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Bascuñana-Ambrós H, Renom-Guiteras M, Nadal-Castells MJ, Beranuy-Rodríguez M, Perrot-González JC, Ramirez-Mirabal E, Trejo-Omeñaca A, Monguet-Fierro JM. Swallowing muscle training for oropharyngeal dysphagia: A non-inferiority study of online versus face-to-face therapy. J Telemed Telecare 2024; 30:116-120. [PMID: 34355589 DOI: 10.1177/1357633x211035033] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study is to show the non-inferiority of the telemedicine therapy versus face-to-face using the exercise therapy of oropharyngeal muscles in 183 patients treated consecutively from 2010 to 2020. METHOD We conducted a retrospective study comparing two dysphagia treatment groups: online versus face-to-face. Patients were distributed in a non-random way but according to patient's preferences. All patients followed the same pathway and were evaluated at the beginning and at the end of the study using the dysphagia outcome and severity scale and the functional oral intake scale. A non-inferiority analysis approximation was done with delta = 1 in both variables. RESULTS Within a total of 183 patients, 114 (62.3%) used the online treatment and 69 (37.7%) the face-to-face one. The main cause of dysphagia was neurological in the total sample (60.7%) and within both groups. When we evaluate the clinical response, we find that both groups improved regardless of the type of therapy. The confidence interval of the difference between the beginning and the end of treatment did not reach the inferior limit of the delta defined, therefore supporting the no inferiority of online versus presential. DISCUSSION This study shows the no inferiority of the online therapy versus the face-to-face one for the oropharyngeal training of the swallow muscles.
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Affiliation(s)
| | - Marta Renom-Guiteras
- Physical Medicine and Rehabilitation Department, Sant Pau University Hospital, Spain
| | | | | | | | - Eliot Ramirez-Mirabal
- Physical Medicine and Rehabilitation Department, Sant Pau University Hospital, Spain
| | - Alex Trejo-Omeñaca
- Department of Engineering and Information Systems, Universitat Politècnica de Catalunya, Barcelona Tech, Spain
| | - Josep Maria Monguet-Fierro
- Department of Engineering and Information Systems, Universitat Politècnica de Catalunya, Barcelona Tech, Spain
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Shadi MS, Rubin JS, Geneid A, Magdy E, Ibrahim RA. Adjustment of Health-Care Service Delivery Among Phoniatricians and ENT Specialists During the COVID-19 Pandemic, A UEP Survey. J Voice 2023; 37:803.e1-803.e9. [PMID: 34172361 PMCID: PMC9355601 DOI: 10.1016/j.jvoice.2021.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Applying measures that prioritize staff safety, while protecting patient safety and care, represents a challenge during the current pandemic. Many documents of recommendations toward safe practice have been developed for this purpose. OBJECTIVE To assess adjustments that have been undertaken by phoniatricians and otolaryngologists in the delivery of health-care services during the pandemic in order to reduce staff exposure to COVID-19 and improve safety. STUDY DESIGN Cross-sectional. METHODS An online self-administered survey was used during the first wave of the COVID-19 pandemic in June 2020 to collect data related to demographics of participants, their sources of information, administrative alterations, and changes they adopted when meeting patients for a consultation/procedure/surgery. RESULTS The eligible 154 responses were grouped into 4 groups based on country of residence. Alterations to service delivery amongst the different groups were compared. CONCLUSIONS The majority of participants were following the suggested recommendations to service delivery adjustments, with some inconsistencies in practice across countries.
