Group rehabilitation for adults with acquired neurological disorders: A systematic review of mono- and interdisciplinary interventions in physical and speech-language therapy.

BACKGROUND: Group treatments and interdisciplinary collaboration are recommended in evidence-based guidelines for neurorehabilitation, including physical and speech-language therapy. Evidence suggests that activating overlapping neural networks for upper extremity motor control and speech-language processing produces synergistic effects during therapy. This systematic review aims to overview and appraise the efficacy of group treatments in traditional rehabilitation and telerehabilitation. In addition to summarizing evidence on monodisciplinary approaches in physical and speech-language therapy, it seeks data on integrative approaches involving one or both disciplines to inform further interdisciplinary collaboration.

METHODS: The review was registered with PROSPERO (CRD42021288012) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic searches were conducted in PubMed, CINAHL, and the Cochrane Library. Two reviewers independently screened studies, extracted data, and assessed quality using AMSTAR 2, the Physiotherapy Evidence Database (PEDro) scale, or the Joanna Briggs Institute (JBI) Checklist, as appropriate. The evidence was summarized in a systematic narrative synthesis and its certainty rated based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: A total of 29 studies were included: 16 on speech-language therapy (861 participants) and 13 on physical therapy (1757 participants). No studies addressed interdisciplinary group interventions, and only two evaluated group telerehabilitation. Outcome domains and measures varied across studies and the certainty of evidence was predominantly low. However, moderate-certainty evidence supports that group speech-language therapy improves quality of life, communication, and language in stroke survivors, especially when interventions emphasize verbal production in communicative settings with multimodal materials and cueing. In physical therapy, circuit class training may be more effective than other group approaches for enhancing quality of life and mobility.

CONCLUSION: Group treatments in neurorehabilitation show some benefits, but further research is needed - especially regarding interdisciplinary approaches and telerehabilitation.