Effectiveness of Telerehabilitation in Aphasia: A Systematic Review and Meta-analysis
Keywords:
stroke, aphasia, telerehabilitation, telepractice, telemedicine, tele-speechAbstract
This study aimed to evaluate the effectiveness of tele-rehabilitation for improving language and speech abilities in individuals with post-stroke aphasia, as well as to report adverse events, costeffectiveness, feasibility, and user satisfaction. A systematic search was conducted in CENTRAL,PubMed, Scopus, and other databases in November 2025 with no restrictions on publication year. Experimental studies comparing tele-rehabilitation with face-to-face rehabilitation were included, afterwhich risk of bias was assessed, and a meta-analysis was performed. The search identified 1,401 records, of which 10 studies met the eligibility criteria (N = 218). Meta-analysis showed no significant differences between tele-rehabilitation and conventional rehabilitation in fluency (standardized mean difference: SMD = 0.17; 95% CI: –0.14 to 0.49), naming (SMD = 0.26; 95%CI: –0.01 to 0.53), reading (SMD = 0.39; 95%CI: –0.02 to 0.81), and functional communication (SMD = –0.16; 95%CI: –0.56 to 0.23). However, tele-rehabilitation demonstrated significantly better outcomes in auditory comprehension (SMD = 0.30; 95%CI: 0.02 to 0.59) and repetition (SMD = 0.49; 95%CI: 0.15 to 0.82). Overall, tele-rehabilitation appeared to be as effective as traditional face-to-face therapy and might be considered a viable alternative depending on the service context. No serious adverse events were reported; and satisfaction levels tended to be positive. Nonetheless, the current evidence is limited by a high or some-concerns risk of bias across several studies. Additional studies with a low risk of bias are needed to confirm these findings. Future clinical research should be conducted through randomized controlled trials with a low risk of bias, and report cost-effectiveness to inform policy and develop practical implementation of tele-rehabilitation services.
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