Abstract
Objectives. The study aims to conduct a meta-analysis on the existence of solid experimental evidence to highlight the effectiveness of interventions in the improvement of speech disorders in patients who have suffered a stroke. It is desired to identify those moderating variables that can influence the effectiveness of these interventions over time, or that demonstrate the extent to which chronicity of stroke may lead to inferior results in speech improvement. Materials and methods. A search was conducted in three databases: Cochrane Library, Web of Science and PubMed, to identify those studies that meet the criterion for intervention, starting with the first records and until now. The qualitative analysis of the studies was performed using Risk of Bias, and the quantitative analysis through Comprehensive Meta-Analysis. Results. As a result of selection, 31 randomized clinical studies were included in the current research, out of the 1923 existing studies. These have been the subject of investigation on aphasia and dysphagia, with a wide range of types and methods of intervention. The results show that the difference in averages between the intervention group and the post-test control group is a significant one (g = 0.528; 95% CI 0.067; 0.004; p = 0.000), while the moderation analysis did not record a statistical significance. Conclusions. Non-pharmacological interventions based on the recovery of speech disorders as a result of stroke have been shown to be effective in many of the researches in specialized literature. Their results show that, as a result of therapies, patients experience improvements in quality of life, communication and many psychiatric disorders. However, it is not clear how effective these interventions are in recovering or ameliorating speech disorders.
Highlights
In addition to the medical act itself, post-stroke recovery is achieved following a diagnosis and evaluation process that refers to: identifying the patient’s needs, setting clear, realistic and achievable intervention goals, the actual intervention to achieve the objectives as well as evaluating and recording the patient’s progress
Studies that met the following conditions were included: they had a randomized experimental design (RCT); they have clearly delimited the target population from other types of population; they reported the result obtained on patients after the intervention; instruments of objective measurement of the results of the intervention to have been applied to the participants in the study; existence of a control group; speech disorder to be secondary to stroke; age of patients over 18 years; minimum number of 4 participants in each group
The results measured in patients with poststroke speech disorders regard speech recovery, improved quality of life related to communication, speech function, argument structure of sentences, and dysphagia and increased capacity and safety of swallowing
Summary
In addition to the medical act itself, post-stroke recovery is achieved following a diagnosis and evaluation process that refers to: identifying the patient’s needs, setting clear, realistic and achievable intervention goals, the actual intervention to achieve the objectives as well as evaluating and recording the patient’s progress. Some systematic researches reveals that no treatment with a higher effectiveness than another [2] has been identified, needed to investigate treatments so that they can be objectively evaluated, on clear criteria, to use the benefits of these therapies. Research with positive results in patient symptoms brings strong arguments for multidisciplinary interventions, but with certain limitations in terms of the application of interventions using technology, without additional support from qualified staff in medical and speech therapy recovery. The treatment of dysphagia includes both compensatory and rehabilitative approaches
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