わが国における言語聴覚療法のエビデンス—システマティックレビューによる検討—記憶障害に対する言語聴覚療法のエビデンス

A systematic review on the effectiveness of speech-language therapy for memory disorders in Japan

【目的】わが国の記憶障害に対する言語聴覚療法のエビデンスを系統的に調べるため，質的システマティックレビューを実施した．

【方法】適格基準を設定し，検索語を明確にして文献を検索・選択し，1次・2次スクリーニングを実施した．選択した各文献について品質の吟味を行い，データの統合と分析によりエビデンスを評価した．

【結果】ランダム化比較試験（以下，RCT）はなく，非RCTは1件，単一事例研究11件，症例対照研究1件であった．効果量を算出できた6件については記憶障害に言語聴覚療法を実施したことで効果がある可能性を示した結果であった．

【考察】わが国の記憶障害を対象とした言語聴覚療法における効果を検討した研究は少なく，RCTのようなエビデンスレベルの高い研究は今回の検索条件では存在せず，単一事例研究が大半であった．また，訓練法による差を直接検討した研究は存在しなかった．今回の検討では，前後比較による効果検証が多かったことから，わが国の記憶障害に対する言語聴覚療法のエビデンスを量的に検討するには，さらなる研究が必要と考えられた．

　Objective：A qualitative systematic review was conducted to systematically investigate the evidence for the effectiveness of speech-language therapy in memory disorders in Japan.

　Methods：Eligibility criteria were established, search terms were defined, and a literature search and selection were conducted, followed by primary and secondary screenings. The quality of each selected study was assessed, and evidence was evaluated through data synthesis and analysis.

　Results：No randomized controlled trials (RCTs) were found, but 1 nonrandomized controlled trial, 11 single-case studies, and 1 case-control study were identified. There were 6 studies for which effect sizes could be calculated and they suggested the possibility of a positive effect of speech-language therapy on memory disorders.

　Discussion：Few studies have examined the effects of speech-language therapy on memory disorders in Japan, and no high-level evidence studies, such as RCTs, were found under the search conditions. Most of the studies were single-case studies, and no studies directly examined differences between therapy methods. The review indicated that most of the evidence was based on pre-post comparisons, suggesting the need for further research to quantitatively assess the evidence for speech-language therapy in memory disorders in Japan.