1
|
Gong X, Han Y, Wang Y, Huang Z. The Effects of Telerehabilitation in Patients with Voice Disorders: A Systematic Review and Meta-Analysis. J Voice 2024:S0892-1997(24)00180-2. [PMID: 38969543 DOI: 10.1016/j.jvoice.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVES To compare the effects of telerehabilitation (TR) and face-to-face rehabilitation (FTF) methods on the outcomes of adults with voice disorders and to analyze the effectiveness of TR. METHODS Following Boolean Logic, a search strategy was devised, combining subject terms and keywords based on the interventions and populations outlined in the inclusion criteria. We searched PubMed, Cochrane Library, Embase, Web of Science, Scopus, CNKI, Wanfang, CQVIP databases, and manually screened academic conference papers, journal articles, and gray literature to identify eligible randomized controlled trials (RCTs) on remote voice therapy. Two researchers assessed the risk of bias in the included studies using the risk of bias assessment tool for RCTs outlined in the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. RESULTS Five trials with a total of 233 patients with voice disorders were included in the study after screening. The results revealed a significant difference in Jitter change values (mean difference [MD]=-0.12, 95%CI [-0.23,-0.01], P = 0.04) between TR and FTF, maximum phonation time (MD=0.76, 95%CI [-0.60,2.13], P = 0.27), Shimmer (MD=-0.04, 95%CI [-0.11,0.03], P = 0.27), voice handicap index (MD=0.87, 95%CI [-1.77,3.50], P = 0.52), and GRBAS(G) (MD=-0.00, 95%CI [-0.01,0.01], P = 0.99) had no significant difference. CONCLUSION TR demonstrates comparable efficacy to FTF in voice treatment and is associated with higher levels of patient satisfaction, making it a viable and effective therapeutic modality. However, given the limited sample size analyzed in this study, further validation of this conclusion necessitates additional RCTs with larger sample sizes. Furthermore, researchers should remain cognizant of the constraints associated with TR and consistently refine treatment protocols to enhance the efficacy of voice therapy.
Collapse
Affiliation(s)
- Xinyi Gong
- Department of Rehabilitation of Sciences, Faculty of Education, East China Normal University, Shanghai, China
| | - Yaoxin Han
- Department of Rehabilitation of Sciences, Faculty of Education, East China Normal University, Shanghai, China
| | - Yongli Wang
- Department of Rehabilitation of Sciences, Faculty of Education, East China Normal University, Shanghai, China.
| | - Zhaoming Huang
- Department of Rehabilitation of Sciences, Faculty of Education, East China Normal University, Shanghai, China
| |
Collapse
|
2
|
Rameau A, Cox SR, Sussman SH, Odigie E. Addressing disparities in speech-language pathology and laryngology services with telehealth. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106349. [PMID: 37321106 PMCID: PMC10239150 DOI: 10.1016/j.jcomdis.2023.106349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 05/10/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic disproportionately affected the health and well-being of marginalized communities, and it brought greater awareness to disparities in health care access and utilization. Addressing these disparities is difficult because of their multidimensional nature. Predisposing factors (demographic information, social structure, and beliefs), enabling factors (family and community) and illness levels (perceived and evaluated illness) are thought to jointly contribute to such disparities. Research has demonstrated that disparities in access and utilization of speech-language pathology and laryngology services are the result of racial and ethnic differences, geographic factors, sex, gender, educational background, income level and insurance status. For example, persons from diverse racial and ethnic backgrounds have been found to be less likely to attend or adhere to voice rehabilitation, and they are more likely to delay health care due to language barriers, longer wait times, a lack of transportation and difficulties contacting their physician. The purpose of this paper is to summarize existing research on telehealth, discuss how telehealth offers the potential to eliminate some disparities in the access and utilization of voice care, review its limitations, and encourage continued research in this area. A clinical perspective from a large volume laryngology clinic in a major city in northeastern United States highlights the use of telehealth in the provision of voice care by a laryngologist and speech-language pathologist during and after the COVID19 pandemic.
