A systematic review of group intervention for acquired dysarthria in adults

Purpose: This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing. 

Materials and methods: A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University’s Critical Review Form, and the TIDieR template for intervention description and replication. 

Results: 21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson’s disease (PD) (97%; n = 321). Treatment approaches included singing therapy (n = 10), loudness therapy (n = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) (n = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches. 

Conclusion: There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.

IMPLICATIONS FOR REHABILITATION Group therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson’s disease. Studies’ employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures. Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD. PROSPERO registration number: CRD42015029374.