Music-based interventions improve gait function in stroke survivors: a systematic review and meta-analysis

BACKGROUND: Stroke is the world's second leading cause of death and a major cause of disability. Post-stroke motor dysfunction often impairs ADLs and quality of life. However, evidence for music-based interventions in stroke rehabilitation remains limited in comparability and generalizability. OBJECTIVE: This study aimed to systematically evaluate and meta-analyze published literature to clarify the role and clinical value of music-based interventions in post-stroke gait rehabilitation, optimize gait-oriented therapeutic strategies, and provide guidance for future clinical research. RESULTS: A total of 1,426 records were screened, with 12 studies (388 participants) meeting inclusion criteria. Meta-analysis suggested that music-based interventions were associated with improvements in gait speed (SMD = 0.81, 95% CI: 0.36-1.26), stride length (SMD = 0.80, 95% CI: 0.33-1.28), and step frequency (SMD = 0.89, 95% CI: 0.05-1.73). However, heterogeneity across studies was substantial, and the cumulative sample size remained modest. Sensitivity analyses supported relatively stable findings for gait speed and stride length, whereas results for step frequency were less robust. Funnel plots and Egger's tests suggested no clear evidence of publication bias for gait speed or stride length, although possible bias was noted for step frequency. CONCLUSION: Music-based interventions appear promising for improving gait speed and stride length in stroke survivors and may offer benefits for post-stroke gait rehabilitation, possibly mediated by multimodal neuroplasticity. Nevertheless, given the modest cumulative sample size, substantial between-study heterogeneity, and potential publication bias, the overall strength of evidence remains limited and the findings should be interpreted cautiously.