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Affiliation(s)
- Mariam S Shadi
- Department of Otorhinolaryngology, Phoniatrics Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - John S Rubin
- Consultant ENT Surgeon, University College Hospitals London NHS Trust. Honorary Consultant ENT Surgeon, National Hospital for Neurology and Neurosurgery. Honorary Associate Professor, Department of Targeted Intervention, University College London. Honorary Visiting Professor, Department of Health Science, City University of London, London, England
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elham Magdy
- Department of Otorhinolaryngology, Phoniatrics Unit, Zagazig University, Zagazig, Egypt
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De Taeye R, Van Lierde K, Alighieri C. Telepractice in the diagnosis and treatment of pediatric speech-language disorders: The opinions and experiences of speech-language pathologists. Int J Pediatr Otorhinolaryngol 2023; 169:111560. [PMID: 37116275 DOI: 10.1016/j.ijporl.2023.111560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE This prospective cross-sectional study aimed to investigate the opinions and experiences with telepractice (TP) of Dutch-speaking speech-language pathologists (SLPs) living in the Dutch-speaking part of Belgium (Flanders). This study will help to optimize care for children with speech-language disorders as we will gain more insight into the experienced barriers and facilitators while using TP for assessing and treating these disorders. METHOD Twenty-nine Dutch-speaking speech-language pathologists living in Flanders (age category 20-30 years: n = 16/29, 55.2%, 31-40 years: n = 10/29, 34.2%, 41-50 years: n = 2/29, 6.9%, 51-60 years: n = 1/29, 3.4%) were recruited through the social media. An online questionnaire was developed based on the available literature and administered to the SLPs. To compare the opinions and experiences of SLPs with TP, χ2 tests or Fisher's exact tests were used. RESULTS The study showed a statistically significant association between years of clinical experience of SLPs and their opinion that TP does not provide more options in a clinical setting compared to face-to-face contact. SLPs who had expertise in multiple domains experienced significantly more added value of TP during the corona pandemic than SLPs who had expertise in only one specific domain. Additionally, SLPs who worked in a private practice indicated significantly more difficulties in developing a therapeutic relationship due to a lack of personal contact than SLPs who worked in other settings. 51.7% (15/29) of the SLPs experienced technical barriers using TP. CONCLUSION Expertise in multiple domains of pediatric speech-language therapy resulted in experiencing more added value of TP during the corona pandemic, possibly because of the experience of multiple different and simultaneous advantages of TP in several domains. Additionally, SLPs in a private practice experienced more difficulties in developing a therapeutic relationship due to a lack of personal contact with their clients. This is in contrast to hospitals where children are often seen for a shorter period. Hence, there may be less chance of a negative perception of relationships with clients. Another conclusion is that treatment drop-out was not larger using TP compared to face-to-face therapy. However, SLPs experienced that the use of TP was not promoted/encouraged by their employer possibly because of technical barriers. It is hoped that the findings of this study will help SLPs and policymakers overthrow existing barriers and make telepractice a substantial, effective, and efficient service delivery model.
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Affiliation(s)
- Robin De Taeye
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences (CESLAS), Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Gent, Belgium.
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Biddau F, Brisotto C, Innocenti T, Ranaldi S, Meneghello F, D'Imperio D, Nordio S. Speech and Language Therapy for Acquired Central Dysgraphia in Neurological Patients: A Systematic Review to Describe and Identify Trainings for Clinical Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:762-785. [PMID: 36857041 DOI: 10.1044/2022_ajslp-22-00042] [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 Acquired central dysgraphia is a heterogeneous neurological disorder that usually co-occurs with other language disorders. Written language training is relevant to improve everyday skills and as a compensatory strategy to support limited oral communication. A systematic evaluation of existing writing treatments is thus needed. METHOD We performed a systematic review of speech and language therapies for acquired dysgraphia in studies of neurological diseases (PROSPERO: CRD42018084221), following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist with a search on several databases for articles written in English and published until August 31, 2021. Only methodological well-designed studies were included. Further assessment of methodological quality was conducted by means of a modified version of the Downs and Black checklist. RESULTS Eleven studies of 43 patients in total were included. For each study, we collected data on type of population, type of impairment, experimental design, type of treatment, and measured outcomes. The studies had a medium level of assessed methodological quality. An informative description of treatments and linkages to deficits is reported. CONCLUSIONS Although there is a need for further experimental evidence, most treatments showed good applicability and improvement of written skills in patients with dysgraphia. Lexical treatments appear to be more frequently adopted and more flexible in improving dysgraphia and communication, especially when a multimodal approach is used. Finally, the reported description of treatment modalities for dysgraphia in relation to patients' deficits may be important for providing tailored therapies in clinical management.
