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Araújo BCL, de Melo Lima TRC, de Gois-Santos VT, Nascimento GKBO, Martins-Filho PR, de Magalhães Simões S. Comparative analysis of masseter muscle electrical activity by nasal patency in children with rhinitis and asthma: a pilot observational study. Eur Arch Otorhinolaryngol 2024; 281:2733-2738. [PMID: 38418553 DOI: 10.1007/s00405-024-08482-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/15/2024] [Indexed: 03/01/2024]
Abstract
PURPOSE This pilot cross-sectional study aimed to evaluate differences in electromyographic activity patterns of the masseter muscle according to the nasal patency in children with rhinitis and asthma. METHODS The study included 43 children aged 5-14 years with rhinitis and/or asthma. Patients underwent peak nasal inspiratory flow (PNIF) measurement to assess nasal patency, and electromyographic evaluation of the right and left masseter muscles during chewing and at rest. Electromyographic activity patterns according to nasal patency were compared using the Mann-Whitney test, and effect sizes were measured using the Glass rank biserial (rb) correlation. A p-value of < 0.05 was considered statistically significant. RESULTS No significant differences in electromyographic activity of the masseter muscle at rest, during unilateral chewing, or during habitual chewing were found between the groups. However, we found that patients with low nasal patency had a median electric activity of the right masseter muscle during maximum contraction of 60.53 (51.74-72.43), while those with adequate nasal patency had a median of 77.40 (56.71-88.45). Although the difference in myoelectric activity between the groups did not reach statistical significance (p = 0.061) at the adopted significance level of 5%, the size of the difference between groups were considered moderate (rb = 0.338) and a potential association between nasal patency and the muscular function of the masseter muscle could be suggested. CONCLUSION The study found no differences in the electromyographic activity of the masseter muscle at rest, during unilateral chewing, or during habitual chewing among children with rhinitis and asthma based on nasal patency. Further research with larger sample sizes is needed to validate these findings and gain a better understanding of the impact of nasal patency on the muscular function of the masseter muscle.
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Affiliation(s)
- Brenda Carla Lima Araújo
- Department of Speech Therapy, Pós-Graduação em Ciências da Saúde, Federal University of Sergipe-UFS, Rua Cláudio Batista, S/N. Bairro Sanatório, Aracaju, Sergipe, 49060-100, Brazil.
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
| | - Thales Rafael Correia de Melo Lima
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Vanessa Tavares de Gois-Santos
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Gerlane Karla Bezerra Oliveira Nascimento
- Department of Speech Therapy, Pós-Graduação em Ciências da Saúde, Federal University of Sergipe-UFS, Rua Cláudio Batista, S/N. Bairro Sanatório, Aracaju, Sergipe, 49060-100, Brazil
| | - Paulo Ricardo Martins-Filho
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Applied Health Sciences Program, Federal University of Sergipe, Lagarto, Brazil
| | - Silvia de Magalhães Simões
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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Franz L, Da Canal A, Tuon M, Defilippi R, Biscaro A, Pasian M, Lucchini E, Marioni G, de Filippis C. Clinical effectiveness of telerehabilitation in voice therapy programs for dysphonia. Am J Otolaryngol 2024; 45:104255. [PMID: 38471418 DOI: 10.1016/j.amjoto.2024.104255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE The main aim of this study was to investigate the clinical efficacy of speech therapy, delivered via tele-practice to patients with dysphonia. A secondary aim was to verify whether a telerehabilitation-only protocol could have a clinical efficacy similar to a combined telerehabilitation and in-person approach. METHODS Thirty-two consecutive patients undergoing telerehabilitation for dysphonia were retrospectively considered. Patients were divided into two groups: those who received combined in-person and telerehabilitation treatment, and those who underwent telerehabilitation only. RESULTS Overall, patients included in this study showed a significant improvement in their VHI-10 scores after treatment (p < 0.001). Such an improvement was also significant in both combined therapy and telerehabilitation only groups (p = 0.019, and p = 0.002, respectively). A significant reduction in general degree of dysphonia (G), roughness (R), breathiness (B) and strain (S) scores (p < 0.001, p = 0.012, p < 0.001, and p < 0.001, respectively) was noticed over the whole sample after treatment. The same parameters showed a significant improvement also in the combined therapy group, while in the telerehabilitation only group, only G, B and S scores significantly improved. Mean phonation time, Jitter and Shimmer values significantly improved in the overall sample as well as in the combined therapy group. A significantly more favorable spectrographic class relative to the vowel /a/ was found after treatment in the whole sample, as well as in both combined therapy and telerehabilitation only groups (p < 0.001, p = 0.002, p = 0.004, respectively). CONCLUSION This study's results seem to support telerehabilitation as a potentially effective tool to administer speech therapy in dysphonic patients, both as a single modality and in combination with traditional in-person sessions. To better characterize the clinical results of telerehabilitation in dysphonia treatment, large-scale prospective investigations are mandatory.
