Greener J, Enderby P, Whurr R
Health Services Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, UK, AB25 2ZD.
Cochrane Database Syst Rev. 2000(2):CD000425. doi: 10.1002/14651858.CD000425.
Aphasia describes language impairment associated with a brain lesion.
The objective of this review was to assess the effects of formal speech and language therapy and non-professional types of support from untrained providers for people with aphasia after stroke.
We searched the Cochrane Stroke Group Trials Register (last searched: March 1999), and reference lists of relevant articles to December 1998. We also contacted academic institutions and other researchers to identify further published and unpublished trials. We searched The International Journal of Disorders of Communication by hand (known by other names in the past), from 1969 to 1998. Date of most recent searches: January 1999.
Randomised controlled trials comparing: 1. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus no treatment. 2. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus any type of informal support for aphasia, given by speech and language therapists or volunteers, whether these were trained or untrained. 3. One type of speech and language therapy versus another type. Outcome measures included measures of any type of communication, other measures of functioning, numbers of drop-outs, and other non-clinical outcomes.
The principal reviewer collected the data, and assessed the quality of the trials with independent data checking and methodological advice. If we could not perform a statistical combination of different studies, we sought missing data. Failing that we provided a description.
We considered sixty studies in detail, from which we identified twelve trials suitable for the review. Most of these trials were relatively old with poor or unassessable methodological quality. None of the trials was detailed enough for us to complete description and analysis. We could not determine whether formal speech and language therapy is more effective than informal support.
REVIEWER'S CONCLUSIONS: The main conclusion of this review is that speech and language therapy treatment for people with aphasia after a stroke has not been shown either to be clearly effective or clearly ineffective within a RCT. Decisions about the management of patients must therefore be based on other forms of evidence. Further research is required to find out if effectiveness of speech and language therapy for aphasic patients is effective. If researchers choose to do a trial, this must be large enough to have adequate statistical power, and be clearly reported.
失语症是指与脑损伤相关的语言障碍。
本综述的目的是评估正规言语和语言治疗以及未经培训的提供者提供的非专业支持方式对中风后失语症患者的影响。
我们检索了Cochrane中风组试验注册库（最后检索时间：1999年3月）以及截至1998年12月的相关文章的参考文献列表。我们还联系了学术机构和其他研究人员以确定更多已发表和未发表的试验。我们手工检索了《国际交流障碍杂志》（过去曾用其他名称），检索时间为1969年至1998年。最近一次检索日期：1999年1月。
随机对照试验比较：1. 由受过培训的言语和语言治疗师在任何环境中实施的任何类型的正规言语和语言治疗与不治疗。2. 由受过培训的言语和语言治疗师在任何环境中实施的任何类型的正规言语和语言治疗与言语和语言治疗师或志愿者提供的任何类型的失语症非正规支持，无论这些人员是否受过培训。3. 一种言语和语言治疗与另一种言语和语言治疗。结局指标包括任何类型的沟通测量、其他功能测量、退出人数以及其他非临床结局。
主要综述作者收集数据，并通过独立的数据核对和方法学建议评估试验质量。如果我们无法对不同研究进行统计合并，我们会寻找缺失数据。若无法找到，则提供描述。
我们详细考虑了60项研究，从中确定了12项适合本综述的试验。这些试验大多较为陈旧，方法学质量较差或无法评估。没有一项试验详细到足以让我们完成描述和分析。我们无法确定正规言语和语言治疗是否比非正规支持更有效。
本综述的主要结论是，在随机对照试验中，尚未表明中风后失语症患者的言语和语言治疗明显有效或明显无效。因此，关于患者管理的决策必须基于其他形式的证据。需要进一步研究以确定言语和语言治疗对失语症患者是否有效。如果研究人员选择进行试验，试验规模必须足够大以具备足够的统计效力，并且报告要清晰。