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Affiliation(s)
| | | | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
- GIMBE Foundation, Bologna, Italy
| | - Sara Ranaldi
- UOIAF (Unità Operativa Infanzia Adolescenza Famiglia), Ulss 3 Serenissima, Venice, Italy
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Tamura F, Kikutani T, Machida R, Isoda T, Hobo K, Yamada H, Kodama M, Genkai S, Mizukami M, Tanaka Y, Sakuda T, Furuya H, Takahashi N. Usefulness of Telemedicine for Disabled Children Receiving Feeding Therapy. Dysphagia 2023; 38:425-434. [PMID: 35768661 PMCID: PMC9244222 DOI: 10.1007/s00455-022-10482-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 06/10/2022] [Indexed: 01/27/2023]
Abstract
We performed a retrospective cohort study using medical records of 374 pediatric patients who visited a university dental clinic specializing in dysphagia rehabilitation in Japan between 2019 and 2020 to clarify the usefulness of telemedicine among disabled children receiving feeding therapy. The primary outcome was the feeding developmental stage confirmed at the final evaluation. Propensity score matching was performed between individuals in two treatment groups (in-person and telemedicine) before the final analysis using patients' age, sex, primary disease, gross motor function, and feeding developmental stage as covariates. A total of 36 patients were enrolled in each of the in-person and telemedicine groups. The initial evaluation for the propensity score matched population using the χ2 test showed no significant difference between the two groups in any parameter. The feeding developmental stage evaluated at the final evaluation using the Wilcoxon signed-rank test significantly improved compared with the stage at the initial evaluation in both groups (in-parson group, p = 0.007; telemedicine group, p = 0.013). The difference in level achieved at the final evaluation revealed that the most common level was "unchanged," followed by "improvement by one level" in both groups, indicating that there was no significant difference in the efficacy of feeding therapy between the two groups (p = 0.314). Our results show that telemedicine can achieve the same therapeutic outcomes as in-person therapy to improve feeding function in children with disabilities when receiving feeding therapy.
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Affiliation(s)
- Fumiyo Tamura
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan.
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan.
| | - Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Reiko Machida
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Tomoko Isoda
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Kimiko Hobo
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Hiroyuki Yamada
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Miho Kodama
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Sae Genkai
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Miki Mizukami
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Yuko Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Taeko Sakuda
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Hiroyasu Furuya
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University Hospital, Tama Oral Rehabilitation Clinic, Koganei-shi, Tokyo, Japan
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Gutierrez-Arias R, González-Mondaca C, Marinkovic-Riffo V, Ortiz-Puebla M, Paillán-Reyes F, Seron P. Considerations for ensuring safety during telerehabilitation of people with stroke. A protocol for a scoping review. PLoS One 2023; 18:e0276354. [PMID: 36608020 PMCID: PMC9821787 DOI: 10.1371/journal.pone.0276354] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Exercise interventions have a positive impact on people with stroke. However, access to exercise interventions is variable, and there may be a delay in the start of rehabilitation. Telerehabilitation has enabled the delivery of exercise interventions replacing the traditional face-to-face approach. Aspects related to the safety of people with stroke should be considered to avoid adverse events during the delivery of exercise interventions remotely. However, such information is scattered in the literature, and the detail with which measures taken during the implementation of exercise interventions for people with stroke are reported is unknown. OBJECTIVE To summarise measures or aspects targeted at reducing the incidence of adverse events during the delivery of exercise interventions through telerehabilitation in patients after stroke. MATERIALS AND METHODS A scoping review will be conducted. A systematic search in MEDLINE-Ovid, Embase-Ovid CENTRAL, CINAHL Complete (EBSCOhost), and other resources will be carried out. We will include primary studies, published in full text in any language, involving people with stroke who undergo telerehabilitation where exercise is the main component. Two reviewers will independently select studies and extract data, and disagreements will be resolved by consensus or a third reviewer. The results will be reported in a narrative form, using tables and figures to support them. DISCUSSION To implement this strategy within rehabilitation services, one of the first aspects to be solved is to ensure the safety of people. The results of this scoping review could contribute an information base for clinicians and decision-makers when designing remotely delivered exercise intervention programs. REGISTRATION NUMBER INPLASY202290104.
