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Effects of Five-Element Music on Language Recovery in Patients with Poststroke Aphasia: A Systematic Review and Meta-Analysis.

Objectives: Five-element music constitutes a complementary therapy in stroke and other acquired brain injuries. Aphasia represents a great problem faced by individuals with stroke. Five-element music, a new type of therapy, may benefit people with poststroke aphasia (PSA). The present study summarized evidences describing the effects of five-element music in language treatment in patients with PSA. Methods: A total of 20 databases and websites were searched from inception to May 2018, including published or unpublished gray literature. Both randomized controlled trials (RCTs) and controlled clinical trials were included in the literature review. Two reviewers independently screened and assessed relevant publications; data extraction was carried out with specific forms. The above reviewers also assessed the quality of each trial by using the Cochrane Handbook for Systematic Reviews of Interventions. After evaluating heterogeneity among studies, quantitative synthesis was applied, where appropriate. Review Manager (Rev Man) 5.3 was employed to examine the pooled effect of five-element music for PSA compared with control therapy. Results: Six RCTs met the eligibility criteria and included 516 patients and were assessed by meta-analysis and quality analysis. Five-element music more significantly increased language scores than Western music therapy or routine care controls in repetition (standardized mean difference [SMD] = 1.96; 95% confidence interval [CI] 0.55-3.37), spontaneous speech (SMD = 1.29; 95% CI 0.53-2.04), and naming (SMD = 1.11; 95% CI 0.80-1.43) (all p < 0.05). No adverse events were reported. Conclusions: Five-element music might moderately improve language rehabilitation in individuals with PSA; however, higher quality RCTs with consistent interventions are required to confirm these findings.