Effects of Five-Element Music on Post-stroke depression: A Systematic Review and Meta-Analysis

Purpose: To assess the effectiveness of Five-Element Music in patients with post-stroke depression (PSD). Methods: The Cochrane Library, PubMed, EMBASE, Web of Science, and 4 Chinese databases were electronically searched for articles published from inception to January 31, 2020. Randomized controlled trials (RCTs) investigating the effects of Five-Element Music on PSD were included. The quality of all included trials was assessed according to guidelines published by the Cochrane Collaboration. Review Manager (Rev Man)5.2 was employed to examine the pooled effect of Five-Element Music for PSD compared with control therapy. Results: Finally, 17 randomized controlled trials were included, and 1492 patients with PSD met the inclusion criteria. There are 4 papers with scientific design and high evaluation quality. Meta-analysis demonstrated that on the basis of routine treatment, patients in the Five-Element Music intervention group experienced a significantly higher treatment effect than controls [OR=4.11,95%CI (2.32,7.27)]. The difference is statistically significant (P<0.05). The treatment group was better than the control group in terms of reducing 17 and 24 scores of Hamilton Depression Scale (HAMD), SDS score, degree of neurological deficit (MESSS) score, Barthel Index (BI) score of self-care ability and 5-hydroxytryptamine(5-HT).(all P < 0.05). Conclusion: This Meta-analysis provides evidence supporting the viewpoint that Five-Element Music is an effective and safe treatment for PSD. Analysis further revealed that Five-Element Music resulted in better outcomes than drug alone therapy in improving depressive symptoms. Further high-quality RCTs are needed to systematically evaluate the effectiveness of Five-Element Music for PSD and develop standardized Five-Element Music protocols.