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Affiliation(s)
- Ruvistay Gutierrez-Arias
- Servicio de Medicina Física y Rehabilitación, Unidad de Kinesiología, Instituto Nacional del Tórax, Santiago, Chile
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
- * E-mail:
| | - Camila González-Mondaca
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Vinka Marinkovic-Riffo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Marietta Ortiz-Puebla
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Fernanda Paillán-Reyes
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Pamela Seron
- Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Telehealth Management of Dysphagia in Adults: A Survey of Speech Language Pathologists' Experiences and Perceptions. Dysphagia 2022:10.1007/s00455-022-10544-z. [PMID: 36515730 PMCID: PMC9749630 DOI: 10.1007/s00455-022-10544-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022]
Abstract
The goal of this study was to explore telehealth use for dysphagia management in response to COVID-19 to understand variables associated with clinician confidence and perceived effectiveness of this service delivery model and determine clinician-perceived benefits and challenges of managing dysphagia via telehealth. Speech-language pathologists (SLPs, n = 235) completed a web-based survey, providing information on demographics, telehealth use during the pandemic, and perspectives on current and future tele-management of dysphagia. Analyses included descriptive statistics to examine usage patterns; logistic regression to determine which variables were associated with telehealth use, clinician confidence, and perceived-effectiveness; and conventional content analysis to analyze responses to open-ended questions. Results revealed a sharp increase in the tele-management of dysphagia during the pandemic. Years of experience with dysphagia management (p = .031) and pre-pandemic use of telehealth (p < .001) were significantly associated with current use patterns. Working in the outpatient setting was associated with greater clinician confidence (p = .003) and perceived effectiveness (p = .007), and use of guidelines (p = .042) was also associated with greater clinician confidence. Key challenges identified included inadequate technological infrastructure, inadequate patient digital literacy, and reimbursement restrictions. Key benefits were treatment continuity, improving access to care, and time savings. The majority (67%) of respondents reported that they would use telehealth in the future. These findings demonstrate SLPs' abilities and desire to expand their practice patterns to include telehealth for dysphagia management. Therefore, clinician training and more research on best practices for assessment and treatment of dysphagia via telehealth is warranted to refine models of care for dysphagia tele-management.
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Sevitz JS, Borders JC, Dakin AE, Kiefer BR, Alcalay RN, Kuo SH, Troche MS. Rehabilitation of Airway Protection in Individuals With Movement Disorders: A Telehealth Feasibility Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2741-2758. [PMID: 36279509 PMCID: PMC9911128 DOI: 10.1044/2022_ajslp-22-00063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/02/2022] [Accepted: 07/28/2022] [Indexed: 05/03/2023]
Abstract
PURPOSE Airway protective deficits (swallowing and cough) greatly reduce health and quality of life and are a pervasive consequence of neurodegenerative movement disorders. Expiratory muscle strength training (EMST) and cough skill training (CST) are two treatment approaches to improve airway protection; however, many patients are unable to access these treatments. Telehealth may improve access to care, but it remains unknown whether these treatments are feasible and efficacious via telehealth. This study aimed to determine the practical feasibility and preliminary treatment effect of EMST and CST via telehealth. METHOD Twenty participants with movement disorders completed 4 weeks of EMST and 2 weeks of CST, including two clinician-directed treatment sessions via telehealth and 3 days of home practice per week. Feasibility was calculated for each treatment. Practical feasibility was defined as completing treatment (EMST or CST) and obtaining the relevant outcome measures-a proxy of maximum expiratory pressure (pMEP) for EMST and peak expiratory flow rate (PEFR) for CST-within a 30-min session/period. Session factors that may have influenced feasibility were examined. Preliminary treatment effect was defined as changes in pMEP and PEFR. RESULTS Time taken to obtain pMEP and complete EMST was 17.48 min, and time taken to obtain PEFR and complete CST was 17.69 min. pMEP, single voluntary cough PEFR, and sequential voluntary cough PEFR increased from pre- to posttreatment. CONCLUSIONS Findings suggest that the delivery of EMST and CST is feasible via telehealth and yield improvements to pMEP and PEFR. This has important implications for expanding service delivery of airway protective interventions and reducing health care disparities in people with neurodegenerative movement disorders. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21357669.
