University of Canterbury/Otago, Christchurch, New Zealand.
New Zealand Brain Research Institute, Christchurch.
Am J Speech Lang Pathol. 2024 Mar 7;33(2):1069-1097. doi: 10.1044/2023_AJSLP-23-00274. Epub 2024 Jan 17.
This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals with dysarthria due to neurodegenerative disease.
Multiple electronic database searches and hand searches of prominent speech-language pathology journals were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards.
The search yielded 1,525 articles, from which 88 met inclusion criteria and were reviewed by two blinded co-investigators. A large range of therapeutic approaches have been added to the evidence base since the last review, including expiratory muscle strength training, singing, and computer- and device-driven programs, as well as a variety of treatment modalities, including teletherapy. Evidence for treatment in several different population groups-including cerebellar ataxia, myotonic dystrophy, autosomal recessive spastic ataxia of Charlevoix-Saguenay, Huntington's disease, multiple system atrophy, and Lewy body dementia-were added to the current review. Synthesis of evidence quality provided strong evidence in support of only one behavioral intervention: Lee Silverman Voice Treatment Program (LSVT LOUD) in people with Parkinson's disease. No other treatment approach or population included in this review demonstrated more than limited evidence, reflecting that these approaches/populations require urgent further examination.
Suggestions about where future research efforts could be significantly strengthened and how clinicians can apply research findings to their practice are provided.
这篇系统综述是对之前针对神经退行性疾病导致构音障碍者呼吸/发声功能障碍的行为管理的文献综述的更新。
根据系统评价和荟萃分析的首选报告项目标准，对多个电子数据库和著名言语病理学杂志进行了手工检索。
搜索结果产生了 1525 篇文章，其中 88 篇符合纳入标准，并由两名盲法共同研究者进行了审查。自上次综述以来，证据基础中增加了大量治疗方法，包括呼气肌力量训练、唱歌和计算机及设备驱动程序，以及各种治疗方式，包括远程治疗。当前综述增加了几个不同人群的治疗证据，包括小脑共济失调、肌强直性营养不良、常染色体隐性痉挛性共济失调、亨廷顿病、多系统萎缩和路易体痴呆。对证据质量的综合分析仅为一种行为干预提供了强有力的证据支持：帕金森病患者的 Lee Silverman 语音治疗计划（LSVT LOUD）。本综述中包含的其他治疗方法或人群没有超过有限的证据，这反映出这些方法/人群需要进一步紧急检查。
提供了有关未来研究工作可以在哪里得到显著加强以及临床医生如何将研究结果应用于实践的建议。