Collapse
Affiliation(s)
- Anaïs Rameau
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America.
| | - Steven R Cox
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, United States of America
| | - Scott H Sussman
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America
| | - Eseosa Odigie
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America
| |
Collapse
|
3
|
Searl J, Genoa K, Fritz A, Kearney A, Doyle PC. Usage of Heat and Moisture Exchange Devices, Virtual Visits, Masking, and Vaccinations Among People With a Laryngectomy During COVID-19. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:592-612. [PMID: 36763837 DOI: 10.1044/2022_ajslp-22-00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE This study described the COVID-19 risk mitigation actions of people with a total laryngectomy (TL) during the pandemic. METHOD An online survey was completed by 215 people with a TL who lived in the United States. The survey was open from December 1, 2021, to January 15, 2022. RESULTS There was a significant increase in frequency of heat and moisture exchange (HME) device use during the pandemic compared with pre-COVID-19. Frequency of HME use was significantly greater for those who were vaccinated and those who had at least one clinical visit with their speech-language pathologist (SLP). The use of virtual visits increased from 9% pre-COVID-19 to 37% during the pandemic. Seventy percent of respondents were "satisfied" or "very satisfied" with virtual visits and 51% judged them "as good as in-person." Eighty percent were vaccinated for COVID-19 and 75% received a booster. One third reported that they did not wear mask over the face or over the tracheostoma. Twenty percent had tested positive for COVID-19 with 70% of these people requiring hospitalization. CONCLUSIONS HME use and virtual SLP visits increased during the pandemic and the vaccination rate was high among this group of respondents. Overall, there were still large percentages of people with a TL who were not using an HME, not vaccinated, and did not wear a mask. SLPs should consider reaching out directly to their TL caseload, particularly those not yet seen during the pandemic, to support uptake of COVID-19 mitigation activities specific to people with a TL as the pandemic persists.
Collapse
Affiliation(s)
- Jeff Searl
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Kathryn Genoa
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Alyssa Fritz
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Ann Kearney
- Department of Otolaryngology-Head and Neck Surgery, Division of Laryngology, Stanford University School of Medicine, CA
| | - Philip C Doyle
- Department of Otolaryngology-Head and Neck Surgery, Division of Laryngology, Stanford University School of Medicine, CA
| |
Collapse
|
4
|
Doyle PC, Damrose EJ. Has Esophageal Speech Returned as an Increasingly Viable Postlaryngectomy Voice and Speech Rehabilitation Option? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4714-4723. [PMID: 36450150 DOI: 10.1044/2022_jslhr-22-00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The literature on postlaryngectomy voice and speech rehabilitation is long-standing. Although multiple rehabilitation options have existed over the years, the acquisition and use of esophageal speech (ES) has decreased significantly over the past 40 years. This reduction coincides with the increased application of tracheoesophageal puncture (TEP) voice restoration. The literature suggests that voice acquisition failures observed secondary to TEP may represent a similar phenomenon that led to ES acquisition failures. METHOD A comprehensive review of the literature on ES and TEP voice/speech was conducted. Specific attention was directed toward information on ES and TEP speech failures. Information on pharyngoesophageal segment (PES) spasm in the context of ES and TEP voicing failures was of specific importance. RESULTS Similarities between voicing failures with both ES and TEP were identified. In order to resolve spasm in TEP speech, proactive efforts to eliminate it were undertaken, and regardless of the method used, voicing improvements were observed. These data suggest that both ES and TEP speech acquisition failures may be related to the same control mechanisms influencing the PES. CONCLUSIONS The elimination of PES spasm provides evidence that justifies the reconsideration of ES. Consequently, ES may return as an increasingly viable postlaryngectomy voice and speech rehabilitation option.
