Efficacy of exercise rehabilitation program accompanied by experiential music for recovery of aphasia in single cerebrovascular accidents: a randomized controlled trial

Efficacy of different rehabilitation therapies on post-stroke aphasia patients: A network meta-analysis

BACKGROUND

Although several rehabilitation interventions are effective in post-stroke aphasia (PSA), the efficacy of different rehabilitation interventions compared to each other remains controversial. Here, we aimed to compare the effectiveness of varying rehabilitation interventions in PSA.

METHODS

Randomized controlled trials on 8 kinds of rehabilitation interventions to improve speech function in patients with PSA were searched by computer from 10 databases, including PubMed, Web of Science, Cochrane, OVID, CINAHL, Embase, CNKI, WanFang, CBM, and VIP. The search scope was from the establishment of the database to August 2023. The literature screening, extraction of basic information, and quality assessment of the literature were conducted independently by 2 researchers. Network meta-analysis (NMA) was performed using Stata 17.0 software.

RESULTS

Fifty-four studies involving 2688 patients with PSA were included. The results of NMA showed that: ① in terms of improving the severity of aphasia, the therapeutic effects of repetitive transcranial magnetic stimulation were the most significant; ② motor imagery therapy was the most effective in improving spontaneous speech, repetition, and naming ability; ③ in terms of improving listening comprehension ability, the therapeutic effects of mirror neuron therapy was the most significant.

CONCLUSION

The 8 rehabilitation interventions have different focuses in improving the speech function of PSA patients, and the clinical therapists can select the optimal rehabilitation interventions in a targeted manner according to the results of this NMA and the patients' conditions and other relevant factors.

What are the effects of acute exercise and exercise training on cerebrovascular hemodynamics following stroke? A systematic review and meta-analysis

INTRODUCTION

Limited data exist regarding the effects of acute exercise and exercise training on cerebrovascular hemodynamic variables post-stroke.

PURPOSE

This systematic review and meta-analysis 1) examined the effects of acute exercise and exercise training on cerebrovascular hemodynamic variables reported in the stroke exercise literature; and 2) synthesized the peak middle cerebral artery blood velocity (MCAv) achieved during an acute bout of moderate-intensity exercise in individuals post-stroke.

METHODS

Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, AMED) were searched from inception to December 1^st 2021, for studies that examined the effect of acute exercise or exercise training on cerebrovascular hemodynamics in adults post-stroke. Two reviewers conducted title and abstract screening, full-text evaluation, data extraction, and quality appraisal. Random effects models were used in meta-analysis.

RESULTS

Nine studies, including 4 acute exercise (n=61) and 5 exercise training studies (n=193), were included. Meta-analyses were not statistically feasible for several cerebrovascular hemodynamic variables. Descriptive analysis reveals that exercise training may increase cerebral blood flow and cerebrovascular reactivity to carbon dioxide among individuals post-stroke. Meta-analysis of three acute exercise studies revealed no significant changes in MCAv during acute moderate intensity exercise (n=48 participants, mean difference = 5.2 cm/s, 95% CI [-0.6, 11.0], P=0.08) compared to resting MCAv values.

CONCLUSION

This review suggests that individuals post-stroke may have attenuated cerebrovascular hemodynamics as measured by the MCAv during acute moderate-intensity exercise. Higher quality research utilizing agreed upon hemodynamic variables are needed to synthesize the effects of exercise training on cerebrovascular hemodynamics post-stroke.

Impact of Music Therapy on Gait After Stroke

Music therapy or music-supported therapy is a therapeutic modality sometimes used during the rehabilitation phase after an acute ischemic or hemorrhagic stroke. The intervention suggests that the resulting audio-motor coupling can enhance motor function. Multiple clinical studies have reported various improvements-including cognitive, mood, and limb function. Gait impairment after stroke confers significant morbidity. The authors present a systematic review of randomized controlled trials that have examined the impact of music therapy on patient recovery, specifically on gait and ambulation.

Preliminary findings from an Acupuncture and experiential/traditional music therapy during the standard care of rehabilitation exercise program for Recovery on post-stroke upper limb dysfunction

Upper limb dysfunction is common damage after stroke posing an important challenge for post-stroke rehabilitation but little is known about the effects of combined therapy with acupuncture and experiential/traditional music during the standard care of rehabilitation exercise program. The aim of this study, therefore, was to systematically assess the effects of exercise rehabilitation program accompanied by experiential music or/+ acupuncture for clinical recovery on post-stroke upper limb dysfunction. This was a randomized controlled study with a total of 116 eligible subjects randomly divided into three groups, namely (1) MG group-(daily listening to experiential/traditional music), (2) AP/MG group (combined treatment with daily listening to experiential/traditional music and AP), and (3) CG group (with no experiential/traditional music therapy or AP (standard care only)), in a 1.3:1:1 ratio. The primary outcomes in this study were the changes between baseline score during the admission and after 6 months Fugl-Meyer Assessment for Upper Extremity (FMA/UE) and the recovery. The secondary outcomes are the mean change in the scores between baseline value during the admission and after 6 months on the Visual Analogue Scale, mini-mental test, Barthel index and Computer tomography Perfusion (CTP) findings- cerebral blood flow (CBF). The results of this study clarify the synergistic effects of AP and daily listening to experiential/traditional music during the standard care rehabilitation program on upper limb dysfunction after stroke.