CoChat
Sign Up
Cited by 111Voice and Speech DisordersDysphagia Assessment and ManagementNeurobiology of Language and Bilingualism

Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury

Open access
Mitchell, Claire, Bowen, Audrey, Tyson, Sarah, Butterfint, Zoe, Conroy, Paul·2017·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd002088.pub3PMC PMC6464736
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Dysarthria is an acquired speech disorder following neurological injury that reduces intelligibility of speech due to weak, imprecise, slow and/or unco-ordinated muscle control. The impact of dysarthria goes beyond communication and affects psychosocial functioning. This is an update of a review previously published in 2005. The scope has been broadened to include additional interventions, and the title amended accordingly. OBJECTIVES: To assess the effects of interventions to improve dysarthric speech following stroke and other non-progressive adult-acquired brain injury such as trauma, infection, tumour and surgery. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (May 2016), CENTRAL (Cochrane Library 2016, Issue 4), MEDLINE, Embase, and CINAHL on 6 May 2016. We also searched Linguistics and Language Behavioral Abstracts (LLBA) (1976 to November 2016) and PsycINFO (1800 to September 2016). To identify further published, unpublished and ongoing trials, we searched major trials registers: WHO ICTRP, the ISRCTN registry, and ClinicalTrials.gov. We also handsearched the reference lists of relevant articles and contacted academic institutions and other researchers regarding other published, unpublished or ongoing trials. We did not impose any language restrictions. SELECTION CRITERIA: We selected randomised controlled trials (RCTs) comparing dysarthria interventions with 1) no intervention, 2) another intervention for dysarthria (this intervention may differ in methodology, timing of delivery, duration, frequency or theory), or 3) an attention control. DATA COLLECTION AND ANALYSIS: Three review authors selected trials for inclusion, extracted data, and assessed risk of bias. We attempted to contact study authors for clarification and missing data as required. We calculated standardised mean difference (SMD) and 95% confidence interval (CI), using a random-effects model, and performed sensitivity analyses to assess the influence of methodological quality. We planned to conduct subgroup analyses for underlying clinical conditions. MAIN RESULTS: We included five small trials that randomised a total of 234 participants. Two studies were assessed as low risk of bias; none of the included studies were adequately powered. Two studies used an attention control and three studies compared to an alternative intervention, which in all cases was one intervention versus usual care intervention. The searches we carried out did not find any trials comparing an intervention with no intervention. The searches did not find any trials of an intervention that compared variations in timing, dose, or intensity of treatment using the same intervention. Four studies included only people with stroke; one included mostly people with stroke, but also those with brain injury. Three studies delivered interventions in the first few months after stroke; two recruited people with chronic dysarthria. Three studies evaluated behavioural interventions, one investigated acupuncture and another transcranial magnetic stimulation. One study included people with dysarthria within a broader trial of people with impaired communication.Our primary analysis of a persisting (three to nine months post-intervention) effect at the activity level of measurement found no evidence in favour of dysarthria intervention compared with any control (SMD 0.18, 95% CI -0.18 to 0.55; 3 trials, 116 participants, GRADE: low quality, I² = 0%). Findings from sensitivity analysis of studies at low risk of bias were similar, with a slightly wider confidence interval and low heterogeneity (SMD 0.21, 95% CI -0.30 to 0.73, I² = 32%; 2 trials, 92 participants, GRADE: low quality). Subgroup analysis results for stroke were similar to the primary analysis because few non-stroke participants had been recruited to trials (SMD 0.16, 95% CI -0.23 to 0.54, I² = 0%; 3 trials, 106 participants, GRADE: low quality).Similar results emerged from most of the secondary analyses. There was no evidence of a persisting effect at the impairment (SMD 0.07, 95% CI -0.91 to 1.06, I² = 70%; 2 trials, 56 participants, GRADE: very low quality) or participation level (SMD -0.11, 95% CI -0.56 to 0.33, I² = 0%; 2 trials, 79 participants, GRADE: low quality) but substantial heterogeneity on the former. Analyses of immediate post-intervention outcomes provided no evidence of any short-term benefit on activity (SMD 0.29, 95% CI -0.07 to 0.66, I² = 0%; 3 trials, 117 participants, GRADE: very low quality); or participation (SMD -0.24, 95% CI -0.94 to 0.45; 1 study, 32 participants) levels of measurement.There was a statistically significant effect favouring intervention at the immediate, impairment level of measurement (SMD 0.47, 95% CI 0.02 to 0.92, P = 0.04, I² = 0%; 4 trials, 99 participants, GRADE: very low quality) but only one of these four trials had a low risk of bias. AUTHORS' CONCLUSIONS: We found no definitive, adequately powered RCTs of interventions for people with

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd002088.pub3

Cites

69 of 69 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Previous small-sample studies have suggested potential benefits of digital speech therapy for individuals with poststroke dysarthria in the chronic phase.

    “Previous small-sample studies have suggested potential benefits of digital speech therapy for individuals with poststroke dysarthria in the chronic phase [17-19].”

    From Efficacy of Digital Speech Therapy for Poststroke Dysarthria: Randomized Noninferiority Trial (2026) · cites this paper as [17]

    The Main results section reports small trials, including two that recruited people with chronic dysarthria. The Characteristics of ongoing studies section describes an online poststroke dysarthria therapy, ReaDySpeech, but reports a planned feasibility trial and proof of deliverability—not evidence of therapeutic benefit. The review therefore does not support the claim that previous small studies suggested benefits of digital therapy specifically in the chronic poststroke phase. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Fukusako 1989 {published data only} Fukusako Y, Endo K, Konno K, Hasegawa K, Tatsumi IF, Masaki S. Changes in the speech of spastic dysarthric patients after treatment based on perceptual analysis. Annual Bulletin of the Research Institute of Logopedics and Phoniatrics 1989;23:119-40. [3226358]
  2. Qinglan 2002 {published data only} Qinglan Y, Zhiwei H, Feng L, Qingjuan Y, Shan G, Junrong H. Treatment of pseudobulbar paralysis with acupuncture and sublingual blood-letting. International Journal of Clinical Acupuncture 2002;13(4):251-4. [3226384
  3. trial.ti. 34. (assign$ or allocat$).tw. 35. controls.tw. 36. 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 37. 9 and 22 and 36 58 Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury (Review) 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Cited by

Sorted by citations

Related

Authors
Mitchell, C., Bowen, A., Tyson, S., Butterfint, Z., & Conroy, P.
Affiliations
  • Manchester Academic Health Science Centre (GB)
  • University of Manchester (GB)
  • University of East Anglia (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2017-01-25
Volume
2017
Issue
1
Pages
CD002088-CD002088
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd002088.pub3
PMC
PMC6464736
OpenAlex
W2581309910
Cited by
111
References
69
Citations by year
2026: 5 · 2025: 7 · 2024: 10 · 2023: 21 · 2022: 16 · 2021: 23 · 2020: 10 · 2019: 8 · 2018: 8 · 2017: 3
FWCI
0.97
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
Funders
National Institute for Health and Care Research (DRF-2014-07-043)
Topics
  • Health Sciences › Medicine › Physiology › Voice and Speech Disorders
  • Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
Keywords
dysarthria, stroke, speech therapy intervention, speech intelligibility, traumatic brain injury, intervention effectiveness, risk of bias, psychosocial functioning, communication disorders, speech motor control, usual care comparison
MeSH terms
Adult, Aged, Dysarthria, Humans, Language Therapy, Middle Aged, Speech Therapy, Randomized Controlled Trials as Topic, Brain Injury, Chronic, Stroke

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review