Browsing by Subject "puheen kuntoutus"

Already a long ago some patients suffering from nonfluent aphasia, having lost their ability to speak complitely or partly, have been noticed to be able to sing words and phrases. Various singing-based speech rehabilitation methods have been developed since then, melodic intonation therapy (MIT) being probably the most well known of them. MIT is an intensive rehabilitation method that consists of several elements: simple melodic intonation that follows the prosody of a normal speech, rhythmic syllables, left hand tapping and multiple repetitions. The aim of this review was to present literature concerning the effectiveness of MIT, and the behavioral and neural mechanisms behind it. Some evidence has been found of the effectiveness of MIT both in the acute phase of the disorder and in the sub-acute and chronic phases. In several studies MIT has been compared with regular speech therapy. However, only preliminary conclusion should be made based on these studies, since they often lacked adaquate control and had too small sample sizes. Also, there is no full consensus concerning the bahavioral mechanisms that make MIT effective. Some studies suggest that it is the rhythmic component that makes the method work. On the other hand, in some studies the melodic intonation in itself has been said to play a crucial role. Results from brain imaging studies suggest that the way in which MIT helps in the speech rehabilitation is that it activates the right hemisphare through singing. This was also the initial idea of the inventors of MIT. At least some aphasia patients having gone through MIT have showed increased activity in the right hemisphere, especially in the sub-acute phase, as well as anatomical changes in the right subcortical areas in association with the rehabilitation. For patients whose left hemisphere language areas are complitely distroyed, MIT may be an especially effective treatment method for language rehabilitation.