The Role of Speech and Language Therapists (SLTs) in International Stroke Teams: A Systematic Review.
Marina Charalambous, John E Pierce, Georgia Pastou and 2 others
PMID 40536137WHAT IT FOUND
Across 42 studies, SLTs were fully embedded in stroke teams in 26, partially involved in 11, and absent in 5.
Full integration was predominantly in high-income countries, which also produced 34 of the 42 studies. In low-income settings, SLTs were often missing from stroke units.
Key findings
01Of the 42 included studies, 26 described SLTs as fully embedded in multidisciplinary stroke teams with shared care responsibilities, 11 described partial involvement (consulted for specific tasks but not in broader team processes), and 5 reported no SLT involvement at all.
02Full SLT integration was predominantly observed in high-income countries, which accounted for 34 of the 42 studies (80%). The literature is dominated by the UK, Australia, and the US.
03In low- and middle-income countries, SLT roles were often limited to general language needs rather than specialized stroke rehabilitation. In Pakistan and India, published studies showed stroke units that did not include SLTs, and in Vietnam there was a shortage of SLTs and poor recruitment of allied health professionals.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Most included studies were observational in design, with relatively few RCTs, so the review describes service provision rather than testing whether SLT presence changes outcomes. Risk of bias varied across the 42 studies, with common issues around sample size, blinding, and unclear reporting of outcome measures. Only 3 studies came from low-middle-income countries and 5 from upper-middle-income countries, making it hard to draw firm conclusions about SLT roles in those settings. The search did not include articles that did not mention SLTs, so it is unclear whether the low number of LMIC studies reflects a true absence of SLT services or simply less published literature. The review was restricted to English-language publications, which may have excluded relevant work from non-Anglophone low- and middle-income countries. The authors note they did not perform a direct analysis of health service teams, so the findings are based on what was reported in the literature rather than on direct observation of team composition.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
This review maps where SLTs sit in stroke teams; it does not compare patient outcomes with and without SLTs. The authors themselves call for a future study to test that question. Reading the 26 'full involvement' studies as proof that SLT presence improves recovery goes beyond what this paper shows.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →