Rehabilitation of asyntactic comprehension in post-stroke aphasic individuals: A systematic review of the literature

Asyntactic comprehension corresponds to a disorder in the comprehension of sentences, which is one of the difficulties that can arise in a context of aphasia following a stroke. To date, rehabilitation of asyntactic comprehension is divided into three main groups of approaches, centered on the structure of the sentence, on the memory or on the verb and its thematic roles. The present study aims to assess the effectiveness of the existing treatments to rehabilitate asyntactic comprehension in post-stroke aphasic individuals, in terms of post-treatment improvements, generalization, long-term maintenance and transfer effects to daily life activities. A systematic review of the literature was carried out and twenty-four studies presenting seven different treatments, were selected, involving a total of 148 post-stroke aphasic patients. The methodological quality of each study has been analyzed following the Santiago-Delefosse grid or the MMAT grid. In general, the analysis of the measures of effectiveness (post-treatment improvement, generalization, maintenance, and transfer effects) showed that the treatments whose approach was centered on the structure of the sentence or on the working memory are those allowing to significantly improve syntactic comprehension for individuals with aphasia. The short-term memory approach did not show improvement in syntactic comprehension but remains little studied. And the approach based on the verb and its thematic roles is so far too understudied to draw a clear conclusion. The present study contributes to the advancement of knowledge on syntactic rehabilitation in the context of post-stroke aphasia leadind to various clinical implications for an informed choice. The few studies available on the subject as well as the few data collected constitute, among other things, a limit to this study.