Collapse
Affiliation(s)
- Philip C Doyle
- Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford University, CA
| | - Edward J Damrose
- Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford University, CA
| |
Collapse
|
5
|
Searl J, Kearney A, Genoa K, Doyle PC. Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2430-2445. [PMID: 34665653 DOI: 10.1044/2021_ajslp-21-00117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This study described the clinical experiences of patients with a total laryngectomy (TL) during the COVID-19 pandemic and identified changes in communication, tracheostoma care, and heat-moisture exchange (HME) use that were recommended or self-implemented. Method An online survey addressing the study aims was completed by 173 people with a TL who live in the United States. The survey was open from July 5 to August 10, 2020. Results In-person clinic visits, appointment cancellations, and contact from their speech-language pathologists (SLPs) were reported by 42%, 19%, and 54% of the TL respondents, respectively. At clinic visits, 78% were required to wear a mask over their nose/mouth, and 73% were required to wear a mask over their tracheostoma. Masks, gloves, and face shields worn by the SLP at these visits were reported by 84%, 82%, and 70% of the TL patients, respectively. Alaryngeal communication changes were recommended by the SLP for 7%-18% of TL patients, depending on their method of communication, whereas 43%-45% implemented changes on their own. Changes in tracheostoma care and HME use were recommended by the SLP for 27% and 21% of the TL respondents, respectively, whereas 54% and 47% made changes on their own. Conclusions Individuals with a TL will require in-person care even during a pandemic, as reflected in this study. Many had not been contacted by their SLP or otolaryngologist about TL guidelines that were becoming available. Notably, larger percentages of TL patients reported self-initiated changes to their communication, tracheostoma care, and HME use because of the pandemic than their SLP had advised. The types of communication changes varied in part, depending on the method of alaryngeal speech a respondent used. Supplemental Material https://doi.org/10.23641/asha.16807270.
Collapse
Affiliation(s)
- Jeff Searl
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Ann Kearney
- Department of Otolaryngology - Head & Neck Surgery, Division of Laryngology, Stanford University School of Medicine, CA
| | - Kathryn Genoa
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Philip C Doyle
- Department of Otolaryngology - Head & Neck Surgery, Division of Laryngology, Stanford University School of Medicine, CA
| |
Collapse
|
6
|
Rejinold N S, Choi G, Piao H, Choy JH. Bovine Serum Albumin-Coated Niclosamide-Zein Nanoparticles as Potential Injectable Medicine against COVID-19. MATERIALS 2021; 14:ma14143792. [PMID: 34300711 PMCID: PMC8307271 DOI: 10.3390/ma14143792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 12/24/2022]
Abstract
(1) Background: COVID-19 has affected millions of people worldwide, but countries with high experimental anti-SARS-CoV-2 vaccination rates among the general population respectively show progress in achieving general herd immunity in the population (a combination of natural and vaccine-induced acquired immunity), resulting in a significant reduction in both newly detected infections and mortality rates. However, the longevity of the vaccines’ ability to provide protection against the ongoing pandemic is still unclear. Therefore, it is of utmost importance to have new medications to fight against the pandemic at the earliest point possible. Recently, it has been found that repurposing already existing drugs could, in fact, be an ideal strategy to formulate effective medication for COVID-19. Though there are many FDA-approved drugs, it has been found that niclosamide (NIC), an anthelmintic drug, has significantly high potential against the SARS-CoV-2 virus. (2) Methods: Here we deployed a simple self-assembling technique through which Zein nanoparticles were successfully used to encapsulate NIC, which was then coated with bovine serum albumin (BSA) in order to improve the drugs’ stability, injectablity, and selectivity towards the virus-infected cells. (3) Results: The particle size for the BSA-stabilized Zein-NIC nanohybrid was found to be less than 200 nm, with excellent colloidal stability and sustained drug release properties. In addition, the nanohybrid showed enhanced drug release behavior under serum conditions, indicating that such a hybrid drug delivery system could be highly beneficial for treating COVID-19 patients suffering from high endothelial glycocalyx damage followed by a cytokine storm related to the severe inflammations.
Collapse
Affiliation(s)
- Sanoj Rejinold N
- Intelligent Nanohybrid Materials Laboratory (INML), Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Korea; (S.R.N.); (G.C.); (H.P.)
| | - Goeun Choi
- Intelligent Nanohybrid Materials Laboratory (INML), Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Korea; (S.R.N.); (G.C.); (H.P.)
- College of Science and Technology, Dankook University, Cheonan 31116, Korea
- Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Korea
| | - Huiyan Piao
- Intelligent Nanohybrid Materials Laboratory (INML), Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Korea; (S.R.N.); (G.C.); (H.P.)
| | - Jin-Ho Choy
- Intelligent Nanohybrid Materials Laboratory (INML), Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 31116, Korea; (S.R.N.); (G.C.); (H.P.)
- Department of Pre-medical Course, College of Medicine, Dankook University, Cheonan 31116, Korea
- Tokyo Tech World Research Hub Initiative (WRHI), Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8503, Japan
- Correspondence:
| |
Collapse
|