運動性言語障礙治療的近期研究趨勢

運動性言語障礙（motor speech disorders, MSD）療法的實證研究日新月異。近年來新科技的發展興起了臨床療法的另類關注。本報告概述自2016年以來針對後天性成人吶語症及言語失用症（apraxia of speech, AOS）的溝通障礙治療方法之驗證，並分析目前治療的新趨勢與臨床效應。研究納入的文獻取自三個電子數據庫（PubMed、EBSCOhost Web、Google Scholar），搜尋與MSD有關的所有研究為分析焦點。再將研究對象限定為後天性成人吶語症及AOS，以治療方法為研究主題，且於2016年～2021年6月間發表之文獻過濾後，共43篇納入本研究進行統整與分析。目前大多數與吶語症治療相關的研究以Parkinson's disease引起的運動不及型吶語症為主，最常被討論的治療技術為Lee Silverman Voice Treatment（LSVT LOUD），而新近越來越多有關磁電儀器的介入也廣為應用在神經性損傷後有溝通障礙患者的治療，並與傳統的行為治療結合，如：經顱直流電刺激術（transcranial direct current stimulation）、重覆經顱磁刺激（repetitive transcranial magnetic stimulation）等。不論是吶語症或是AOS的治療皆可見與磁電刺激有關的研究，並呈現出一定的治療效果，臨床語言治療師在具備專業的技能時，也必須瞭解與認知如何與這些新興輔助的治療方式共存甚至達到互利，進而加惠於MSD的患者。

關鍵字

運動性言語障礙；言語治療；吶語症；言語失用症；系統性回顧

並列摘要

More research has been studied naval and new treatments of motor speech disorders, but lack of the systematic reports related to the effects of therapeutic treatments. This review paper provided an overview of the treatments and treatment effects along with the treatment trends in acquired dysarthria and apraxia of speech (AOS). Literature search was conducted using three electronic databases (PubMed, EBSCOhost Web, Google Scholar). The articles were screened and selected with the criteria of having adult study participants, treatment intervention, and within 2016-June, 2021. There were 43 qualified research articles being included in this review. The results were analyzed, discussed, and sorted according to types of the disorders, etiology, treatments, and results of the studies. In recent literature, the treatment interventions were more likely implemented on the hypokinetic dysarthria related to Parkinson's disease, often seen in using behavioral therapies, e.g., Lee Silverman Voice Treatment (LSVT LOUD). Electrotherapy stimulation and/or on-line computer-based program have become a new and growing trend in combination with traditional practice, such as transcranial direct current stimulation, repetitive transcranial magnetic stimulation. Applying advanced technical treatments for both dysarthria and AOS have been supported positive effects in clinical practice. These techniques improve the outcomes by traditional treatment remedies and could serve as a complementary therapy in conjunction with behavioral therapy. Further, it provides more evidence-based treatment options for consideration of clinical practice which in turn would benefit healthcare outcomes for patients with motor speech disorders.

並列關鍵字

Motor speech disorders ； Speech therapy ； Dysarthria ； Apraxia of speech ； Systematic review

參考文獻

Yuan, F., Guo, X., Wei, X., Xie, F., Zheng, J., Huang, Y., ... Wang, Q. (2020). Lee Silverman Voice Treatment for dysarthria in patients with Parkinson’s disease: A systematic review and meta-analysis. European Journal of Neurology, 27, 1957-1970. doi:10.1111/ene.14399

Zhao, Y., Kuruvilla-Dugdale, M., & Song, M. (2020). Voice conversion for Persons with amyotrophic lateral sclerosis. IEEE Journal of Biomedical and Health Informatics, 24, 2942-2949. doi:10.1109/JBHI.2019.2961844

Azekawa, M., & Lagasse, A. B. (2018). Singing exercises for speech and vocal abilities in individuals with hypokinetic dysarthria: A feasibility study. Music Therapy Perspectives, 36, 40-49. doi:10.1093/mtp/miw042

Ballard, K. J., Etter, N. M., Shen, S., Monroe, P., & Tien Tan, C. (2019). Feasibility of automatic speech recognition for providing feedback during tablet-based treatment for apraxia of speech plus aphasia. American Journal of Speech-Language Pathology, 28, 818-834. doi:10.1044/2018_AJSLP-MSC18-18-0109

Basilakos, A. (2018). Contemporary approaches to the management of post-stroke apraxia of speech. Seminars in Speech and Language, 39, 25-36. doi:10.1055/s-0037-1608853

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運動性言語障礙治療的近期研究趨勢

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