Telerehabilitation Delivery of Multi-Modality Aphasia Therapy (M-MAT Tele): A Pilot Feasibility Trial

Vicky Aston, Emily Eley, Dana Wong, Annie J. Hill, Marcella Carragher, Miranda L. Rose, Rachelle Pitt, John E. Pierce

Author PDF https://doi.org/10.63144/ijt.2025.6727

Multi-Modality Aphasia Therapy (M-MAT) is a group-based treatment for aphasia. It supports spoken language by combining speech with gesture, writing, reading and drawing. People with aphasia practice word retrieval within phrases and sentences.

A large trial showed benefits for word finding, functional communication and quality of life.

M-MAT Tele

M-MAT Tele is the telehealth version of the same treatment. It was adapted through co-design so people with aphasia could take part in structured, interactive group therapy from home.

We wanted to test M-MAT Tele.

A therapy may not necessarily be as effective online as it is face to face. This pilot trial tested whether our M-MAT Tele adaptation was feasible, acceptable and promising enough to take into a larger study.

Participants

Nine people with chronic post-stroke aphasia took part. They were placed into 3 x small groups of three - two mild groups and one moderate group.

Therapy schedule

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7


2 hours

2 hours

2 hours
x5 weeks

M-MAT Tele was provided online by a speech pathologist in small groups, with 15 x two-hour sessions across five weeks - a total of 30 hours of treatment.

Results

66%
Eligibility
Two in three screened participants were eligible.
0
Withdrawals
No one withdrew after starting the trial.
95%
Online assessments completed
Online assessment procedures worked well.
81%
Median treatment completed
Participants received most of the scheduled therapy dose.
1.8/10
End-of-session fatigue
Fatigue was low overall.
94%
Treatment fidelity
The therapy was delivered as intended.

Clinical outcomes

Results were encouraging, with the clearest positive signals seen in word finding, functional communication and communication-related quality of life.

Participant experiences

“My speech pathologist is on a one-to-one sort of therapy, so having a larger group is very motivating... It inspired me to work and improve myself harder.”
“Come to this session and have a chat, and do therapy as well.”
“A friend, new one. And he’s amazing, he was a stroke as well.”

Participant feedback was positive. People described M-MAT Tele as easy to access, enjoyable and socially motivating, with many valuing the convenience of joining from home and the chance to connect with others with aphasia. Several participants reported greater confidence in everyday communication and longer spoken sentences over time.

Eight of nine participants rating M-MAT Tele positively and seven saying they would definitely recommend it to others.

Therapist perspectives

Therapists valued the multimodal approach and the group format, and felt the software largely worked as intended. Their feedback also pointed to useful refinements for future trials, including larger and clearer images, streamlined administration, clearer expectations for carers, and more challenge for people with milder aphasia.

Areas for refinement

Minor software and protocol changes were recommended. Some participants with mild aphasia wanted more challenge.

Summary