Speech rehabilitation in dysarthria after stroke, a systematic review of the studies

Introduction: Speech difficulties such as dysarthria or aphasia are frequently seen, in addition to motor impairments, in subjects after stroke.

Evidence acquisition: 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 (C. R. and V. M.) from 15 December 2019 to 15 January 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 logopaedic 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 analysed 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.

Evidence synthesis: 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.

Conclusions: 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.