European Stroke Organisation (ESO) Guideline on Aphasia Rehabilitation
European Stroke Journal
Brady, M. C., Mills, C., et al. (2025).
European Stroke Journal, 10(4), 1189-1220.
<div>This evidence-based clinical practice guideline provides speech-language therapy recommendations for the management of stroke-related aphasia.</div>
European Stroke Organisation
<div>"In people with aphasia post-stroke, we recommend high dose [speech-language therapy] SLT interventions (⩾20hours) rather than lower dose SLT (<20 hours) should be offered" (p. 1197; LoE: Low; SoR: Strong).</div>
<div>"In people with aphasia post-stroke, we suggest high intensity SLT (⩾3hours per weeks) rather than lower intensity should be offered" (p. 1200; LoE: Low; SoR: Weak).</div>
<div>"In people with aphasia post-stroke, we suggest high frequency SLT (⩾4days per week) should be offered rather than lower frequency SLT (<4days per week)" (p. 1201; LoE: Low; SoR: Weak).</div>
<div>"In people with aphasia after stroke, we suggest using either in-person or digitally delivered SLT" (p. 1203; LoE: Very Low; SoR: Weak). "In-person SLT plus digital augmentation should be offered rather than usual in-person SLT" (p. 1204; LoE: Very Low; SoR: Weak).</div>
<div>"In people with aphasia post-stroke, we suggest using either one-to-one or group therapy" (p. 1206; LoE: Low; SoR: Weak).</div>
<div>"The decision on the format of the intervention may be made with reference to the health service context and resources available" (p. 1206; Expert consensus statement).</div>
<div>"In people with aphasia post-stroke, the benefits of providing one-to-one plus group SLT compared to one-to-one SLT alone are uncertain and therefore we cannot make a recommendation" (p. 1207; LoE: Very Low).</div>
<div>"In people with aphasia following stroke where access to one-to-one therapy is constrained by resource availability, we suggest that group therapy delivered in addition to one-to-one SLT may facilitate increased therapy time, provide additional opportunities to use language in a social context and enhance communication confidence. </div>
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<div>We also suggest that the therapy timing and format should follow other recommendations in this clinical guideline, aiming to enhance language recovery, communication, participation, and quality of life" (p. 1207; Expert consensus statement).</div>
<div>"In people with aphasia post-stroke, the benefits of SLT plus [transcranial direct current stimulation] tDCS compared to SLT plus sham tDCS are uncertain and therefore we cannot make a recommendation" (p. 1210; LoE: Very Low).</div>
<div>"In people with aphasia following stroke, we suggest that in the clinical context, SLT should be delivered alone, rather than SLT alongside tDCS. Individualised tDCS protocols for post-stroke aphasia may be beneficial, but further evidence is required" (p. 1210; Expert consensus statement).</div>
<div>"In people with aphasia post-stroke, we suggest tailored SLT by functional relevance rather than non-tailored SLT by functional relevance should be offered" (p. 1211; LoE: Very Low; SoR: Weak).</div>
<div>"In people with aphasia post-stroke, we suggest that SLT individually-tailored by level of language task difficulty should be offered" (p. 1211; LoE: Very Low; SoR: Weak).</div>
