Table 1.

Summary of the included studies and the detail of intervention and measurement.

Reference	Participants	Intervention (follow-up)	Control/comparison	Outcome measures	Results
Raglio et al. (15)	N = 38; age range: 54–89	The standard of care and relational active music therapy approach (n = 19) Repeat exercise: 20 sessions lasting 30 min each, 3-weekly	Only standard of care, including physiotherapy and occupational therapy (n = 19)	Measured at baseline and at the end of treatment Neurologic: It-NIHSS Physical and cognitive disability: FIM Strength/dexterity of the hands: the Grip-Pinch Dynamometric Test and the Nine-hole Peg Test Gross mobility: TUG Psychological traits and quality of life: HADS and MQOL-It Video-recorded sessions: MTRS	Neurologic: no significant difference between groups Physical and cognitive disability: improved both in experimental and control groups (p = 0.001) Strength/dexterity of the hands: the amount of left paretic patients (n = 5) improved more than control groups (n = 2) Gross mobility: improved both in experimental and control groups (p = 0.032) Psychological traits and quality of life: a decrease of anxiety and depression and a significant positive trend
Street et al. (16)	N = 11; age range: 53–67	Play acoustic musical instruments and/or iPads with touch screen musical instruments (n = 6) Repeat exercise: 20–30 min a session, twice weekly for 6 weeks	Received no intervention (n = 5)	Measured at baseline and at 6-, 9-, 15-, and 18-week follow-up Arm function: the action research arm test and the 9-hole peg test	Arm function: no significant difference between groups
Street et al. (9)	N = 14; age range: 18–90	Therapeutic instrumental music performance therapy (n = 7) Repeat exercise: twice weekly for 6 weeks	Received no intervention (n = 7)	Measured at baseline and at 6-, 9-, 15-, and 18-week follow-up Arm function: the action research arm test and the 9-hole peg test Electroencephalography Recording	Arm function: no significant difference between groups Electroencephalography recording: no significant difference between groups
Grau-Sanchez et al. (17)	N = 39; age range: 54–92	The regular therapy and extra sessions to play a keyboard and an electronic drum set (n = 20) Repeat exercise: 20 individual sessions, 30 min each, 5 sessions/week for 4 weeks	Extra time for exercises for the upper extremity based on the regular therapy (n = 20)	Measured at baseline, after the intervention, and at a 3-month follow-up Functional movements: the action research arm test Motor outcomes: FMA and grip strength Fine dexterity: the 9-hole peg test and BBT Activities of daily living: CAHAI Working memory and attention: the digit span subtest from the Wechsler Adult Intelligence Scale III, response inhibition by the Stroop task and processing speed and mental flexibility by the trail-making test Verbal memory: RAVLT and the story recall from the Rivermead behavioral memory test Mood outcomes: the Profile of Mood States, the Beck Depression Inventory Scale, the Positive and Negative Affect Scale, and the Apathy Evaluation Scale. QoL outcomes: the Stroke-Specific QoL Scale and health-related QoL with the health survey questionnaire SF36.	Functional movements: significantly improved functional performance score in the MST group compared with CT group (mean ± SD, standard treatment with exercise, 9.8 ± 7.9, vs. exercise, 6.7 ± 7.9; p < 0.001) Motor outcomes: no significant difference between groups Fine dexterity: no significant difference between groups Activities of daily living: no significant difference between groups The cognitive outcomes: no significant difference between groups QoL outcomes: significantly improved in the MST group from baseline to posttreatment compared with CT group (MST group of t(18) = −2.23, p < 0.05, d = 0.54 vs. CT group of no improvements) Mood outcomes: no significant differences between groups in the change scores
Jun et al. (18)	N = 30; age range: 54–93	Received music and movement therapy (n = 15). Repeat exercise: 1 h/session, 3 times/week for 8 weeks	Received routine care (n = 15)	Measured at baseline and at 8-week follow-up Physical functions: range of joint motion Muscle strength: Medical Research Council scale Activities of daily living: K-MBI Mood state: the Korean version of the Profile of Mood States Brief instrument Depression: CES-D	Physical functions: no significant difference between groups Muscle strength: no significant difference between groups Activities of daily living: no significant difference between groups Mood state: the score of experimental group members improved when compared with that of the control group (t = 1.818, p = 0.040) Depression: no significant difference between groups
Van Vugt et al. (19)	N = 34; age range: 30–75	Received its sounds after a random delay sampled from a flat distribution between 100 and 600 ms when the patients play the piano (n = 19) Repeat exercise: 10 sessions of half an hour	Received the its sounds immediately when the patients play the piano (n = 15)	Measured at baseline, after the intervention Fine motor control: the 9-hole peg test Finger tapping measurements: a triaxial accelerometer (ADXL 335) Mood measurements: POMS	Fine motor control: significantly improved fine motor score in the jitter group compared with normal group (mean ± SD, the average improvement of jitter group, 14 ± 53.6 vs. normal, 3.8 ± 17.9; p < 0.001) Tapping speed: no significant difference between groups Tapping variability: no significant difference between groups Mood measurements: no significant difference between groups