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Affiliation(s)
- Jordanna S Sevitz
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - James C Borders
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Avery E Dakin
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Brianna R Kiefer
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Roy N Alcalay
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
- Department of Neurology, Tel Aviv Sourasky Medical Center, Israel
| | - Sheng-Han Kuo
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Michelle S Troche
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
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Reverberi C, Gottardo G, Battel I, Castagnetti E. The neurogenic dysphagia management via telemedicine: a systematic review. Eur J Phys Rehabil Med 2022; 58:179-189. [PMID: 34605620 PMCID: PMC9980496 DOI: 10.23736/s1973-9087.21.06921-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Telerehabilitation is the provision of rehabilitation remotely through Information and Communication Technologies (ICT). Recently, there has been an increase of interest in its application thanks to increasing a new technology. The aim of this systematic review was to examine the evidence of the literature regarding the management of neurogenic dysphagia via telerehabilitation, compared to face-to-face rehabilitation treatment. The secondary aim was to create recommendations on telerehabilitation sessions for patients diagnosed with neurogenic dysphagia. EVIDENCE ACQUISITION The databases were: Medline, Embase, CINAHL, Scopus. A total of 235 records emerged from bibliographic research, manual search of full text and from gray literature, published until January 2021. Two blinded authors carried out titles and abstract screening and followed by full-text analysis. Sixteen articles were included in the systematic review and assessed through critical appraisal tools. EVIDENCE SYNTHESIS The research shows that the majority of the studies on neurogenic dysphagia involved the Clinical Swallow Examination via telerehabilitation, compared with the in-person modality. Significant levels of agreement and high satisfaction from clinicians and patients are reported to support the use of telerehabilitation. Based on the results of this systematic review and qualitative analysis, the authors developed practical recommendations for the management of telerehabilitation sessions for patients with neurogenic dysphagia. CONCLUSIONS Despite the presence of barriers, telerehabilitation allowed healthcare provision and increasing access to care and services with specialized professionals, remote rehabilitation can be a valid resource during the health emergency due to COVID-19.
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Affiliation(s)
- Cristina Reverberi
- Department of Health Professions, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Irene Battel
- Department of Physical and Medical Rehabilitation, San Giovanni e Paolo Civil Hospital, Azienda ULSS3 Serenissima, Venice, Italy -
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Serel-Arslan S, Demir N, Belafsky PC. The Status of Dysphagia Clinics During the COVID-19 Pandemic. Dysphagia 2021; 37:1258-1265. [PMID: 34792621 PMCID: PMC8600486 DOI: 10.1007/s00455-021-10386-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/30/2021] [Indexed: 11/17/2022]
Abstract
The study aimed to determine the status of dysphagia clinics and procedures applied in dysphagia clinics during the COVID-19 pandemic. Clinicians working in an outpatient dysphagia clinic were included. A 30-question survey inquiring about the descriptive information of the participants and their clinics, their clinical practice, and the tele-health applications during the COVID-19 pandemic. The survey was administered via Google forms. The participants were asked to fill out the survey on behalf of their clinics. One survey was completed per dysphagia clinic. Twenty-three clinicians responded on behalf of their clinics. The number of patients and dysphagia evaluations decreased during the COVID-19 pandemic (p < 0.05). The COVID-19 screening procedures mostly performed before dysphagia evaluations were temperature check (n = 14, 60.9%), nasopharyngeal swab test (n = 9, 39.1%), anamnestic risk assessment (n = 6, 26.1%), and saturation test (n = 6, 26.1%). Protective equipments mostly used while dysphagia evaluations were surgical mask, FFP3 mask, standard gloves, glasses, and face shield. It was found that 69.6% (n = 16) of the dysphagia clinics were reported to be suitable for working under pandemic conditions, and 30.4% (n = 7) were reported to be unsuitable. The use of tele-health applications significantly increased from 13.0% (n = 3) to 52.2% (n = 12) (p = 0.003). The present study provides a general overview of the status of dysphagia clinics and procedures applied in dysphagia clinics during the COVID-19 pandemic period. The study showed that working conditions, the number of patients, and the total number of evaluations have changed throughout the pandemic, and the use of tele-health applications increased.
