Ballard Kirrie J, Wambaugh Julie L, Duffy Joseph R, Layfield Claire, Maas Edwin, Mauszycki Shannon, McNeil Malcolm R
Am J Speech Lang Pathol. 2015 May 1;24(2):316-337. doi: 10.1044/2015_AJSLP-14-0118.
The aim was for the appointed committee of the Academy of Neurological Communication Disorders and Sciences to conduct a systematic review of published intervention studies of acquired apraxia of speech (AOS), updating the previous committee's review article from 2006.
A systematic search of 11 databases identified 215 articles, with 26 meeting inclusion criteria of (a) stating intention to measure effects of treatment on AOS and (b) data representing treatment effects for at least 1 individual stated to have AOS.
All studies involved within-participant experimental designs, with sample sizes of 1 to 44 (median = 1). Confidence in diagnosis was rated high to reasonable in 18 of 26 studies. Most studies (24/26) reported on articulatory-kinematic approaches; 2 applied rhythm/rate control methods. Six studies had sufficient experimental control for Class III rating according to the Clinical Practice Guidelines Process Manual (American Academy of Neurology, 2011), with 15 others satisfying all criteria for Class III except use of independent or objective outcome measurement.
The most important global clinical conclusion from this review is that the weight of evidence supports a strong effect for both articulatory-kinematic and rate/rhythm approaches to AOS treatment. The quantity of work, experimental rigor, and reporting of diagnostic criteria continue to improve and strengthen confidence in the corpus of research.
神经交流障碍与科学学会指定的委员会旨在对已发表的获得性言语失用症(AOS)干预研究进行系统综述,更新该委员会2006年的综述文章。
对11个数据库进行系统检索,共识别出215篇文章,其中26篇符合纳入标准:(a)表明有意测量治疗对AOS的效果;(b)数据代表至少1名确诊为AOS患者的治疗效果。
所有研究均采用受试者内实验设计,样本量为1至44(中位数 = 1)。26项研究中有18项对诊断的信心评级为高到合理。大多数研究(24/26)报告了发音运动学方法;2项采用了节奏/速率控制方法。根据《临床实践指南流程手册》(美国神经病学学会,2011年),6项研究具有足够的实验对照,可评为III级,另有15项除未使用独立或客观的结局测量外,满足III级的所有标准。
本次综述最重要的总体临床结论是,证据权重支持发音运动学方法和速率/节奏方法对AOS治疗均有显著效果。研究工作的数量、实验严谨性以及诊断标准的报告都在不断改进,增强了对研究总体的信心。