How Game Features and Treatment-Related Factors Facilitate Generalization in Technology-Based Aphasia Rehabilitation: A Systematic Review

Background Nowadays, developers offer mobile applications for aphasia treatment. Although their overall effectiveness and acceptance by the target audience was proved, it has not been established what aspects of technology-based aphasia rehabilitation facilitate these improvements and translate into generalization.Objective The objectives were to analyze what technology- and treatment-related factors, including treatment dose, intensity and duration, affect treatment efficacy and facilitate generalization.Methods The PubMed and ScienceDirect databases were searched in February 2024. The review included experimental articles testing mobile- or computer-based applications for aphasia rehabilitation. Studies were excluded if they described AAC techniques or assistive tools, or focused solely on quality of life. ROB-2 was used to assess risk of bias in the included randomized controlled trials.Results Eighteen articles meeting the inclusion criteria were analyzed. The key factors increasing the therapy effect and leading to generalization were automatic feedback, diversity of the tasks employed in the training, longer periods of treatment, and interaction between the user and the clinician.Conclusions Technology-based aphasia treatment is an effective therapy tool. Contact with the clinician, simultaneous practice targeted at various language domains and executive functions, as well as feedback, positively influence outcomes. The review, however, has limitations, as it lacks statistical analysis and synthesizes heterogeneous data.