Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.
Clin Rehabil. 2021 May;35(5):639-655. doi: 10.1177/0269215520976267. Epub 2020 Nov 24.
To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease.
Systematic review and meta-analysis of randomized controlled trials.
We performed a literature search of randomized controlled trials using PubMed, Web of Science, Science Direct and Cochrane database (last search October 2020). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. The data were pooled and a meta-analysis was completed for sound pressure levels, perceptual intelligibility and inflection of voice fundamental frequency.
We selected 15 high to moderate quality studies, which included 619 patients with Parkinson's disease. After pooling the data, 7 studies, which compared different speech language therapies to no treatment, control groups and 3 of their variables, (sound pressure level, semitone standard deviation and perceptual intelligibility) were included in the analysis.Results showed significant differences in favor of SLT for sound pressure level sustained phonation tasks (standard mean difference = 1.79; 95% confidence interval = 0.86, 2.72; ⩽ 0.0001). Significant results were also observed for sound pressure level and semitone standard deviation in reading tasks (standard mean difference = 1.32; 95% confidence interval = 1.03, 1.61; ⩽ 0.0001). Additionally, sound pressure levels in monologue tasks showed similar results when SLT was compared to other treatments (standard mean difference = 0.87; 95% confidence interval = 0.46, 1.28; ⩽ 0.0001).
This meta-analysis suggests a beneficial effect of SLT for reducing Hypokinetic Dysarthria in Parkinson's disease, improving perceptual intelligibility, sound pressure level and semitone standard deviation.
评估言语语言治疗（SLT）对帕金森病运动障碍性构音障碍（HD）的疗效。
随机对照试验的系统评价和荟萃分析。
我们使用 PubMed、Web of Science、Science Direct 和 Cochrane 数据库（最后一次搜索时间为 2020 年 10 月）进行了随机对照试验的文献检索。使用 Downs 和 Black 量表以及 Cochrane 工具评估质量和偏倚风险。对数据进行合并，并对声压级、感知可懂度和基频语调进行荟萃分析。
我们选择了 15 项高质量到中等质量的研究，其中包括 619 名帕金森病患者。对数据进行合并后，纳入了 7 项研究，这些研究比较了不同的言语语言治疗与无治疗、对照组以及其中 3 个变量（声压级、半音标准差和感知可懂度）的差异。结果显示，在持续发音任务的声压级（标准均数差 = 1.79；95%置信区间 = 0.86，2.72； ⩽ 0.0001）方面，SLT 有显著优势。在阅读任务的声压级和半音标准差方面也观察到了显著结果（标准均数差 = 1.32；95%置信区间 = 1.03，1.61； ⩽ 0.0001）。此外，在与其他治疗方法比较时，SLT 对独白任务的声压级也有类似的效果（标准均数差 = 0.87；95%置信区间 = 0.46，1.28； ⩽ 0.0001）。
这项荟萃分析表明，SLT 对降低帕金森病运动障碍性构音障碍、提高感知可懂度、声压级和半音标准差有有益作用。
