神经肌肉电刺激治疗发音障碍和构音障碍:系统综述

Franziska Schreiber, Nayara de Lima Froio, R. Coll-Fernández, Fernanda Queiroz Petrus, Bethânia Soares dos Santos, Angélica Flores Flores, L. M. Morales Ojeda, Laura De Leon Benedetti, Vinicius Trindade, Mustafa Reha Dodurgali, Claudia Renata Dos Santos Barros, Bianca Barros Parron Fernandes, Christiany M. Tapia Argudo, Cristina Stephan, F. Buffone
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摘要

引言:患有构音障碍、发音困难等言语障碍的人难以产生言语,这通常与言语肌肉功能障碍有关。神经肌肉电刺激(NMES)可以激活运动单位,改善其向性和功能。因此,本系统综述旨在评估NMES对构音障碍和发音困难患者的发声、语音质量、可懂度、言语肌肉力量和生活质量的影响。方法:根据系统评价和荟萃分析指南的首选报告项目进行系统评价。2022年9月,我们在EMBASE、Pub-Med和Cochrane数据库中搜索了评估NMES对构音障碍和发音困难影响的研究。搜索策略包括随机对照试验、观察性研究、病例系列和病例报告。使用ROBINS-I工具评估每项研究中的偏倚风险。结果:本综述包括四项设计为低偏倚风险的病例研究或非随机试验的研究。NMES对构音障碍和/或发音困难患者的音质和发声有积极影响。报告的改善包括负责喉部抬高的肌肉功能恢复,声音呼吸和紧张程度降低,以及关节功能增强。讨论:NMES似乎是一种很有前途的语言障碍患者康复工具。应该进行随机临床试验来确认这些益处。
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Neuromuscular Electrical Stimulation for Dysphonia and Dysarthria: A Systematic Review
Introduction: People with speech disorders such as dysarthria and dysphonia have difficulty producing speech, which is often related to speech muscle dysfunction. Neuromuscular electrical stimulation (NMES) can activate motor units and improve their tropism and functionality. Therefore, this systematic review aimed to evaluate the effects of NMES on the phonation, voice quality, intelligibility, speech muscle strength, and quality of life of patients with dysarthria and dysphonia. Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In September 2022, we searched the EMBASE, Pub-Med, and Cochrane databases for studies that evaluated the effect of NMES on dysarthria and dysphonia. Randomized controlled trials, observational studies, case series, and case reports were included in the search strategy. The risk of bias in each study was assessed using the ROBINS-I tool. Results: This review included four studies designed as case studies or non-randomized trials with a low risk of bias. NMES showed a positive effect on voice quality and phonation in patients with dysarthria and/or dysphonia. Reported improvements included restored function of the muscles responsible for laryngeal elevation, a reduction in voice breathiness and strain, and enhanced articulation. Discussion: NMES seems to be a promising tool for the rehabilitation of patients with speech disorders. Randomized clinical trials should be conducted to confirm these benefits.
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