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Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data

Melodic Intonation Therapy (MIT) is a prominent rehabilitation program for individuals with post‐stroke aphasia. Our meta‐analysis investigated the efficacy of MIT while considering quality of outcomes, experimental design, influence of spontaneous recovery, MIT protocol variant, and level of genera...

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Autores principales: Popescu, Tudor, Stahl, Benjamin, Wiernik, Brenton M., Haiduk, Felix, Zemanek, Michaela, Helm, Hannah, Matzinger, Theresa, Beisteiner, Roland, Fitch, W. Tecumseh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804200/
https://www.ncbi.nlm.nih.gov/pubmed/35918503
http://dx.doi.org/10.1111/nyas.14848
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author Popescu, Tudor
Stahl, Benjamin
Wiernik, Brenton M.
Haiduk, Felix
Zemanek, Michaela
Helm, Hannah
Matzinger, Theresa
Beisteiner, Roland
Fitch, W. Tecumseh
author_facet Popescu, Tudor
Stahl, Benjamin
Wiernik, Brenton M.
Haiduk, Felix
Zemanek, Michaela
Helm, Hannah
Matzinger, Theresa
Beisteiner, Roland
Fitch, W. Tecumseh
author_sort Popescu, Tudor
collection PubMed
description Melodic Intonation Therapy (MIT) is a prominent rehabilitation program for individuals with post‐stroke aphasia. Our meta‐analysis investigated the efficacy of MIT while considering quality of outcomes, experimental design, influence of spontaneous recovery, MIT protocol variant, and level of generalization. Extensive literature search identified 606 studies in major databases and trial registers; of those, 22 studies—overall 129 participants—met all eligibility criteria. Multi‐level mixed‐ and random‐effects models served to separately meta‐analyze randomized controlled trial (RCT) and non‐RCT data. RCT evidence on validated outcomes revealed a small‐to‐moderate standardized effect in noncommunicative language expression for MIT—with substantial uncertainty. Unvalidated outcomes attenuated MIT's effect size compared to validated tests. MIT's effect size was 5.7 times larger for non‐RCT data compared to RCT data (g̅(case report) = 2.01 vs. g̅(RCT) = 0.35 for validated Non‐Communicative Language Expression measures). Effect size for non‐RCT data decreased with number of months post‐stroke, suggesting confound through spontaneous recovery. Deviation from the original MIT protocol did not systematically alter benefit from treatment. Progress on validated tests arose mainly from gains in repetition tasks rather than other domains of verbal expression, such as everyday communication ability. Our results confirm the promising role of MIT in improving trained and untrained performance on unvalidated outcomes, alongside validated repetition tasks, and highlight possible limitations in promoting everyday communication ability.
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spelling pubmed-98042002023-01-03 Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data Popescu, Tudor Stahl, Benjamin Wiernik, Brenton M. Haiduk, Felix Zemanek, Michaela Helm, Hannah Matzinger, Theresa Beisteiner, Roland Fitch, W. Tecumseh Ann N Y Acad Sci Reviews Melodic Intonation Therapy (MIT) is a prominent rehabilitation program for individuals with post‐stroke aphasia. Our meta‐analysis investigated the efficacy of MIT while considering quality of outcomes, experimental design, influence of spontaneous recovery, MIT protocol variant, and level of generalization. Extensive literature search identified 606 studies in major databases and trial registers; of those, 22 studies—overall 129 participants—met all eligibility criteria. Multi‐level mixed‐ and random‐effects models served to separately meta‐analyze randomized controlled trial (RCT) and non‐RCT data. RCT evidence on validated outcomes revealed a small‐to‐moderate standardized effect in noncommunicative language expression for MIT—with substantial uncertainty. Unvalidated outcomes attenuated MIT's effect size compared to validated tests. MIT's effect size was 5.7 times larger for non‐RCT data compared to RCT data (g̅(case report) = 2.01 vs. g̅(RCT) = 0.35 for validated Non‐Communicative Language Expression measures). Effect size for non‐RCT data decreased with number of months post‐stroke, suggesting confound through spontaneous recovery. Deviation from the original MIT protocol did not systematically alter benefit from treatment. Progress on validated tests arose mainly from gains in repetition tasks rather than other domains of verbal expression, such as everyday communication ability. Our results confirm the promising role of MIT in improving trained and untrained performance on unvalidated outcomes, alongside validated repetition tasks, and highlight possible limitations in promoting everyday communication ability. John Wiley and Sons Inc. 2022-08-02 2022-10 /pmc/articles/PMC9804200/ /pubmed/35918503 http://dx.doi.org/10.1111/nyas.14848 Text en © 2022 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Reviews
Popescu, Tudor
Stahl, Benjamin
Wiernik, Brenton M.
Haiduk, Felix
Zemanek, Michaela
Helm, Hannah
Matzinger, Theresa
Beisteiner, Roland
Fitch, W. Tecumseh
Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title_full Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title_fullStr Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title_full_unstemmed Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title_short Melodic Intonation Therapy for aphasia: A multi‐level meta‐analysis of randomized controlled trials and individual participant data
title_sort melodic intonation therapy for aphasia: a multi‐level meta‐analysis of randomized controlled trials and individual participant data
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804200/
https://www.ncbi.nlm.nih.gov/pubmed/35918503
http://dx.doi.org/10.1111/nyas.14848
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