Reconsidering music in stroke rehabilitation: a scoping review from auditory stimulus to relational process.

Introduction: Over the past three decades, music has been increasingly incorporated into stroke motor rehabilitation; however, the term Methods: This scoping review examined how music and sound have been conceptualized and applied in stroke motor rehabilitation research published between 1993 and 2023. Ninety-seven studies were identified through major databases. Data were extracted on definitions of music and sound, auditory stimulus characteristics, delivery methods, and provider expertise, followed by numerical and thematic analyses. Results: Substantial heterogeneity was found in how musical elements and auditory designs were reported, with many studies lacking essential information on stimulus structure. Comparative analysis identified three overarching approaches: (1) stimulus-based methods targeting movement timing, (2) task-based methods involving rhythmic or instrumental performance, and (3) process-based methods emphasizing relational and interactive engagement. These approaches were positioned along a continuum ranging from mechanically oriented to relationship-centered interventions. Discussion: The findings highlight persistent conceptual ambiguity between music and sound and underscore the need for clearer and more systematic reporting of musical parameters. Conceptualizing music as a multidimensional therapeutic component may support stronger integration of neuroscientific and clinical perspectives when explaining mechanisms of stroke motor recovery.