Effectiveness and feasibility of a virtual Intensive and comprehensive aphasia program: a comparative analysis

Purpose Intensive and Comprehensive Aphasia Programs (ICAPs) have been implemented globally. Research has documented substantial improvements in impairment levels, activity and participation domains, and quality of life outcomes. However, concerns have been raised about high setup costs, patient commuting challenges, and mobility issues, etc. While virtual therapy may alleviate some of these concerns, uncertainties remain about maintaining treatment comprehensiveness and patient eligibility within the ICAP treatment framework. Our objective was to evaluate the effectiveness and feasibility of a virtual ICAP model compared with an in-person ICAP model.Method Our study used a non-randomized, parallel-group, dose-controlled, pre- and post-test design. Twenty-six adults with chronic aphasia participated in either the in-person or virtual ICAP group, based on participants’ availability and personal considerations. Both treatment models delivered a 39-hour, 2.5-week intervention consisting of impairment-based treatment, functional-based treatment, app-based treatment, education, and group therapy sessions. First, we assessed changes in linguistic performance and quality of life outcomes for each model at both individual and group levels at post-treatment and at one-month follow-up. Then, we compared the effectiveness of the two models across all measures. Finally, we conducted interviews with stakeholders—including participants, communication partners, supervisors, and students engaged in both modalities—to gather feedback and evaluate the feasibility of implementing an ICAP in a virtual setting.Results At the individual level, 85% (11/13) of the in-person and 92% (12/13) of the virtual ICAPs achieved therapeutic gains across linguistic measures, meeting the criteria for Minimum Detectable Change90. At the group level, both models indicated significant improvements in language and quality of life outcomes at post-treatment and demonstrated maintenance effects. When the two models were compared, no significant differences were noted in any measures. Qualitative data revealed high agreement among stakeholders that telepractice is a feasible delivery model for an ICAP. Interviews with participants and communication partners indicated that prior exposure to and confidence in virtual therapy may influence the model’s feasibility. Feedback from supervisors and students emphasized participants’ characteristics and caregiver support as primary considerations impacting the feasibility of a virtual ICAP.Conclusion Our findings indicate that a virtual ICAP is comparable to an in-person ICAP in enhancing PWA’s linguistic skills, communication confidence, and communication effectiveness. We also summarize potential factors that may influence the feasibility of implementing a virtual ICAP. The outlined implementation procedure and the accompanying suggestions could facilitate future implementation of virtual ICAPs.