College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
College of Rehabilitation, Weifang Medical University, Weifang, Shandong, China.
Medicine (Baltimore). 2024 May 24;103(21):e38255. doi: 10.1097/MD.0000000000038255.
Although several rehabilitation interventions are effective in post-stroke aphasia (PSA), the efficacy of different rehabilitation interventions compared to each other remains controversial. Here, we aimed to compare the effectiveness of varying rehabilitation interventions in PSA.
Randomized controlled trials on 8 kinds of rehabilitation interventions to improve speech function in patients with PSA were searched by computer from 10 databases, including PubMed, Web of Science, Cochrane, OVID, CINAHL, Embase, CNKI, WanFang, CBM, and VIP. The search scope was from the establishment of the database to August 2023. The literature screening, extraction of basic information, and quality assessment of the literature were conducted independently by 2 researchers. Network meta-analysis (NMA) was performed using Stata 17.0 software.
Fifty-four studies involving 2688 patients with PSA were included. The results of NMA showed that: ① in terms of improving the severity of aphasia, the therapeutic effects of repetitive transcranial magnetic stimulation were the most significant; ② motor imagery therapy was the most effective in improving spontaneous speech, repetition, and naming ability; ③ in terms of improving listening comprehension ability, the therapeutic effects of mirror neuron therapy was the most significant.
The 8 rehabilitation interventions have different focuses in improving the speech function of PSA patients, and the clinical therapists can select the optimal rehabilitation interventions in a targeted manner according to the results of this NMA and the patients' conditions and other relevant factors.
尽管有几种康复干预措施对中风后失语症(PSA)有效,但不同康复干预措施之间的疗效比较仍存在争议。在此,我们旨在比较 PSA 患者不同康复干预措施的有效性。
通过计算机从 10 个数据库(包括 PubMed、Web of Science、Cochrane、OVID、CINAHL、Embase、CNKI、WanFang、CBM 和 VIP)中搜索了 8 种改善 PSA 患者言语功能的康复干预措施的随机对照试验。检索范围为从数据库建立到 2023 年 8 月。由 2 名研究人员独立进行文献筛选、基本信息提取和文献质量评估。使用 Stata 17.0 软件进行网络荟萃分析(NMA)。
纳入 54 项研究,共 2688 例 PSA 患者。NMA 的结果表明:①在改善失语症严重程度方面,重复经颅磁刺激治疗效果最显著;②运动想象疗法在改善自发性言语、重复和命名能力方面最有效;③在改善听力理解能力方面,镜像神经元疗法治疗效果最显著。
8 种康复干预措施在改善 PSA 患者的言语功能方面各有侧重,临床治疗师可根据本次 NMA 结果及患者病情等相关因素有针对性地选择最佳的康复干预措施。