Music-based interventions in adult stroke rehabilitation: a narrative review of clinical applications, proposed mechanisms, and implementation

 I bet your incompetent? doctor never created a music protocol for your stroke recovery and this will do nothing to change that mind! How long before s/he is fired for incompetence?

music (94 posts back to March 2011)

music therapy (85 posts back to October 2014)

musical training (13 posts back to June 2014)

singing (12 posts to July 2013)

• music playing (2 posts to April 2023)

 Music-based interventions in adult stroke rehabilitation: a narrative review of clinical applications, proposed mechanisms, and implementation

Xue Gong

,

Jingting Kong

,

Zixuan Zhang

&

Hua Sun

Received 29 Jul 2025, Accepted 05 Sep 2026, Published online: 15 Sep 2026

• Cite this article

https://doi.org/10.1080/10749357.2026.2733390

ABSTRACT

Background

Music is used in stroke rehabilitation through therapist-delivered music therapy, neurologic music therapy techniques, other structured music-based interventions, and technology-assisted systems. Inconsistent terminology and overstated mechanisms complicate interpretation.

Objectives

To synthesize the clinical applications, proposed mechanisms, limitations, and implementation considerations of music-based interventions in adult stroke rehabilitation.

Methods

We conducted a targeted narrative review of peer-reviewed English-language literature identified through PubMed/MEDLINE, CINAHL, and reference chaining. We prioritized adult stroke systematic reviews, controlled studies, mechanistic investigations, and implementation research through June 2026. Seminal pre-2010 studies and evidence from other neurological populations were used only to explain mechanisms or gaps and are labeled as indirect. We did not undertake exhaustive retrieval, formal risk-of-bias assessment, or quantitative pooling.

Results

Evidence is most consistent for rhythmic auditory stimulation for gait and selected music-supported upper-limb programs. Melodic intonation therapy may improve trained utterances and repetition in nonfluent aphasia, but transfer to everyday communication is uncertain. Listening and singing programs show potential for cognition, mood, engagement, and sleep, although protocols are heterogeneous. Post-stroke swallowing evidence is preliminary, and blood-brain barrier effects remain preclinical. Outcomes may vary with stroke phase, phenotype, cognition, hearing, comorbidity, musical reward and preference, dose, and provider expertise.

Conclusions

Music-based rehabilitation comprises mechanism-informed adjuncts rather than one treatment. Clinical use should link a defined musical ingredient to a functional target, document provider and dose, incorporate preference and safety screening, and measure everyday transfer. Larger pragmatic and mechanism-specific trials with prespecified moderator analyses are needed.