旋律語調治療法對中風合併非流暢型失語症患者語言能力之成效

Effects of Melodic Intonation Therapy on Language Ability in Post-Stroke Patients with Non-Fluent Aphasia

10.6320/FJM.202409_28(5).0002

張佑瑄(Yu-Hsuan Chang)；蘇雅珍(Ya-Zhen Su)；林巧敏(Chiao-Min Lin)；郭雅雯(Ya-Wen Kuo)；蘇清菁(Ching-Ching Su)

中風 ； 失語症 ； 旋律語調治療法 ； 語言能力 ； stroke ； aphasia ； melodic intonation therapy ； language ability

台灣醫學

28卷5期（2024 / 09 / 25）

514 - 526

繁體中文;英文

失語是中風後常見的症狀，當患者面對無法表達的情況時，容易產生負面情緒，而過去有研究指出透過旋律語調治療法，可改善非流暢型失語症患者之語言能力。以系統性文獻回顧方式，探討旋律語調治療法，對中風合併非流暢型失語症患者語言能力之成效。運用關鍵字搭配自然語言及Mesh term，於5個資料庫搜尋2024年5月前中英文資料庫，共發現163篇，經排除重複、納入及排除條件篩選後，最終納入8篇符合文章主題之文獻，並以CASP隨機對照試驗評讀工具，與Oxford CEBM檢測文章品質及證據等級。結果納入8篇文獻皆顯示，實驗組接受旋律語調治療法後，對於中風合併非流利失語症患者的語言能力有顯著療效，4篇文獻顯示實驗組在複誦項目分數均高於對照組；3篇文獻顯示聽覺理解能力、自發性言語平均分數均高於對照組；4篇文獻顯示實驗組在命名項目分數均高於對照組。結論為運用MIT可改善中風後非流暢型失語患者之語言能力，未來建議可根據中風患者個別屬性，設計適用於台灣中風患者的歌曲旋律，以促進語言能力之恢復。

Aphasia is a common symptom of stroke. When patients unable to express themselves may be prone to negative emotions. Previous studies have shown that melodic intonation therapy (MIT) can improve language abilities in patients with non-fluent aphasia. We used a systematic literature review to explore the effectiveness of MIT on the language abilities of post-stroke patients with non-fluent aphasia. We used keywords with natural language and medical subject heading (MeSH) terms to search five Chinese and English databases for studies published before March 2024. A total of 163 articles were obtained. After filtering to exclude duplicates and narrowing of search results using inclusion and exclusion conditions, eight articles that met our study theme were selected, and the Critical Appraisal Skills Programme (CASP) randomized controlled trial review tool and the Oxford Centre for Evidence-Based Medicine (CEBM) resource were used to detect the quality and evidence level of each article. In all eight studies, the experimental group received MIT, which was shown to have significant effects on language abilities in stroke patients with non-fluent aphasia. Four studies found that the scores of the experimental group on recitation items were higher than for the control group, three studies showed that the average scores of comprehension ability and spontaneous speech were higher than for the control group, and four studies showed that the scores of the experimental group on naming items were higher than for the control group. MIT can improve language abilities of post-stroke patients with non-fluent aphasia. In future, we recommend that song melodies suitable for stroke patients in Taiwan be designed based on the individual attributes of stroke patients to promote recovery of language ability.