Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 4:12:700115.
doi: 10.3389/fneur.2021.700115. eCollection 2021.

Melodic Intonation Therapy for Post-stroke Non-fluent Aphasia: Systematic Review and Meta-Analysis

Ana Haro-Martínez  1 , Carmen M Pérez-Araujo  2 , Juan M Sanchez-Caro  3 , Blanca Fuentes  3 , Exuperio Díez-Tejedor  3
Affiliations

Melodic Intonation Therapy for Post-stroke Non-fluent Aphasia: Systematic Review and Meta-Analysis

Ana Haro-Martínez et al. Front Neurol. .

Abstract

Introduction: Melodic intonation therapy (MIT) is one of the most studied speech and language therapy (SLT) approaches for patients with non-fluent aphasia, although the methodological quality of the studies has been rated as low in previous reviews. The aim of this study is to update current evidence on the possible efficacy of MIT for the treatment of non-fluent post-stroke aphasia. Methods: A systematic review and meta-analysis. We selected randomized clinical trials (RCT) that included adult patients over 18 years of age with non-fluent post-stroke aphasia, whose intervention was MIT vs. no therapy or other therapy. We excluded non-RCT studies, mixed populations including patients with aphasia of non-stroke etiology, studies with no availability of post-stroke aphasia-specific data, and incomplete studies. Three sections of communicative ability were analyzed as outcomes: functional communication, expressive language (naming and repetition), and comprehension. Results: We identified a total of four eligible RCTs involving 94 patients. Despite the heterogeneity in the psychometric tests employed among the trials, a significant effect of MIT on functional communication (evaluated by the Communication Activity Log) was found (SMD 1.47; 95% CI 0.39-2.56). In addition, a positive effect of MIT on expressive language (repetition) was found (SMD 0.45; 95% CI 0.01-0.90). No significant effects on comprehension measurements were found, despite a lack of significant statistical heterogeneity. Conclusion: This systematic review and meta-analysis shows a significant effect of MIT on improving functional communication and on repetition tasks. Future larger RCT specifically addressing those outcomes should provide the definite evidence on the efficacy of MIT on post-stroke aphasia recovery. Systematic Review Registration:PROSPERO-URL https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020144604.

Keywords: melodic intonation therapy; meta-analysis; post-stroke aphasia; speech and language therapy; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the selection of eligible studies.
Figure 2
Figure 2
Forest plot of the effect of MIT on functional communication.
Figure 3
Figure 3
Forest plot of the effect of MIT on expressive language. (A) Naming; (B) Repetition.
Figure 4
Figure 4
Forest plot of the effect of MIT on comprehension.
See this image and copyright information in PMC

References

    1. Flowers HL, Skoretz SA, Silver FL, Rochon E, Fang J, Flamand-Roze C, et al. . Poststroke aphasia frequency, recovery, and outcomes: a systematic review and meta-analysis. Arch Phys Med Rehabil. (2016) 97:2188–201. 10.1016/j.apmr.2016.03.006 - DOI - PubMed
    1. Lindsay P, Furie KL, Davis SM, Donnan G a, Norrving B. World stroke organization global stroke services guidelines and action plan. Int J Stroke. (2014) 9:4–13. 10.1111/ijs.12371 - DOI - PubMed
    1. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. . AHA/ASA Guideline for adult stroke rehabilitation and recovery. Stroke. (2016) 47:e98–e169. 10.1161/STR.0000000000000098 - DOI - PubMed
    1. Hebert D, Lindsay MP, McIntyre A, Kirton A, Rumney PG, Bagg S, et al. . Canadian stroke best practice recommendations: stroke rehabilitation practice guidelines, update 2015. Int J Stroke. (2016) 11:459–84. 10.1177/1747493016643553 - DOI - PubMed
    1. Brady M, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. (2016) 2016:CD000425. 10.1002/14651858.CD000425.pub4 - DOI - PMC - PubMed

Publication types

LinkOut - more resources