Effect of selected components of aural rehabilitation delivered in-person versus guided internet-based modalities on quality of life in adults with hearing loss: a systematic review and meta-analyses

OBJECTIVE: This systematic review and meta-analysis compared the effects of specific components of aural rehabilitation delivered in-person and guided internet-based modalities on the quality of life (QoL) of adults with acquired hearing loss. DESIGN: Articles published up to August 2025 in scientific databases- PubMed, Cochrane Library, Scopus, and Web of Science were searched. A search strategy was built using terms associated with aural rehabilitation, offline, online, internet, tele-audiology, hearing loss, and adults and was tailored to the subject headings and syntax of each database. STUDY SAMPLE: Among the 6,646 studies retrieved, 49 met the inclusion criteria. RESULTS: This systematic review included 49 studies, 12 of which were included in the meta-analyses. In-person aural rehabilitation showed a medium effect size, while internet-based aural rehabilitation showed a small but statistically significant improvement in hearing-related QoL measures. In terms of health-related QoL, only internet-based but not in-person aural rehabilitation had a small statistically significant improvement. CONCLUSIONS: These findings indicate that adults with hearing loss benefit from both in-person and internet-based aural rehabilitation regarding hearing-related QoL outcomes. More investigations are needed to understand the effectiveness of particular components of aural rehabilitation in improving the health-related QoL of adults with hearing loss.