Telerehabilitation in aphasia after stroke: a systematic review of qualitative research

Background & aims Aphasia is a common consequence of stroke that significantly impacts communication and quality of life. While telerehabilitation has emerged as a viable solution to overcome geographical and logistical barriers to traditional therapy, existing reviews have primarily focused on quantitative outcomes. This systematic review aims to critically synthesise qualitative research findings to understand the lived experiences, perceptions, barriers, and facilitators of telerehabilitation for people with aphasia (PWA) and clinicians.Methods & procedures Following PRISMA guidelines, a systematic search was conducted across five electronic databases: Cochrane, CINAHL, PsycINFO, Web of Science, and PubMed. Eligible studies employed qualitative or mixed methods designs focusing on therapeutic telerehabilitation interventions for PWA. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and data were synthesised using thematic synthesis.Outcomes & results Twenty-four studies involving 533 participants (311 PWA and 222 clinicians) were included. The synthesis identified three major analytical themes: (1) The Digital Bridge: Access and Feasibility, which describes telerehabilitation as a convenient tool that fosters autonomy despite persistent technical and organisational hurdles; (2) The “Active Ingredients”: Optimising Outcomes, highlighting that clinical tailoring, collaborative goal-setting, and increased therapy “dose” are critical for success; and (3) Beyond Language: Identity and Empowerment, which identifies virtual environments as “safe spaces” that support social connection and identity reconstruction. While participant satisfaction was generally high, barriers such as technical failures and a lack of clinician comfort with technology remain significant challenges.Conclusions Telerehabilitation constitutes a highly acceptable service delivery model that supports recovery throughout the care continuum, from the acute to the chronic stages of aphasia. It offers more than language remediation by providing a platform for social connection and personal independence. To enhance clinical implementation, it is recommended that developers prioritise patient-centred design and that healthcare providers receive comprehensive training to effectively transition to technology-supported, home-based care.