Relative qualities of telerehabilitation compared to traditional in-person speech and language treatment for individuals with aphasia: A meta-analysis.

Abstract

Background: Stroke is a leading cause of disability and one of the primary causes of death worldwide. Stroke survivors often experience a range of symptoms, including impaired motor function, speech and language abnormalities, swallowing difficulties, cognitive deficits, visual disturbances, and sensory impairments.

Objectives: This meta-analysis was conducted to assess and compare the relative effectiveness of telerehabilitation compared to traditional in-person speech and language therapy for individuals with aphasia.

Material and methods: A comprehensive literature search was conducted up to October 2024, reviewing 1,185 identified studies. Ultimately, 6 studies were selected that included a total of 168 participants with aphasia at baseline. The meta-analysis examined the relative effectiveness of telerehabilitation compared to traditional in-person speech and language therapy using continuous outcomes, with mean differences (MD) and 95% confidence intervals (95% CIs) calculated. Analyses were performed using either fixed-effect or random-effects models, depending on heterogeneity.

Results: In individuals with aphasia, telerehabilitation demonstrated significantly greater improvements in generalization post-intervention compared to face-to-face treatment (MD = 11.53; 95% CI: 3.64-19.43; p = 0.004). However, no significant differences were found between telerehabilitation and face-to-face treatment in naming accuracy post-intervention (MD = 3.09; 95% CI: 1.98-8.16; p = 0.23), Western Aphasia Battery (WAB) aphasia quotient (MD = -0.54; 95% CI: -9.96-8.88; p = 0.91), auditory comprehension post-intervention (MD = 0.66; 95% CI: -8.83-10.14; p = 0.89), or functional communication post-intervention (MD = -0.95; 95% CI: -10.19-8.29; p = 0.84).

Conclusion: In individuals with aphasia, telerehabilitation showed significantly greater improvements in generalization post-intervention compared to face-to-face treatment. However, no significant differences were observed between the 2 approaches in naming accuracy, WAB aphasia quotient, auditory comprehension, or functional communication post-intervention. To validate these findings, further research is needed, and caution should be exercised when interpreting the current results due to the limited number of included studies.