Motor speech interventions for cerebral palsy (Korkalainen et al., 2023)

Purpose: Dysarthria is common among children with cerebral palsy (CP) and results in poor speech intelligibility and subsequently low communicative participation. Neuroplasticity evidence suggests that adherence to principles of motor learning (PML) improves motor speech intervention outcomes. Motor speech interventions aim to improve speech intelligibility and ultimately facilitate participation, but the effectiveness of these interventions and their inclusion of PML are not clear. Aims are as follows: (a) evaluate the effectiveness motor speech interventions in improving speech intelligibility; (b) summarize the aims, outcome measures, and outcomes relating to the International Classification of Functioning and Disability Child and Youth; and (c) summarize the principles of motor learning used in the intervention.
Method: Eight databases were searched, complemented by a hand search. Studies of any level of evidence were included if they used a motor speech intervention and measured speech in children with CP aged 0–18 years. Studies before 2000 or not in English were excluded. The review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was rated using the Single Case Experimental Design Scale and Physiotherapy Evidence Database-P rating scales. The strength of evidence was evaluated with Grading of Recommendations, Assessment, Development and Evaluation.
Results: Of 1,036 initial articles, 21 were included. Eight interventions were identified including 131 participants aged 3–18 years. All studies aimed to improve speech intelligibility or articulation and reported improvement at sound, word, or sentence level. One study reported improvements in communicative participation. The strength of evidence ranged from very low to moderate for one intervention. Adherence to PML was inconsistent.
Conclusions: The quality of evidence is very low to moderate. More research on motor speech interventions that adhere to principles of motor learning is required.
Supplemental Material S1. PML used in the analysis. 
Supplemental Material S2. Benefits of principles of motor learning in motor speech interventions for children with CAS and upper limb motor interventions for children with CP.
Korkalainen, J., McCabe, P., Smidt, A., & Morgan, C. (2023). Motor speech interventions for children with cerebral palsy: A systematic review. Journal of Speech, Language, and Hearing Research, 66(1), 110–125. https://doi.org/10.1044/2022_JSLHR-22-00375

目的：脑瘫（CP）儿童中运动性构音障碍（Dysarthria）较为常见，导致言语清晰度下降，进而影响沟通参与度。神经可塑性研究表明，遵循运动学习原则（PML）可改善运动言语干预效果。运动言语干预旨在提高言语清晰度，最终促进参与，但其干预效果及其对运动学习原则的包含尚不明确。研究目标如下：（a）评估运动言语干预在提高言语清晰度方面的有效性；（b）总结与儿童和青少年功能残疾国际分类（ICF-CY）相关的目标、结果衡量指标和结果；（c）总结干预中使用的运动学习原则。方法：检索了八个数据库，并辅以手工检索。纳入了使用运动言语干预并测量0-18岁CP儿童言语的任何级别证据的研究。排除2000年之前或非英文的研究。根据系统评价和荟萃分析优先报告项目（PRISMA）指南进行并报告了该综述。使用单一案例实验设计量表和物理治疗证据数据库（PEDro）评级量表对研究质量进行评级。使用推荐评估、发展和评价分级（GRADE）系统评估证据强度。结果：在1036篇初始文章中，有21篇被纳入。确定了包括131名3-18岁参与者的8项干预措施。所有研究均旨在提高言语清晰度或发音，并在声音、单词或句子级别报告了改善。一项研究报告了沟通参与度的改善。一项干预措施的证据强度从非常低到中等不等。对PML的遵循不一致。结论：证据质量非常低至中等。需要更多研究，以探讨遵循运动学习原则的运动言语干预。补充材料S1：分析中使用的PML。补充材料S2：运动学习原则在儿童运动言语干预中的益处，以及儿童脑瘫上肢运动干预的益处。Korkalainen, J., McCabe, P., Smidt, A., & Morgan, C. (2023). 脑瘫儿童的运动言语干预：系统评价。言语、语言和听力研究杂志，66(1)，110–125. https://doi.org/10.1044/2022_JSLHR-22-00375