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Three Part Question

In [adults with dysarthria with non-progressive neurological conditions], are [non-speech oro-motor exercises] effective in [increasing intelligibility of speech]?

Clinical Scenario

A 72 year old man is admitted to the Stroke Unit following collapse and a suspected CVA. He presents with dysarthria and a CT scan confirms an acute stroke. You wonder whether oro-motor exercises will help to improve the intelligibility of his speech.

Search Strategy

The Cochrane database was searched using the term ‘dysarthria’.

Medline was then searched for articles subsequent to the identified Cochrane review, from 2002-week 17/10/2011 using the OVID interface.
Search terms used were: (oral motor OR oro-motor OR oro-facial) AND exercises AND (speech OR dysarthria) NOT child*

Search Outcome

On the Cochrane database, 8 papers were found of which one was relevant.

On Medline, 7 papers were found of which 6 were irrelevant. One systematic review was excluded as it contained no relevant studies subsequent to the Cochrane review.

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Sellars et al (2002) UK	No studies met stated criteria for inclusion.	Cochrane review	Not applicable	Not applicable	Not applicable

Comment(s)

Few studies have been completed into the benefits of oro-motor exercises for dysarthria. Those that are published report variable outcomes but all have considerable methodological limitations, such as small sample size. Further good quality research is required in this area.

Clinical Bottom Line

There is insufficient evidence to support or refute the use of oro-motor exercises, to increase the intelligibility of speech, in dysarthria due to non-progressive neurological conditions.

References

1. Sellars, C., Hughes, T. and Langhorne, P. Speech and langauge therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review Clinical Rehabilitation 2002; 61-67