Writing and Arm Use in Aphasia Rehabilitation for Left-Handed Individuals: A Scoping Review Protocol

This project will conduct a scoping review to examine the existing literature on aphasia recovery in left-handed or non-right-handed individuals, with particular emphasis on the role of motor status, dominant-hand preservation, and manual communication strategies such as writing and gesture in rehabilitation. Aphasia is a common consequence of stroke and is frequently associated with right-sided hemiparesis due to damage to left-hemisphere language regions that are adjacent to motor areas controlling the contralateral upper limb. Because most individuals are right-handed, this pattern of motor impairment often affects the dominant hand and may limit the use of writing or other manual strategies during rehabilitation. However, in left-handed individuals with left-hemisphere damage, motor impairment patterns may differ, and some patients may retain functional use of their dominant hand. This preserved motor capacity may influence participation in rehabilitation approaches that involve writing, drawing, or gesture-based communication. Despite these potentially important clinical implications, handedness is rarely examined systematically in aphasia research, and most rehabilitation studies do not analyze whether dominant-hand preservation influences recovery outcomes or engagement in therapy. Furthermore, although writing and other manual communication modalities are sometimes used in aphasia therapy, their relationship to motor status and handedness has not been comprehensively mapped across the literature. The purpose of this scoping review will be to map and synthesize the breadth of existing evidence related to aphasia recovery in left-handed individuals. Specifically, the review will examine how frequently handedness is considered in aphasia research, how motor impairment and dominant-hand preservation are described in this population, and how writing, gesture, or other manual communication strategies are incorporated into rehabilitation or communication support. By systematically identifying and charting studies that report on left-handed individuals with aphasia, the review will provide an overview of the types of evidence available, the methodologies used, and the main themes emerging in the literature. The expected outcomes of this project include a comprehensive evidence map describing how handedness has been addressed in aphasia research, as well as the identification of major knowledge gaps in the field. In particular, the review will highlight the limited empirical investigation of the relationship between handedness, motor impairment, and rehabilitation strategies. The findings will help inform future research directions and may contribute to the development of more individualized aphasia rehabilitation approaches that consider motor function and dominant-hand use as part of therapy planning.