AphasiaGeneralization

First systematic review of VR in aphasia rehabilitation: a comprehensive synthesis of the evidence base from City University of London / Center for Excellence in Aphasia Research

Devane N et al. · 2023 · Disability and Rehabilitation · Systematic Review 0 · Systematic review of VR in aphasia rehabilitation · DOI
Evidence certainty: High certainty
How this was rated

Systematic review conducted by the City University of London / Center for Excellence in Aphasia Research team - Devane, Behn, Marshall, Hilari are all established aphasia researchers. Peer-reviewed in Disability and Rehabilitation (Taylor & Francis, established rehabilitation journal). Pre-registered systematic methodology, large citation impact (11,000+ article views). Limitations: review covers literature up to its 2022 cutoff; the more recent Franco 2025 RCT post-dates this synthesis; heterogeneity of included studies limits the strength of effect-size pooling across diverse aphasia types and VR delivery modes.

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The first systematic review synthesizing the evidence base for using virtual reality in the rehabilitation of aphasia. Conducted by the Devane / Marshall / Hilari City University of London group. Published in Disability and Rehabilitation, the established Taylor & Francis peer-reviewed rehabilitation journal. The review covers types of VR systems used, target rehabilitation goals (anomia, conversation, social participation, attention), outcome measures, and effectiveness across the included studies. With 26+ citations and over 11,000 article views by 2025, this is the foundational synthesis reference for VR-in-aphasia rehabilitation work.

Clinical bottom line

The foundational systematic review for VR in aphasia rehabilitation. For SLPs working with people with aphasia and considering VR as a therapy modality, this is the single most authoritative synthesis available. Establishes what VR types are being used, what aphasia rehabilitation goals are being targeted, and what the effectiveness pattern looks like across studies. Complements Franco 2025 (the strongest individual RCT-style aphasia VR study) by providing the field-mapping synthesis.

Key findings

  • First systematic review of VR in aphasia rehabilitation, published in Disability and Rehabilitation 2023 (online Nov 2022)
  • Lead authors Devane and Marshall + Hilari at City University of London / Center for Excellence in Aphasia Research - established aphasia clinical-research lineage
  • Coverage of types of VR systems used in aphasia rehabilitation - immersive HMD vs desktop vs CAVE - and how the modality choice maps to specific aphasia rehabilitation goals
  • Rehabilitation goals examined include: anomia (word-finding), conversation, social participation, attention, generalization to real-world communication
  • Substantial citation impact: 26+ citing articles, 11,000+ article views by 2025 - the canonical citation for aphasia+VR in the past two years
  • Open access via Taylor & Francis (CC BY for the published article)
  • Complements but does NOT supersede the more recent Franco 2025 RCT-style aphasia anomia study (in our Hub) which provides head-to-head comparison evidence

Background

Aphasia is a common consequence of stroke and other acquired brain injury, with persistent communication impairment that limits social participation and quality of life. Virtual reality has been proposed as a rehabilitation modality but the field had no comprehensive systematic synthesis prior to this review.

What they did and found

A systematic review of the VR-in-aphasia rehabilitation literature, conducted by the Devane / Marshall / Hilari City University of London group. Coverage of VR types, rehabilitation targets, outcome measures, and effectiveness across included studies. Specific number of included studies and pooled findings reported in the published article.

Why it matters

For SLPs, this is the foundational synthesis reference for VR-in-aphasia work. For procurement teams and grant applications, this is the citation of choice. Complements Franco 2025 (our strongest individual RCT-style aphasia VR study) with field-mapping context.

Limitations

Pre-2022 literature cutoff means more recent work (Franco 2025) is not included. Heterogeneity of VR systems and aphasia types across studies limits effect-size pooling. Single-team perspective on the literature.

Implications for practice

For SLPs working in aphasia rehabilitation, this systematic review is the foundational synthesis reference. For mapping the state of the field, choosing VR delivery modes, and identifying relevant outcome measures, this paper is the most authoritative single source. For specific clinical efficacy claims (e.g., 'iVR is better than digital static for anomia'), pair with Franco 2025 which provides the rigorous within-subjects head-to-head comparison.

Related Studies

AphasiaGeneralization

Immersive VR helps healthy adults learn rare words faster than a tablet method, but does not outperform a structured tablet method for aphasia anomia rehabilitation

Two within-subject experiments using a virtual marketplace iVR application against a matched-exposure tablet (digital static learning, DSL) method. In 32 neurotypical French adults learning rare French words, iVR significantly outperformed DSL by Day 3 (z = 4.556, p < .0001). In 16 people with mild-to-moderate post-stroke aphasia learning frequent French words in a crossover design, both methods produced significant learning gains across Day 1, 5, 12, and 19 (p < .001), but iVR was NOT significantly better than DSL on accuracy (estimate 0.025, p = .704).

Franco J et al. · 2025 Read Summary
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VR conversational practice helps people with aphasia communicate more effectively

A pilot RCT with 36 people with chronic aphasia comparing semi-immersive VR conversational practice (NeuroVR 2.0 on a 50-inch curved screen - not a headset) to conventional therapy over 6 months. No significant between-group differences were found on any measure. Within-group analysis showed the VR group improved on more domains, and only the VR group improved on self-esteem and emotional/mood state.