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Affiliation(s)
- Leonardo Franz
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Arianna Da Canal
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Martina Tuon
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Roberta Defilippi
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Ariella Biscaro
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Massimo Pasian
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Emanuela Lucchini
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy.
| | - Cosimo de Filippis
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
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Maseko L, Adams F, Myezwa H. Let the records speak: an exploration of rehabilitation services offered in primary healthcare, Johannesburg metropolitan district. BMC Health Serv Res 2024; 24:501. [PMID: 38649859 PMCID: PMC11035128 DOI: 10.1186/s12913-024-10965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Primary healthcare in South Africa aims to transform the national health system by emphasising community-based care and preventive strategies. However, rehabilitation services, particularly for individuals with disabilities and chronic non-communicable diseases, are often overlooked in primary healthcare. This study aimed to investigate the provision of primary healthcare rehabilitation services in the Johannesburg Metropolitan District by exploring client sociodemographics and variations in services provided by rehabilitation professionals. METHODS A retrospective review of clinic rehabilitation records from 2011 to 2020 was conducted at nine provincially funded community health centres (CHCs) offering rehabilitation services. Stratified sampling facilitated record selection based on rehabilitation service type and year. A specifically designed data extraction tool captured demographics, disabilities, rehabilitation received, and referral sources. Descriptive analysis used means, standard deviations, and frequencies. RESULTS The findings show a diverse client population with a wide age range, with a significant proportion falling into the < 5 years and 30-49 years age groups. Neuromusculoskeletal and movement-related disabilities were most prevalent, affecting approximately two-thirds of clients. Referral sources were often undocumented, and inconsistent discharge information with no record of patient follow up, highlighted the need for improved documentation practices. Clinic visits were the primary service delivery mode, followed by limited home visits and outreach services. Occupational therapy and physiotherapy were the most used services. Speech and language therapy services were underused, and some CHCs lacked audiology services. There were variations in the number of individual and group sessions provided by the different rehabilitation services, and there were age- and disability-specific differences in service use. CONCLUSION This study offers insights into rehabilitation service provision in the Johannesburg Metropolitan District and enhances our understanding of rehabilitation services in primary healthcare settings. It underscores the importance of a multidisciplinary rehabilitation team to address diverse rehabilitation needs, improving documentation and discharge practices, expanding service delivery models, and reducing disparities in service use. The findings inform strategies for optimising service delivery, workforce, resource allocation, and intersectoral collaboration to ultimately enhance the quality and accessibility of integrated rehabilitation services.
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Affiliation(s)
- Lebogang Maseko
- Occupational Therapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
| | - Fasloen Adams
- Department of Health and Rehabilitation Sciences, Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Hellen Myezwa
- Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Unger N, Stahl B, Darkow R, Scholz V, Weinmar I, Schmidt J, Breitenstein C, Meinzer M, Grewe T, Flöel A. [Transcranial direct current stimulation to enhance training effectiveness in chronic poststroke aphasia-A challenge for recruiting participants]. Nervenarzt 2024; 95:368-375. [PMID: 38175228 PMCID: PMC11014807 DOI: 10.1007/s00115-023-01572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION/BACKGROUND DC_TRAIN_APHASIA is an ongoing multicenter, randomized controlled trial, conducted since November 2019 under the lead of the University Medicine Greifswald (ClinicalTrials.gov Identifier: NCT03930121). The study seeks to determine whether adjuvant transcranial direct current stimulation (tDCS) can increase the effectiveness of a 3‑week treatment with intensive speech-language therapy in chronic post-stroke aphasia. MATERIAL AND METHOD Until the end of 2024, a total of 130 patients are to be included in Germany. Recruitment has been a challenge throughout the study and substantial efforts went into devising innovative recruiting approaches. Standard recruitment strategies were used, such as directly approaching people with aphasia in clinical settings, inpatient and outpatient language rehabilitation facilities, and patient support and advocacy groups, alongside more innovative techniques including radio commercials, dissemination of study information via national television and social media platforms. PROVISIONAL RESULTS Up until now, 110 patients have been included into the study. The largest short-term response was achieved via television and radio. The largest long-term response was obtained through recruitment via logopaedic and neurological facilities, patient support groups, and social media. Participants served as "testimonials", expressing that they were satisfied with the therapy and the tDCS application. DISCUSSION The multicenter study DC_TRAIN_APHASIA aims to provide evidence on tDCS as an adjuvant application to increase the effect size of intensive speech-language therapy in chronic post-stroke aphasia. The present review may guide future studies in recruiting samples that involve people with impaired communicative abilities.
