Telerehabilitation for people with aphasia: A systematic review and meta-analysis

Objectives: To evaluate effectiveness or non-inferiority of telerehabilitation for people with aphasia when compared to conventional face-to-face speech and language therapy. Materials and methods: Five electronic databases (PUBMED, EMBASE, WEB OF SCIENCE, SCOPUS and the Cochrane Library) were searched. We extrapolated data from the included studies and evaluated the methodological quality using the Revised Cochrane risk-of-bias tool for Randomized Trials (RoB 2) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). A meta-analysis compared effects of intervention, and it was conducted using the Review Manager 5.3 software. GRADE profile to assess overall quality of evidence was carried out. Results: Out of a total of 1157 records, five studies met the inclusion criteria and were eligible for meta-analysis with a total of 132 participants with post-stroke aphasia. Discussion: Results revealed that telerehabilitation and face-to-face speech and language treatment are comparable with respect to the gains achieved in auditory comprehension (SMD = −0.02; 95% CI −0.39, 0.35), naming accuracy (SMD = −0.09; 95% CI −0.44, 0.25), Aphasia Quotient (MD = −2.18; 95% CI −16.00, 11.64), generalization (SMD = 0.77; 95% IC −0.95, 2.49) and functional communication skills (SMD = −0.08; 95% IC −0.54, 0.38). Conclusion: Although evidence is still insufficient to guide clinical decision making due to the relatively low quality of the evidence identified, the analysis of the results suggest that telerehabilitation training for aphasia seems to be as effective as the conventional face-to-face treatment.