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Affiliation(s)
- Selen Serel-Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey.
| | - Numan Demir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey
| | - Peter Charles Belafsky
- Department of Otolaryngology Head and Neck Surgery, Davis School of Medicine, University of California, Sacramento, CA, USA
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Effectiveness and feasibility of home-based telerehabilitation for community-dwelling elderly people in Southeast Asian countries and regions: a systematic review. Aging Clin Exp Res 2021; 33:2657-2669. [PMID: 33765258 PMCID: PMC7993072 DOI: 10.1007/s40520-021-01820-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/17/2021] [Indexed: 02/03/2023]
Abstract
This systematic review aimed to evaluate the impact of home-based telerehabilitation on physical function among community-dwelling elderly people in Southeast Asian countries and regions, and to investigate its feasibility. A systematic electronic literature search was conducted in PubMed/MEDLINE and PEDro according to PRISMA guidelines. Randomized controlled trials conducted in the area that involved elderly people and any physical function indexes were included. Home-based telerehabilitation was defined as a specific remote rehabilitation intervention that used any kind of technological device allowing healthcare professional/patient interaction. Information regarding the effect and feasibility (intervention completion rate) of home-based telerehabilitation was extracted from eligible articles. We used the Revised Cochrane risk-of-bias tool for randomized trials to assess methodological quality of the included articles. Eventually, six studies were included as eligible articles. The overall risk of bias judgement was assessed as “High” in five studies. All studies were conducted in either China or South Korea, and heterogeneity in terms of participants’ health condition and intervention regimen was observed across the studies. Our narrative-based analysis showed that compared with conventional rehabilitation, either equal or better effects on physical function were reported across the six studies. The intervention completion rates were 81% ± 11 on average (range 59–96%). Although we could not obtain conclusive evidence due to limited relevant information with heterogeneity across the studies, our findings suggest that home-based telerehabilitation can be a strategy for rehabilitation service delivery with acceptable feasibility comparable to conventional rehabilitation for elderly people in the area.