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Affiliation(s)
- Nina Unger
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland.
| | - Benjamin Stahl
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
- Fakultät Naturwissenschaften, Medical School Berlin, Berlin, Deutschland
- Max-Planck-Institut für Kognitions- und Neurowissenschaften, Leipzig, Deutschland
| | | | - Veronika Scholz
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Isabel Weinmar
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Johanna Schmidt
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Caterina Breitenstein
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universität Münster, Münster, Deutschland
| | - Marcus Meinzer
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Tanja Grewe
- Abt. Technik & Gesundheit für Menschen, Studiengang Logopädie, Jade Hochschule, Oldenburg, Deutschland
| | - Agnes Flöel
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
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Klarmann S, Hierundar A, Deffner T, Markewitz A, Waydhas C. [Therapeutic healthcare professional staffing requirements in intensive care units]. Med Klin Intensivmed Notfmed 2024:10.1007/s00063-024-01125-z. [PMID: 38546865 DOI: 10.1007/s00063-024-01125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/24/2024] [Accepted: 02/19/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Therapeutic healthcare professionals in the multiprofessional intensive care unit (ICU) team are important for early mobilization, dysphagia therapy, and psychosocial care of critically ill patients. OBJECTIVE Despite the high relevance of therapeutic healthcare professions for care in ICUs, there are no recommendations on the specific staffing of therapists in ICUs. RESULTS Considering the main areas of activity of the individual professional groups and based on productivity time, a requirements analysis for staffing ICUs of different care levels with physiotherapists, occupational therapists, speech therapists, and psychologists was performed. For every 10 beds in the highest care level (LoC3), 1.28 full-time equivalent (FTE) physiotherapists, 0.91 FTE occupational therapists and speech therapists, and 0.80 FTE psychologists should be employed. CONCLUSION In order to implement multiprofessional patient treatment and support for relatives in the ICU, it is essential to employ a proportionate number of therapeutic healthcare professionals.
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Affiliation(s)
- Silke Klarmann
- Leitung Therapiezentrum , Schön Klinik - Rendsburg und Schön Klinik - Eckernförde, 24768, Rendsburg, Deutschland
| | - Anke Hierundar
- Klinik und Poliklinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Teresa Deffner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland.
| | - Andreas Markewitz
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI), (DIVI), Deutschland
| | - Christian Waydhas
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Essen, Deutschland
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Dolgoy N, Bernard S, Huang F, Driga A, Hall-Lavoie D, Brown A, Pituskin E, Fairchild A, McNeely ML. Determining the destination: a co-designed chronic advanced cancer rehabilitation conceptual framework for engagement of individuals with lived experience in rehabilitation research. Res Involv Engagem 2024; 10:35. [PMID: 38528573 DOI: 10.1186/s40900-024-00566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Individuals living with chronic advanced cancer (CAC) often face distinct physical, functional, and cognitive issues. Their rehabilitation needs are not yet routinely met, warranting further CAC-specific rehabilitation-based research. Given the complexity of functional and symptom presentations, engagement of individuals living with CAC as partners in the research process is encouraged to better understand the lived perspective. Formal engagement requires both structured approaches and iterative processes. The aim was to co-design a conceptual framework to develop and integrate engagement strategies into rehabilitation research focused on CAC populations. METHODS A multidisciplinary team of authors, including two individuals with lived experience, conducted an implementation-focused descriptive study to inform future research design, including: interviews and follow-up, review of current models and approaches, and development of a co-designed conceptual framework for engaging individuals with lived experience into CAC-specific rehabilitation research. RESULTS Emergent themes include shared understanding, transparent appreciation, iterative processes and unique partnership needs. A definition, guiding principles and tools for engagement were identified. In consultation with individuals with lived experience, and application of the emergent themes in context, a conceptual framework to guide the engagement process was developed. CONCLUSION A novel conceptual framework for engaging individuals with lived experience with CAC as partners in rehabilitation research is proposed to facilitate implementation-focused team-based approaches for this population.
