Introduction
Aphasia is an acquired language impairment that initially impacts up to one-third of stroke survivors. Speech and language therapy can significantly improve communication effects for people with aphasia; however, comprehensive clinical guidance is required to support the delivery of high-quality services. Adherence to clinical practice guidelines can facilitate high-quality service delivery and optimize patient effects. The routine use of clinical practice guidelines can improve health and economic outcomes for people living with stroke. However, there is presently no high-quality guidance specific to post-stroke aphasia management.
Objective
This systematic review aims to identify and assess suggestions from high-quality stroke guidelines that can inform aphasia management.
Methods
- This systematic review was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to determine high-quality clinical guidelines.
- Primary searches were conducted using electronic databases: PubMed, EMBASE, CINAHL, and Web of Science.
- Gray literature searches were performed using Google Scholar, stroke websites, and guideline databases.
- Clinical practice guidelines were assessed using the Appraisal of Guidelines and Research and Evaluation (AGREE II) tool.
- Guideline quality was assessed using the rigor of the development score of the AGREE II instrument.
Results
- Through database searches, a total of 1749 sources were retrieved and through a gray literature search, 41 sources were retrieved.
- Twenty-three stroke clinical practice guidelines were determined and 9 met the criteria for rigor of development.
- From these guidelines, 82 recommendations for aphasia management were extracted out of which 31 were aphasia-specific, 51 aphasia-related, 67 evidence-based, and 15 consensus-based.
Conclusion
The results of this systematic review suggest that most recommendations were aphasia-related; aphasia-specific recommendation gaps were identified in three clinical practice areas accessing community support, leisure, driving, return to work, and interprofessional practice. Rigorous research in these areas may strengthen the existing evidence- base and improve the clinical benefits delivered to people with aphasia.