Chiaramonte Rita, Pavone Piero, Vecchio Michele
Department of Physical Medicine and Rehabilitation, ASP 7, Scicli Hospital, Ragusa, Italy -
Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy -
Eur J Phys Rehabil Med. 2020 Oct;56(5):547-562. doi: 10.23736/S1973-9087.20.06185-7. Epub 2020 May 19.
Speech difficulties such as dysarthria or aphasia are frequently seen, in addition to motor impairments, in subjects after stroke.
Literature searches with the keywords: "stroke" AND "dysarthria" AND "speech therapy" OR "language therapy" were conducted in PubMed, EMBASE, Cochrane Library and Web of Science to perform the systematic review about the several strategies used to treat dysarthria in subjects after stroke. The search was performed independently by two authors (CR and VM) from December 15 2019 to January 15 2020, using the PICOS criteria: participants were aging adults (>18 years old) affected by stroke; intervention was based on rehabilitation speech therapy; comparator was any comparator (all logopedic and speech rehabilitation tools); outcomes included clinical assessments, diagnostic scales and acoustic analysis of voice; and study design was RCTs, case series and case report, observational studies. The research identified a total of 94 articles for the first search and 56 for the second search. Sixty selected articles were analyzed by the reviewers. Twenty-five publications met the inclusion criteria and were included in the systematic review. Thirty-three articles were excluded for the following reasons: 12 involved individuals with aphasia or other speech problems different from dysarthria, 10 examined the clinical features of dysarthria, 3 treated on the impact of dysarthria on social participation following stroke, 8 did not include cases after stroke.
A systematic review was performed to identify the main used speech rehabilitation treatments for dysarthria after stroke. We defined the several techniques to better guide the physician to delineate a speech rehabilitation protocol adopting the better strategies described in the current literature.
This systematic review tried to provide to the reader a complete overview of the literature of all possible different speech treatments for dysarthria after stroke. A correct protocol could permit to improve the communication and the quality of life of these subjects.
除运动障碍外，构音障碍或失语等言语困难在中风后的患者中也很常见。
在PubMed、EMBASE、Cochrane图书馆和科学网中使用关键词“中风”、“构音障碍”、“言语治疗”或“语言治疗”进行文献检索，以对用于治疗中风后患者构音障碍的几种策略进行系统评价。检索由两位作者（CR和VM）于2019年12月15日至2020年1月15日独立进行，采用PICOS标准：参与者为中风后的成年患者（>18岁）；干预基于康复言语治疗；对照为任何对照（所有言语治疗和言语康复工具）；结局包括临床评估、诊断量表和嗓音声学分析；研究设计为随机对照试验、病例系列和病例报告、观察性研究。首次检索共识别出94篇文章，第二次检索识别出56篇文章。评审人员分析了60篇选定的文章。25篇出版物符合纳入标准并被纳入系统评价。33篇文章因以下原因被排除：12篇涉及失语或其他与构音障碍不同的言语问题的个体，10篇研究了构音障碍的临床特征，3篇探讨了构音障碍对中风后社会参与的影响，8篇未纳入中风后病例。
进行了一项系统评价，以确定中风后构音障碍主要使用的言语康复治疗方法。我们定义了几种技术，以更好地指导医生制定言语康复方案，采用当前文献中描述的更好策略。
本系统评价试图为读者提供中风后构音障碍所有可能不同言语治疗的文献综述。正确的方案可以改善这些患者的沟通能力和生活质量。