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Affiliation(s)
- Naomi Dolgoy
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada.
| | - Stephanie Bernard
- École des sciences de la réadaptation, Faculté de Médecine, Université Laval, Quebec City, Canada
| | - Fleur Huang
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Amy Driga
- Alberta Health Services, Edmonton, AB, Canada
| | | | - Adam Brown
- Individuals With Lived Experience, Edmonton, AB, Canada
| | - Edith Pituskin
- Faculty of Nursing, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - Alysa Fairchild
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada
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Portalete CR, Moraes DADO, Pagliarin KC, Keske-Soares M, Cielo CA. Acoustic and Physiological Voice Assessment And Maximum Phonation Time In Patients With Different Types Of Dysarthria. J Voice 2024; 38:540.e1-540.e11. [PMID: 34895782 DOI: 10.1016/j.jvoice.2021.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare the maximum phonation time of /a/, acoustic glottal source parameters, and physiological measures in patients with dysarthria. METHOD Thirteen patients were classified according to dysarthria type and divided into functional profiles (hypofunctional, hyperfunctional, and mixed). Assessments of maximum phonation time of /a/, glottal source parameters, electroglottography, and nasometry were performed. Results were compared between groups using ANOVA and Tukey posthoc tests. RESULTS The highest fundamental frequency differed significantly between groups, with the hyperfunctional profile showing higher values than the other participant groups. Reductions in the maximum phonation time of /a/ and alterations in acoustic glottal source parameters and electroglottography measures were observed in all groups, with no significant differences between them. The remaining measures did not differ between groups. CONCLUSION The maximum phonation times for /a/ were reduced in all participant groups, suggesting air escape during phonation. The presence of alterations in several glottal source parameters in all participant groups is indicative of noise, tremor, and vocal instability. Lastly, the high fundamental frequency in patients with a hyperfunctional profile reinforces the presence of vocal instability. These findings suggest that, although the characteristics observed in the assessments were consistent with expectations of patients with dysarthria, it is difficult to perform a differential diagnosis of this condition based on acoustic and physiological parameters alone.
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Dias C, Rodrigues IT, Gonçalves H, Duarte I. Communication strategies for adults in palliative care: the speech-language therapists' perspective. BMC Palliat Care 2024; 23:49. [PMID: 38383383 PMCID: PMC10880300 DOI: 10.1186/s12904-024-01382-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Communication disorders are a challenge that many patients in palliative care (PC) may encounter. This intervention area is emerging for the speech-language therapist (SLT), the professional who works in preventing, assessing, diagnosing, and treating human communication disorders. This study aims to identify and classify the communication strategies considered most important by SLTs for use in PC and evaluate whether there are any differences in perception regarding the importance of strategies between SLTs with and without PC experience. METHODS This cross-sectional quantitative study was conducted using a survey, which employed a well-structured, self-completion questionnaire previously validated by a panel of experts with over six years of PC experience. RESULTS The strategies rated as most important within each group were the following: (i) adjust the patient's position and minimise environmental noise; (ii) establish eye contact and adjust the pace of speech; (iii) adjust the language level and raise one topic at a time; (iv) use images of the patient's interests and their personal objects; (v) use orality and multimodal form; (vi) use simplified language and structured pauses; and (vii) use tables with images and books with pictures. CONCLUSIONS Verbal and non-verbal strategies were rated as highly important. There was no evidence of differences in perception in terms of importance between the SLTs with or without experience in PC, but more studies are needed to support this aspect. The patient's communication ability is one of the cornerstones of PC quality. Through their actions, speech-language professionals could empower the patient with strategies so that they can autonomously and self-determinedly express their experiences and most significant needs.
