented, but Figure 1 could benefit from additional information about the study characteristics.

1.4. Self-contained and Relevant:

There are few limitations to the manuscript and it effectively communicates findings that align with the meta-analysis's stated objectives. A more explicit statement of the clinical implications of the results would strengthen the relevance of the discussion on pages 8-12, which appropriately links the findings back to the research question.

2. Experimental Design

The manuscript does not present original research, but it is a valid meta-analysis that fills an important gap in the literature about music-based interventions for stroke rehabilitation.

2.2. Methods Description:

Although the methods section is comprehensive, it could benefit from more transparency. For example, more information on how potential publication bias was assessed would strengthen the methodological rigor.

3. Validity of the Findings

3.1. Data Robustness and Statistical Soundness:

The data analyzed are substantial, and the statistical methods employed are appropriate for a meta-analysis. 

 

Author Response

1. Basic Reporting

1.1. Clarity and Language:

In general, the manuscript is well-written and demonstrates proficiency in professional English. However, some sections could be made clearer. For instance, on page 3, the criteria for including studies in the meta-analysis could be outlined more clearly.

Response: Thank you for your helpful comments and attentive evaluation of our manuscript. We have edited some sections for clarity.

1.2. Literature and Context:

The authors provide a comprehensive overview of the literature pertinent to the meta-analysis, effectively framing the research question. There is, however, a need to include more recent studies in the literature review, particularly those published in the last two years (e.g., page 8), which would emphasize the research's relevance and timeliness.

Response: We agree. We have included and analyzed more recent studies. The search spanned from the inception of each database to October 25, 2023.

1.3. Structure, Figures, and Tables:

The manuscript follows a logical structure, moving smoothly from the introduction to the analysis and conclusion. The figures and tables are generally well presented, but Figure 1 could benefit from additional information about the study characteristics.

Response: We agree. We have added additional information about the study characteristics (Fig. 1).

1.4. Self-contained and Relevant:

There are few limitations to the manuscript and it effectively communicates findings that align with the meta-analysis's stated objectives. A more explicit statement of the clinical implications of the results would strengthen the relevance of the discussion on pages 8-12, which appropriately links the findings back to the research question.

Response: We edited the last paragraph.

2. Experimental Design

The manuscript does not present original research, but it is a valid meta-analysis that fills an important gap in the literature about music-based interventions for stroke rehabilitation.

Response: Thank you very much for the feedback.

2.2. Methods Description:

Although the methods section is comprehensive, it could benefit from more transparency. For example, more information on how potential publication bias was assessed would strengthen the methodological rigor.

Response: We agree with this and have incorporated your suggestion in the method section. “The research question for the review was the following: What evidence exists about the benefits of music interventions to enhance executive functions and EWB in patients with stroke. This review considered including study designs with varying risk of bias due to the few published studies that include our specific variables of analysis. Under this argument, our quality assessment was based on the main objective of our study rather than on the study design. Only research that addressed our primary goal and offered reliable and practical information was reviewed. The appropriateness of the inclusion criteria, description of music interventions, outcomes measurements, and key results were assessed by blind pairs of reviewers who worked independently and with sufficient reliability to determine the validity of eligible studies. To reduce bias, studies were evaluated for inclusion based on selection criteria that were piloted to ensure their reliability and flowed directly from the primary goal.

In order to minimize bias, studies were assessed for inclusion using selection criteria flowed directly from the main objective and that were piloted to check that they can be reliably applied (Munn et al., 2018).

3. Validity of the Findings

3.1. Data Robustness and Statistical Soundness:

The data analyzed are substantial, and the statistical methods employed are appropriate for a meta-analysis.

Response: Thank you very much for the feedback.

Reviewer 2 Report

Comments and Suggestions for Authors

The scoping review aims at exploring whether music interventions can be beneficial for the improvement of executive functions and emotional wellbeing in patients with stroke.  I found the review well written and well conducted. I don’t have any concerns about the manuscript. Just two minor points: Firstly, it would be interesting considering the importance of music-based interventions in stroke patients as well as in other patients also in light of the scarce results obtained with traditional interventions such as cognitive rehabilitation. Indeed, previous studies have shown that cognitive rehabilitation has inconsistent effects on cognitive functions in different pathologies (see for instance Giustiniani et al., 2022). Further, I would state something about the possibility of understanding the effects of these interventions in other cognitive domains, besides executive functions.

Giustiniani, A., Maistrello, L., Danesin, L., Rigon, E., & Burgio, F. (2022). Effects of cognitive rehabilitation in Parkinson disease: a meta-analysis. Neurological Sciences, 43(4), 2323-2337.

Author Response

The scoping review aims at exploring whether music interventions can be beneficial for the improvement of executive functions and emotional wellbeing in patients with stroke.  I found the review well written and well conducted. I don’t have any concerns about the manuscript. Just two minor points: Firstly, it would be interesting considering the importance of music-based interventions in stroke patients as well as in other patients also in light of the scarce results obtained with traditional interventions such as cognitive rehabilitation. Indeed, previous studies have shown that cognitive rehabilitation has inconsistent effects on cognitive functions in different pathologies (see for instance Giustiniani et al., 2022). Further, I would state something about the possibility of understanding the effects of these interventions in other cognitive domains, besides executive functions.

Giustiniani, A., Maistrello, L., Danesin, L., Rigon, E., & Burgio, F. (2022). Effects of cognitive rehabilitation in Parkinson disease: a meta-analysis. Neurological Sciences, 43(4), 2323-2337.

Response: Thank you for pointing this out. We agree with this comment. We have begun to analyze the publications related to the two domains that are most frequently affected after stroke, such as executive functioning and well-being, because in addition to being frequent, we consider that they are pillars for rehabilitation and recovery in other cognitive domains, including the motor and/or functional domain. It would have been interesting to explore the effects of these interventions in other cognitive domains.

Reviewer 3 Report

Comments and Suggestions for Authors

The authors did a litterature search according to PRISMA principles using several databases on the value of music intervention/therapy in stroke patients and found various documented effects. The paper is well written and I have no special comments on the structure or results. The broad range of results of course limits the practical implications. English language is fine.

Author Response

The authors did a literature search according to PRISMA principles using several databases on the value of music intervention/therapy in stroke patients and found various documented effects. The paper is well written and I have no special comments on the structure or results. The broad range of results of course limits the practical implications. English language is fine.

Response: We agree that the wide range of results limits the practical implications. We believe the changes made in response to other comments have made the comprehensive interpretation of the main results clearer. We are grateful to the reviewer for their insightful comments on our paper.