Giachero A et al. · 2020 Read Summary
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An interactive gaming system helps people with aphasia improve word-finding and verbal fluency

An RCT found that people with aphasia who used an interactive gaming system showed improvements in naming ability and verbal fluency compared to those receiving conventional support, suggesting game-based approaches can complement language recovery.

Grechuta K et al. · 2019 Read Summary
Dementia & ProgressiveTBI Cognitive-Comm.Implementation

A seven-year interdisciplinary case study of co-designing an immersive VR kitchen environment for speech-language pathology rehabilitation and aging-in-place

A multi-phase, multi-disciplinary case study describing the seven-year design, development, and feasibility testing of an immersive VR kitchen environment for speech-language pathology rehabilitation and aging-in-place practice. The collaboration brought together speech-language pathologists, interior designers (aging-in-place specialists), VR programrs, and technology consultants. The paper describes the design-thinking methodology, phase-by-phase development, HIPAA-aware infrastructure choices, and lessons for interdisciplinary VR co-development - rather than reporting clinical outcome data on patients.

Harvey-Northrop J et al. · 2025 Read Summary
Social CommunicationAphasiaGeneralization

A virtual world gives people with aphasia more opportunities to practice communication

People with aphasia who spent time communicating in a virtual world called EVA Park showed meaningful improvements in functional communication and reported greater confidence in their everyday interactions.

Marshall J et al. · 2016 Read Summary
AphasiaSocial CommunicationGeneralization

A feasibility RCT of group social support in a virtual world for aphasia - feasibility met, no significant quantitative outcomes

A waitlist randomized feasibility RCT with 34 recruited (29 completed, 85.3%). People with aphasia attended 14 EVA Park social group sessions over 6 months. Feasibility targets were met: recruitment achieved, 85.3% completion, all groups ran as planned. However, no significant change was observed on any quantitative outcome measure (wellbeing, communication, social connectedness, quality of life). Qualitative reports were positive. Trial registered NCT03115268.

Marshall J et al. · 2020 Read Summary
Dementia & ProgressiveGeneralization

A tutorial overview of how immersive VR might support people with neurogenic communication differences

An ASHA tutorial reviewing immersive VR for speech-language rehabilitation of adults with neurogenic communication disorders. The author's overall conclusion is that there is currently insufficient evidence that immersive VR directly benefits communication outcomes in this population. withVR is named once as one example of emerging applications 'being developed by and for persons with communication differences'; the paper does not use, test, or evaluate withVR.

Stark BC · 2025 Read Summary
ImplementationAcceptability

Mixed-methods study of 15 speech-language pathologists' acceptance, barriers, and enablers of using an immersive VR kitchen environment for communication rehabilitation

Fifteen speech-language pathologists participated in everyday-life communication activities inside an immersive VR kitchen environment, then completed system-usability and motion-sickness surveys plus semi-structured interviews. System usability was average; motion sickness was low. The qualitative analysis identified five themes - attitude toward VR in communication rehabilitation, perceived usefulness, perceived ease of use, intention to use, and clinical adoption barriers and enablers. SLPs were broadly positive about VR's potential as an ecologically valid communication-rehab tool while identifying real-world implementation barriers.

Vaezipour A et al. · 2022 Read Summary

Cite this study

If you reference this study in your work, the canonical citation formats are:

APA 7th
Devane, N., Behn, N., Marshall, J., Ramachandran, A., Wilson, S., & Hilari, K. (2023). The use of virtual reality in the rehabilitation of aphasia: a systematic review. Disability and Rehabilitation. https://doi.org/10.1080/09638288.2022.2138573.
AMA 11th
Devane N, Behn N, Marshall J, Ramachandran A, Wilson S, Hilari K. The use of virtual reality in the rehabilitation of aphasia: a systematic review. Disability and Rehabilitation. 2023. doi:10.1080/09638288.2022.2138573.
BibTeX
@article{devane2023,
  author = {Devane, N. and Behn, N. and Marshall, J. and Ramachandran, A. and Wilson, S. and Hilari, K.},
  title = {The use of virtual reality in the rehabilitation of aphasia: a systematic review},
  journal = {Disability and Rehabilitation},
  year = {2023},
  doi = {10.1080/09638288.2022.2138573},
  url = {https://withvr.app/evidence/studies/devane-2023}
}
RIS
TY  - JOUR
AU  - Devane, N.
AU  - Behn, N.
AU  - Marshall, J.
AU  - Ramachandran, A.
AU  - Wilson, S.
AU  - Hilari, K.
TI  - The use of virtual reality in the rehabilitation of aphasia: a systematic review
JO  - Disability and Rehabilitation
PY  - 2023
DO  - 10.1080/09638288.2022.2138573
UR  - https://withvr.app/evidence/studies/devane-2023
ER  -

Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.

Funding & independence

Affiliations: Devane, Behn, Marshall, Ramachandran, Wilson, Hilari at City University of London / Center for Excellence in Aphasia Research. Open access. Peer-reviewed in Disability and Rehabilitation (Taylor & Francis). No withVR BV involvement. Summary prepared independently by withVR.

Last reviewed: 2026-05-17 Next review due: 2027-05-17 Reviewed by: Gareth Walkom