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Affiliation(s)
- Cátia Dias
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Inês Tello Rodrigues
- Centre for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, Leiria, Portugal
- Alcoitão School of Health Sciences (ESSAlcoitão), Alcabideche, Portugal
| | - Hernâni Gonçalves
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ivone Duarte
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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Knuijt S, Nonnekes J, van de Warrenburg BPC, Nijkamp M, Scholten S, de Swart BJM, Kalf JG. The Use of the Voice Trainer App for Vocal Control in People with a Degenerative Ataxia: A Pilot Intervention Study. Cerebellum 2024:10.1007/s12311-024-01662-5. [PMID: 38285133 DOI: 10.1007/s12311-024-01662-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 01/30/2024]
Abstract
Dysarthria is disabling in persons with degenerative ataxia. There is limited evidence for speech therapy interventions. In this pilot study, we used the Voice trainer app, which was originally developed for patients with Parkinson's disease, as a feedback tool for vocal control. We hypothesized that patients with ataxic dysarthria would benefit from the Voice trainer app to better control their loudness and pitch, resulting in a lower speaking rate and better intelligibility. This intervention study consisted of five therapy sessions of 30 min within 3 weeks using the principles of the Pitch Limiting Voice Treatment. Patients received real-time visual feedback on loudness and pitch during the exercises. Besides, they were encouraged to practice at home or to use the Voice trainer in daily life. We used observer-rated and patient-rated outcome measures. The primary outcome measure was intelligibility, as measured by the Dutch sentence intelligibility test. Twenty-one out of 25 included patients with degenerative ataxia completed the therapy. We found no statistically significant improvements in intelligibility (p = .56). However, after the intervention, patients were speaking slower (p = .03) and the pause durations were longer (p < .001). The patients were satisfied about using the app. At the group level, we found no evidence for an effect of the Voice trainer app on intelligibility in degenerative ataxia. Because of the heterogeneity of ataxic dysarthria, a more tailor-made rather than generic intervention seems warranted.
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Affiliation(s)
- S Knuijt
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - J Nonnekes
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
- Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, the Netherlands
| | - B P C van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M Nijkamp
- Voice and Swallowing Center Parkstad, Heerlen, the Netherlands
| | - S Scholten
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - B J M de Swart
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J G Kalf
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
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Batista DDJ, Duarte JMDT, Siqueira LTD, Almeida AA, Lopes LW, Ribeiro VV. Volitional and Non-volitional Devices Used in Voice Therapy and Training: A Scoping Review-Part A. J Voice 2023:S0892-1997(23)00348-X. [PMID: 38155057 DOI: 10.1016/j.jvoice.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To map the volitional and non-volitional devices used by speech and language pathologists (SLPs) in voice training and therapy and characterize their use in research on voice interventions. METHODS This scoping review is the first part of a larger study. The electronic search was carried out by mapping the references in PubMed/Medline, LILACS/BVS, Scopus, Web of Science, EMBASE, and the Cochrane Library, and the manual search was carried out in the grey literature. Two blind independent reviewers selected and extracted data; divergences were solved by consensus. The data extracted in this part of the study were the authorship and year of publication, country, study design, sample characteristics, intervention modality, ingredient, target, mechanism of action, dosage, and outcome measures. They were addressed with descriptive analysis. RESULTS Publications that use devices as ingredients are mostly from the last two decades, mainly carried out in the United States of America and Brazil, in adults of both sexes with behavioral dysphonia. Forty-two types of devices were used, many of them with similar approaches but different nomenclatures. Most devices were used voluntarily, focusing on vocal function, and aiming to increase source and filter interaction. Most studies used silicone tubes. The most reported technical specification to apply the ingredient was surface electrodes on the neck. Device dosage was time-controlled, and the most used outcomes were self-assessment and acoustic analysis. CONCLUSION Devices are currently used as ingredients in vocal interventions, with a greater focus on increasing the source and filter interaction, associated with silicone tubes (the most used devices in these studies), which have been dosed with performance time. Outcomes were measured with self-assessment instruments.
