Music and Stroke Rehabilitation: A Narrative Synthesis of the Music-Based Treatments used to Rehabilitate Disorders of Speech and Language following Left-Hemispheric Stroke

摘要

Stroke is a leading cause of long-term disability. A stroke can damage areas of the brain associated with communication, resulting in speech and language disorders. Such disorders are frequently acquired impairments from left-hemispheric stroke. Music-based treatments have been implemented, and researched in practice, for the past thirty years; however, the number of published reports reviewing these treatments is limited. This paper uses the four elements of the narrative synthesis framework to investigate, scrutinise and synthesise music-based treatments used in the rehabilitation of patients with speech and language disorders. A systematic review revealed that fifteen studies meet the inclusion criteria set out. It was found that the music-based treatments utilised included: Melodic Intonation Therapy (MIT), Modified Melodic Intonation Therapy (MMIT), adapted forms of MIT, the Singing Intonation, Prosody, breathing (German: Atmung), Rhythm and Improvisation (SIPARI) method and a variety of methods using singing and songs. From a synthesis of the data, three themes emerged which were key elements of the interventions; they were: (a) singing songs and vocal exercises, (b) stimulating the right hemisphere and (c) use of speech prosody. These themes are discussed and implications for newly-qualified practitioners are explored.