Telehealth

Abstract

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.

An Online Telepractice Model for the Prevention of Voice Disorders in Vocally Healthy Student Teachers Evaluated by a Smartphone Application

“…Research has demonstrated that synchronous telepractice methods produce similar clinical outcomes when compared with in-person speech-language pathology services for neurogenic communication disorders, fluency disorders, voice disorders, dysphagia, and childhood speech and language disorders (Hill & Theodoros, 2002; Lowe, O’Brian, & Onslow, 2013; Mashima & Brown, 2011; Mashima & Doarn, 2008; Swanepoel & Hall, 2011; Theodoros, 2008). In addition to positive clinical outcomes that mirror those of in-person services, client and clinician satisfaction have been remarkably positive across the majority of studies (Brennan, 2006; Brennan, Georgeadis, & Baron, 2002; Georgeadis, Brennan, Barker, & Baron, 2004; Kully, 2002; Mashima et al, 2003), a finding consistent with other areas of telehealth research (Cardoso & Steinberg, 2010). …”

“…Three additional treatment studies for voice disorders are found in the literature that are not tied to patients with PD (Fu, Theodoros, & Ward, 2015; Mashima et al, 2003; Rangarathnam et al, 2015). Fu et al (2015) delivered intensive voice therapy (i.e., eight sessions over three weeks) via videoconferencing to 10 women with vocal nodules and found significant improvements in acoustic, perceptual, quality-of-life measures, and nodule size at post-treatment, mirroring the outcomes in a separate in-person study.…”

“…Fu et al (2015) delivered intensive voice therapy (i.e., eight sessions over three weeks) via videoconferencing to 10 women with vocal nodules and found significant improvements in acoustic, perceptual, quality-of-life measures, and nodule size at post-treatment, mirroring the outcomes in a separate in-person study. In Mashima et al (2003), 23 adult participants with voice disorders were treated online using a videoconferencing system integrated with speech analysis software. An additional 28 adult participants with voice disorders were treated in a traditional, in-person method.…”

Telerehabilitation of anomia in primary progressive aphasia

“…More recently, telerehabilitation has been shown to be effective in the treatment of speech and language disorders, including voice disorders (Constantinescu et al, 2010; Mashima et al, 2003; Theodoros et al, 2006; Tindall, Huebner, Stemple, & Kleinert, 2008), apraxia of speech (Lasker, Stierwalt, Spence, & Calvin-Root, 2010), and stuttering (Kully, 2000; O’Brian, Packman, & Onslow, 2008; Wilson, Onslow, & Lincoln, 2004). Telerehabilitation has also been utilized to train the production of personally relevant speech in participants with Broca’s aphasia (Goldberg, Haley, & Jacks, 2012).…”

Massed Versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Therapy Versus a Long-Term Traditional Voice Therapy

“…The third possibility is a combination of the above two paths: starting with a gradual reduction of frequency, followed by a follow-up program and a boost IVT when needed. Telepractice might be a useful tool in follow-up (Fu, Theodoros, & Ward, 2015b;Mashima et al, 2003;Rangarathnam et al, 2015). Further research is needed to confirm whether these innovative service delivery models should be the new standard for voice therapy.…”