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Affiliation(s)
- Denis de Jesus Batista
- Center for Exact and Natural Sciences, Postgraduate program in Decision Models and Health of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil
| | - João M da Trindade Duarte
- Center for Human Sciences, Letters and Arts, Postgraduate program in Linguistics of Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Larissa T D Siqueira
- Department of Speech-Language Pathology and Audiology of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Anna A Almeida
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Leonardo W Lopes
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Department of Speech-Language Pathology and Audiology, Graduate Program in Linguistics, and Graduate Program in Decision Models and Health of the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Vanessa V Ribeiro
- Health Sciences Center, Associated Postgraduate Program in Speech-Language Pathology and Audiology at the Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte, and Universidade Estadual de Ciências da Saúde de Alagoas, João Pessoa, Paraíba, Brazil; Faculty of Medicine, Speech-Language Pathology and Audiology course and the Postgraduate Program in Medical Sciences of the Universidade de Brasília, Brasília, Distrito Federal, Brazil.
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Nerurkar NK, Nagree Z, Malik E, Jahnavi. Vocal Outcomes Following Pitch Alteration Surgeries. Indian J Otolaryngol Head Neck Surg 2023; 75:2741-2746. [PMID: 37974673 PMCID: PMC10645986 DOI: 10.1007/s12070-023-03837-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/24/2023] [Indexed: 11/19/2023] Open
Abstract
Our study aims to ascertain the results of speech therapy and surgery in patients who desire pitch alteration. Typically, patients desirous of an increase in their vocal pitch are male-to-female transpersons, and patients desirous of a drop in their pitch are puberphonia patients. This is a 3-year retrospective study of patients who have been operated for pitch alteration. This is a study of seven patients each of Wendlers glottoplasty (WG) and relaxation laryngeal framework surgery (RLFS). The records were reviewed for the preoperative and the 1-year post-operative fundamental frequency (FO), patient subjective satisfaction score (PSSS), and healing time. A total of 7/35 patients of puberphonia underwent RLFS in which the average preoperative F0 was 216 Hz and 1-year post-operative F0 was 114 Hz (p 0.004). The average pre- and post-operative PSSS was 4 and 9 (p 0.0004). Patients of WG had an average preoperative F0 of 153 Hz and 1-year post-operative F0 of 223 Hz (p 0.0005). The average pre and 1-year postoperative PSSS was 4 and 8 (p 0.002). The average healing time was 3 weeks 4 days in the RLFS patients and 8 weeks 5 days for WG patients. The results of RFLS yielded a high PSSS with a pitch drop of more than 100 Hz. The results of WG yielded an increase in the pitch of 70 Hz with a good PSSS. The average healing time taken following WG was double the time taken for RFLS.
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Affiliation(s)
- Nupur Kapoor Nerurkar
- Bombay Hospital Voice and Swallowing Centre, 2nd Floor MRC, Mumbai, Maharashtra India
- Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra India
| | - Zainab Nagree
- Bombay Hospital Voice and Swallowing Centre, 2nd Floor MRC, Mumbai, Maharashtra India
- Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra India
| | - Enu Malik
- Bombay Hospital Voice and Swallowing Centre, 2nd Floor MRC, Mumbai, Maharashtra India
- Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra India
| | - Jahnavi
- Bombay Hospital Voice and Swallowing Centre, 2nd Floor MRC, Mumbai, Maharashtra India
- Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra India
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de Jesus Batista D, Lopes LW, Almeida AA, Siqueira LTD, Ribeiro VV. What Factors Determine the Use of Volitional and Non-Volitional Devices in Vocal Interventions Performed by Brazilian Speech-Language Pathologists? J Voice 2023:S0892-1997(23)00346-6. [PMID: 37957072 DOI: 10.1016/j.jvoice.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To analyze the determining factors for using devices in vocal interventions and characterize their use by Brazilian speech-language pathologists (SLPs). METHODS This cross-sectional observational study had a sample of 148 SLPs with clinical practice in voice. They answered an online questionnaire via Google Forms about sociodemographic data, training, work in the area, and the use of devices in vocal interventions. Data were analyzed descriptively and inferentially. RESULTS Tubes, straws, and masks were the most commonly used devices. SLPs specializing in voice are more inclined to use thermotherapy and kinesio tapings while being less inclined to use therapeutic ultrasounds and nebulizers. Voice specialists are less likely to employ electrostimulation. The choice to use photobiomodulation and auditory monitoring devices is influenced by the years of clinical experience, whereas the speech-language therapy training duration affects the use of electrostimulation. The age of the professional also plays a role in the utilization of vibratory stimulation. Vibratory stimulation, auditory monitoring devices, thermotherapy, and nebulization are more frequently utilized among individuals who rely on their voices for occupational purposes, whereas electrostimulation is less common. The use of photobiomodulation is infrequent in children; vibratory stimulation is more common in adolescents, and thermotherapy is relatively common among older individuals. Most of these devices are typically prescribed in execution time during vocal intervention. CONCLUSION The specialization, the time since graduation and in the occupation, and the target population of the service are the determining factors for the use of devices. They are used in vocal therapy and training, targeting vocal function.
