Network meta-analysis of speech therapy for poststroke aphasia finds no single superior approach.

OBJECTIVE: Various speech therapies are available for treating poststroke aphasia; however, the effects of these strategies on poststroke aphasia have yet to be compared. We conducted a network meta-analysis to investigate the effects of different speech therapies on quality of life and language performance for patients with poststroke aphasia. METHODS: This systematic review and network meta-analysis was registered in the PROSPERO database (CRD42023465936) on October 2, 2023. We searched the PubMed, EMBASE, and Cochrane Library electronic databases from their inception to September 20, 2023. We included trials that (1) involved participants with poststroke aphasia regardless of phase; (2) adopted speech therapy as the intervention; (3) applied either no intervention or another speech therapy as the control treatment; (4) reported quality of life or language performance as outcomes. The network meta-analysis was performed using the online tool ShinyNMA (version 1.01). RESULTS: We examined 17 articles involving 931 patients. Our analyses revealed that both multimodality aphasia therapy and constraint-induced aphasia therapy prompted significant improvements in quality of life. However, no specific speech therapy showed statistically significant superiority over no intervention across isolated language domains. All significant results were also clinically meaningful. No significant inconsistencies were observed between the results of direct and indirect comparisons. CONCLUSIONS: Our results suggest that multimodality aphasia therapy and constraint-induced aphasia therapy show promise for improving quality of life in patients with poststroke aphasia. However, no single speech therapy demonstrated statistical superiority over no intervention across specific language domains.