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Maresca G, Maggio MG, De Luca R, Manuli A, Tonin P, Pignolo L, Calabrò RS. Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives. Front Neurol 2020; 11:563375. [PMID: 33101176 PMCID: PMC7554582 DOI: 10.3389/fneur.2020.563375] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/26/2020] [Indexed: 11/20/2022] Open
Abstract
Current research suggests that the management of neurological diseases, both in adults and children, requires an ever increasing commitment of resources for the national healthcare system (NHS). In Italy, due to the aging of the population, increase in chronicity and morbidity of pathologies, and presence of islands and rural areas, health needs to be supported by innovative technologies. Telemedicine is a method of providing healthcare services at distance, remotely connecting health professionals and patients (or two professionals). In Italy, telemedicine is under development, and the NHS has not yet exploited and independently developed all the possibilities that telemedicine offers. Tele-rehabilitation consists in the use of information and communication technologies for the remote support of rehabilitation services. By allowing “home care,” it represents a valid support during the home rehabilitation process. This review is aimed at evaluating the role of telerehabilitation in Italy, with regard to the motor and cognitive rehabilitation programs applied to neurological pathologies, in both pediatric and adult patients. We screened the studies published between 2010 and 2019 on PubMed, Scopus, Cochrane, and Web of Sciences databases. Using the PICO model, the search combined the terms “telerehabilitation”; “neurological disorders”; “neurodegenerative disease,” “motor telerehabilitation”; “cognitive rehabilitation.” This review showed that telerehabilitation is a promising healthcare tool, as it guarantees continuity of care over time (after discharge) and in space (from hospital to patient's home), especially in patients with stroke. Furthermore, it allows to increase the frequency and intensity of rehabilitation programs, provide individualized rehabilitation treatment in comfortable and familiar environment for patient, monitor and evaluate patients' needs and progress, stimulate patient motivation and achieve better patient satisfaction, verify the results achieved by the patients, and potentially reduce the service costs. Unfortunately, almost all neurorehabilitation studies are characterized by small samples and wide variability of results, and would benefit from standardized procedures, aims and targets. Future telerehabilitation trials should include cost-effectiveness analysis associated with clinical outcomes to better assess the validity of this promising tool.
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Affiliation(s)
| | | | | | | | - Paolo Tonin
- S. Anna Institute, Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Loris Pignolo
- S. Anna Institute, Research in Advanced Neurorehabilitation, Crotone, Italy
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Brodsky MB, Gilbert RJ. The Long-Term Effects of COVID-19 on Dysphagia Evaluation and Treatment. Arch Phys Med Rehabil 2020; 101:1662-1664. [PMID: 32534801 PMCID: PMC7286637 DOI: 10.1016/j.apmr.2020.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Martin B Brodsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Richard J Gilbert
- Laboratory for Biological Architecture, Research Service, Providence VAMC, Warren Alpert Medical School, Brown University, Providence, RI
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Fritz MA, Howell RJ, Brodsky MB, Suiter DM, Dhar SI, Rameau A, Richard T, Skelley M, Ashford JR, O'Rourke AK, Kuhn MA. Moving Forward with Dysphagia Care: Implementing Strategies during the COVID-19 Pandemic and Beyond. Dysphagia 2020; 36:161-169. [PMID: 32519150 PMCID: PMC7282541 DOI: 10.1007/s00455-020-10144-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 01/25/2023]
Abstract
Growing numbers of SARS-CoV-2 cases coupled with limited understanding of transmissibility and virulence, have challenged the current workflow and clinical care pathways for the dysphagia provider. At the same time, the need for non-COVID-19-related dysphagia care persists. Increased awareness of asymptomatic virus carriers and variable expression of the disease have also focused attention to appropriate patient care in the context of protection for the healthcare workforce. The objective of this review was to create a clinical algorithm and reference for dysphagia clinicians across clinical settings to minimize spread of COVID-19 cases while providing optimal care to patients suffering from swallowing disorders. Every practitioner and healthcare system will likely have different constraints or preferences leading to the utilization of one technique over another. Knowledge about this pandemic increases every day, but the algorithms provided here will help in considering the best options for proceeding with safe and effective dysphagia care in this new era.
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Affiliation(s)
- Mark A Fritz
- Department of Otolaryngology, Head and Neck Surgery, University of Kentucky, 740 S Limestone, E300E, Lexington, KY, 40536, USA.
| | - Rebecca J Howell
- Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati, Cincinnati, USA
| | - Martin B Brodsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, USA
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, USA
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Debra M Suiter
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington, USA
| | - Shumon I Dhar
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University, Baltimore, USA
| | - Anais Rameau
- Department of Otolaryngology, Head and Neck Surgery, Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - Ashli K O'Rourke
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
| | - Maggie A Kuhn
- Department of Otolaryngology, Head and Neck Surgery, University of California-Davis Medical Center, Sacramento, USA
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