A systematic review of melodic intonation therapy used by speech therapists on speech recovery for patients with non-fluent aphasia
Main Article Content
Abstract
Background: Many studies have reported positive results regarding the benefits of melodic intonation therapy (MIT) in patients with non-fluent aphasia. Currently, there is no specific inclusion of speech therapists (STs) in MIT research. Investigating effective speech therapy (ST) techniques to address the language functions hindered by non-fluent aphasia could yield evidence for aphasia rehabilitation research.
Objective: This systematic review (SR) examines the effectiveness of the traditional MIT protocol used by STs on speech recovery for patients with non-fluent aphasia after stroke. It also discusses other characteristics of the traditional MIT, such as the participants, the MIT protocol applied, the therapy intensity, and the role of STs.
Materials and methods: This SR followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 statement. The four computerized databases (PubMed, Embase, ICTRP, and Google Scholar) were searched in February 2024 to review all empirical findings. We also conducted a hand search in relevant journals. The search yielded 538 studies, of which 2 met the criteria and underwent review. The methodological quality of the included studies was evaluated using the Cochrane Collaboration’s tool for assessing the risk of bias. Furthermore, the protocol was registered in PROSPERO under the reference CRD42024508733.
Results: This review included 2 randomized controlled trials (RCTs) involving 44 patients. We found evidence that MIT significantly improved speech recovery, precise language repetition, and functional communication in patients with non-fluent aphasia. STs were interventionists in MIT research and used MIT following the American manual, and they had previously received MIT training.
Conclusion: Our review provides some evidence of the effectiveness of MIT on speech recovery in patients with non-fluent aphasia after stroke. MIT may be a practical alternative to standard ST. There is some indication that MIT requires music therapy (MT) skills and training; therefore, STs must also have these abilities.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
Benson DF, Ardila A. Aphasia: A clinical perspective. Oxford University Press, USA; 1996.
Engelter ST, Gostynski M, Papa S, Frei M, Born C, Ajdacic-Gross V, Gutzwiller F, Lyrer PA. Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke. 2006; 37(6): 1379-84. doi: 10.1161/01.STR. 0000221815.64093.8c
Laska AC, Hellblom A, Murray V, Kahan T, Von Arbin M. Aphasia in acute stroke and relation to outcome. J Intern Med. 2001; 249(5): 413-22. doi: 10.1046/ j.1365-2796.2001.00812.x
National Institute on Deafness and Other Communication Disorders. NIDCD fact sheet: Aphasia. 2015 [cited 2024 Apr 26]. Available from: https://www. nidcd.nih. gov/sites/default/files/Documents/health/voice/ Aphasia.pdf.
Acharya AB, Wroten M. Broca Aphasia. 2023 [Updated 2023 Feb 13; cited 2024 Apr 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih. gov/books/NBK436010/
Kernich CA. MSN, RN. Aphasia. The Neurologist. 2004; 10(3): 169-70. doi: 10.1097/01.nrl.00001265 91.23625.6e
Van der Meulen I, van de Sandt-Koenderman WM, Heijenbrok-Kal MH, Visch-Brink EG, Ribbers GM. The efficacy and timing of melodic intonation therapy in subacute aphasia. Neurorehabil Neural Repair. 2014; 28(6): 536-44. doi: 10.1177/1545968313517753
Van Der Meulen I, De Sandt-Koenderman V, Mieke WM, Heijenbrok MH, Visch-Brink E, Ribbers GM. Melodic intonation therapy in chronic aphasia: Evidence from a pilot randomized controlled trial. Front Hum Neurosci. 2016; 10: 221011. doi: 10.3389/ fnhum.2016.00533
Haro-Martínez AM, Lubrini G, Madero-Jarabo R, Díez-Tejedor E, Fuentes B. Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial. Clin Rehabil. 2019; 33(1): 44-53. doi: 10.1177/ 0269215518791004
van de Sandt-Koenderman MW, Mendez Orellana CP, van der Meulen I, Smits M, Ribbers GM. Language lateralisation after melodic intonation therapy: an fMRI study in subacute and chronic aphasia. Aphasiology. 2018; 32(7): 765-83. doi: 10.1080/0268 7038.2016.1240353
Haro-Martínez AM, García-Concejero VE, LópezRamos A, Maté-Arribas E, López-Táppero J, Lubrini G, Díez-Tejedor E, Fuentes B. Adaptation of melodic intonation therapy to Spanish: a feasibility pilot study. Aphasiology. 2017; 31(11): 1333-43. doi: 10.1 080/02687038.2017.1279731
Tabei KI, Satoh M, Nakano C, Ito A, Shimoji Y, Kida H, Sakuma H, Tomimoto H. Improved neural processing efficiency in a chronic aphasia patient following melodic intonation therapy: A neuropsychological and functional MRI study. Front Neurol. 2016; 7: 148. doi: 10.3389/fneur.2016.00148
Albert ML, Sparks RW, Helm NA. Melodic intonation therapy for aphasia. Arch Neurol. 1973; 29(2): 130-1. doi:10.1001/archneur.1973.00490260074018
Zumbansen A, Peretz I, Hébert S. Melodic intonation therapy: back to basics for future research. Front Neurol. 2014; 5: 7. doi: 10.3389/fneur.2014.00007
Helm-Estabrooks N. Exploiting the right hemisphere for language rehabilitation: Melodic Intonation Therapy. In: Perecman E, ed. Cognitive Processing in the Right Hemisphere. New York, NY: Academic Press; 1983: 229-240.
Schlaug G, Marchina S, Norton A. Evidence for plasticity in white-matter tracts of patients with chronic Broca’s aphasia undergoing intense intonationbased speech therapy. Ann N Y Acad Sci. 2009; 1169: 385-94. doi: 10.1111/j.1749-6632.2009.04587.x
Schlaug G, Norton A, Marchina S, Zipse L, Wan CY. From singing to speaking: facilitating recovery from nonfluent aphasia. Future Neurol. 2010; 5(5): 657- 65. doi: 10.2217/fnl.10.44
Zipse L, Norton A, Marchina S, Schlaug G. Singing versus speaking in nonfluent aphasia. NeuroImage. 2009; 47: S119. doi: 10.1016/S1053-8119(09)71121-8.
Mata HL. A systematic review of melodic intonation therapy that involved music therapists (Doctoral dissertation).
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71. doi: 10.1136/ bmj.n71
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011; 343: d5928. doi: 10.1136/bmj.d5928
Plukwongchuen T, Klubchai P, Punchasuwan P, Uma M, Kanlaya S. Effect of Melodic Intonation Therapy on Scoring of Spontaneous Speech, Repetition and Naming in Thai Non-fluent Aphasic Patient. Poster session presented at Annual academic conference 32nd “Healthcare in a Changing World”, 2016 April 3-5; Songkla, Thailand.
El Hachioui H, Lingsma H, Van de Sandt-Koenderman WME, Dippel D, Koudstaal P, Visch-Brink EG. Recovery from aphasia after stroke: a one year follow-up study. J Neurol. 2013; 260: 166-71. doi: 10.1007/s00415- 012-6607-2
Bakheit A, Shaw S, Carrington S, Griffiths S. The rate and extent of improvement with therapy from different types of aphasia in the first year after stroke. Clin Rehabil. 2007; 21: 941-9. doi: 10.1177/02 69215507078452
Hojo K, Watanabe S, Tasaki H, Sato T, Metoki H, Saito M. [Recovery in aphasia (Part 1)]. No To Shinkei. 1985; 37(8): 791-7. Japanese. PMID: 4074584.
Van Lancker Sidtis D, Postman WA. Formulaic expressions in spontaneous speech of left‐and right‐ hemisphere‐damaged subjects. Aphasiology. 2006 May 1; 20(5): 411-26. doi: 10.1080/0268703050053 8148
Meinzer M, Flaisch T, Breitenstein C, Wienbruch C, Elbert T, Rockstroh B. Functional re-recruitment of dysfunctional brain areas predicts language recovery in chronic aphasia. Neuroimage. 2008; 39(4): 2038- 46. doi: 10.1016/j.neuroimage.2007.10.008
Lum CC, Ellis AW. Is "nonpropositional" speech preserved in aphasia?. Brain and Lang
Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev; 2016; 6: CD00 0425.
doi: 10.1002/14651858.CD000425.pub4