Fotakopoulos and Kotlia (20)	N = 65; age range: 71–79	A music group (MG) (daily listening to experiential/traditional music) Repeat exercise: 6 months at a frequency of four training sessions/week, of 45 min each session	A control group (CG) with no experiential/traditional music therapy (standard care only)	Measured at baseline, after the intervention Cognitive deficits: mMt Performance in activities of daily living: BI CT perfusion: CBF	Cognitive deficits: significantly improved cognitive score in the recovery group compared with no-recovery group (mean ± SD, the recovery group, 26.38 ± 1 vs. no-recovery group, 24.33 ± 2; p < 0.001) Performance in activities of daily living: significantly improved ADL score in the recovery group compared with no-recovery group (mean ± SD, the recovery group, 81.92 ± 2 vs. no-recovery group, 76.53 ± 7; p = 0.007) CT perfusion: significantly improved in CBF in affected area in the recovery group compared with no-recovery group (mean ± SD, the recovery group, 29.16 ± 4 vs. no-recovery group, 12.27 ± 11; p < 0.001)
Bunketorp-Käll et al. (21)	N = 123; age range: 56–70.4	Rhythm-and-music therapy (n =41 ) Horse-riding therapy (n = 41) Repeat exercise: 2 times a week for 12 weeks	Control group continue with their regular activities and usual care such as outpatient physiotherapy, occupational therapy, or speech therapy (n = 41)	Outcome measures were reported at 0 and 6 months postintervention Hand strength: Grippit	Hand strength: significant differences in the mean changes in right-sided maximum and left-sided final grip force Rhythm-and-music group significantly improved their right-sided maximum grip force(16.41 [95% CI, 5.65–27.17]) and left-sided final grip force (17.26 [95% CI, 6.19–28.33]) compared with controls (−1.29 [95% CI, −7.99 to 5.41]) (0.55 [95% CI, −7.07 to 8.17]; p = 0.015 and 0.042, respectively); The left-sided improvements were sustained at the 6-month follow-up (p = 0.011).
Tong et al. (12)	N = 33; age range: 34–64.9	Audible music group (MG) includes conventional rehabilitation treatments and extra sessions of audible musical instrument training (n = 15) Repeat exercise: 20 extra sessions over 4 weeks	Mute music group (CG) includes conventional rehabilitation treatments and extra sessions of “mute” musical instrument training (n = 18) Repeat exercise: 20 extra sessions over 4 weeks	Measured at baseline, after the intervention Motor function: WMFT, FMA	Motor functions of upper limbs: significant improvements Significant differences in the WMFT were found between the two groups (WMFT-quality: p = 0.025; WMFT-time: p = 0.037) but not in the FMA (p = 0.448). Subjects in MG demonstrated greater improvement than those in CG.
Schneider et al. (22)	N = 77; age range: 41.2–68	Music-supported therapy in addition to conventional therapy (n = 32). Repeat exercise: 30 min each unit in duration, totally 27.4 units, over 3 weeks	Conventional treatment only (n = 30), Without specific additional selection criteria (n = 15) standard therapies (physical therapy and individual occupational therapy) 30 min each unit in duration. TG: 28.0 units over 3 weeks CG: 27.2 units over 3 weeks	Measured at baseline, 3-week intervention Motor functions: BBT, the 9-hole peg test, action research arm test, arm paresis score Motor test/parameter: frequency (FREQ), Number of inversions of velocity profiles, Average maximum angular velocity in °/s	BBT, the 9-hole peg test, action research arm test, and arm paresis score: significant improvements in groups TG and MG. Conventional physiotherapy in CG did not produce an improvement, differences between MG, CG, and TG were highly significant, F(2, 66) = 6.66, p = 0.002. BBT: MG increased the number of cubes grasped by around 10/min. Differences between MG, CG, and TG were highly significant, F(2, 74) = 57.08, p < 0.001. FREQ: Increase in MG but not TG and CG
Fujioka et al. (23)	N = 29; age range: 54.3–64.2	Music-supported therapy used an electronic keyboard and a series of eight electronic drum pads (n = 14). Repeat exercise: 30 h of training over 10 weeks	Conventional physical training (n = 14) Repeat exercise: 30 h of training over 10 weeks	Measured at baseline, after 5 weeks, after 10 weeks, and 3 months after training completion. Arm and hand subsections of the CMSA Impairment Inventory, action research arm test, BBT	CMSA: Both showed only minor changes over the time course of treatment, hand score was improved at the post 2 time point compared with pre [t(27) = −2.27, p = 0.031]. A tendency for such improvement was found for the MST group [t(13) = −1.88, p = 0.082]. The improvement in the GRASP group was not significant. Action research arm test: in the MST group, the decrease between pre and post 2 time points approached significance [t(13) = 2.10, p = 0.056]. BBT: not to analyze, as eight participants were unable to perform the test at any time point using their affected hand.
Bunketorp-Käll et al. (24)	N = 123; age range: 56–70.4	Rhythm-and-music therapy (n = 41) Horse-riding therapy (n = 41) Repeat exercise: 2 times a week for 12 weeks.	Control group continue with their regular activities and usual care such as outpatient physiotherapy, occupational therapy, or speech therapy (n = 41).	Measured at baseline, after the intervention Motor function: Modified Motor Assessment Scale.	Modified Motor Assessment Scale: The MST group did not produce any immediate gains. 6 months 31 post-intervention, the MST group performed better with respect to time; −0.75 s [95% CI, −1.36 to −0.14]; (p = 0.035)

It-NIHSS, the National Institutes of Health Stroke Scale; FIM, the Functional Independence Measure; HADS, the Hospital Anxiety and Depression Scale; MQOL-It, the Italian version of McGill Quality-of-Life Questionnaire; TUG, the Timed Up and Go Test; MTRS, the Music Therapy Rating Scale; mMt, the mini mental test; BI, the Barthel Index; CBF, cerebral blood flow; CMSA, the Chedoke–McMaster Stroke; CAHAI, the Chedoke Arm and Hand Activity Inventory; RAVLT, the Rey auditory verbal learning test; K-MBI, Korean-modified Barthel index; CES-D, The Center for Epidemiologic Studies Depression Scale; POMS, the Profile of Mood States; WMFT, Wolf motor function test; FMA, Fugl–Meyer assessment; BBT, Box and Block test.