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Affiliation(s)
- Denis de Jesus Batista
- Postgraduate Program in Decision Models and Health, Statistics Departament, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas.
| | - Leonardo Wanderley Lopes
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Department of Speech-Language Therapy, and Postgraduate Program in Decision Models and Health at the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Anna Alice Almeida
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Department of Speech-Language Therapy, and Postgraduate Program in Decision Models and Health at the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Vanessa Veis Ribeiro
- Associate Postgraduate Program in Speech-language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas; Speech-language Therapy Course and Postgraduate Program in Medical Sciences, Universidade de Brasília
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Wauters LD, Croot K, Dial HR, Duffy JR, Grasso SM, Kim E, Schaffer Mendez K, Ballard KJ, Clark HM, Kohley L, Murray LL, Rogalski EJ, Figeys M, Milman L, Henry ML. Behavioral Treatment for Speech and Language in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech: A Systematic Review. Neuropsychol Rev 2023:10.1007/s11065-023-09607-1. [PMID: 37792075 DOI: 10.1007/s11065-023-09607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/13/2023] [Indexed: 10/05/2023]
Abstract
Primary progressive aphasia (PPA) and primary progressive apraxia of speech (PPAOS) are neurodegenerative syndromes characterized by progressive decline in language or speech. There is a growing number of studies investigating speech-language interventions for PPA/PPAOS. An updated systematic evaluation of the treatment evidence is warranted to inform best clinical practice and guide future treatment research. We systematically reviewed the evidence for behavioral treatment for speech and language in this population. Reviewed articles were published in peer-reviewed journals through 31 May 2021. We evaluated level of evidence, reporting quality, and risk of bias using a modified version of the American Speech-Language Hearing Association (ASHA) Levels of Evidence, an appraisal point system, additional reporting quality and internal/external validity items, and, as appropriate, the Single Case Experimental Design Scale or the Physiotherapy Evidence Database - PsycBITE Rating Scale for Randomized and Non-Randomized Controlled Trials. Results were synthesized using quantitative summaries and narrative review. A total of 103 studies reported treatment outcomes for 626 individuals with PPA; no studies used the diagnostic label PPAOS. Most studies evaluated interventions for word retrieval. The highest-quality evidence was provided by 45 experimental and quasi-experimental studies (16 controlled group studies, 29 single-subject designs). All (k = 45/45) reported improvement on a primary outcome measure; most reported generalization (k = 34/43), maintenance (k = 34/39), or social validity (k = 17/19) of treatment for at least one participant. The available evidence supports speech-language intervention for persons with PPA; however, treatment for PPAOS awaits systematic investigation. Implications and limitations of the evidence and the review are discussed.
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Affiliation(s)
- Lisa D Wauters
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), 78712, Austin, TX, USA
| | - Karen Croot
- School of Psychology, University of Sydney, 2006, Sydney, NSW, Australia
| | - Heather R Dial
- Department of Communication Sciences and Disorders, University of Houston, Houston, TX, 77204, USA
| | - Joseph R Duffy
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, 55902, USA
| | - Stephanie M Grasso
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), 78712, Austin, TX, USA
| | - Esther Kim
- US Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, T6G 2R3, Edmonton, AB, Canada
| | | | - Kirrie J Ballard
- Faculty of Medicine & Health and Brain & Mind Centre, University of Sydney, Sydney, NSW, 2006, Australia
| | - Heather M Clark
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, 55902, USA
| | - Leeah Kohley
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), 78712, Austin, TX, USA
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, ON, N6A 3K7, Canada
| | - Emily J Rogalski
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, 60611, Chicago, IL, USA
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Feinberg School of Medicine, 60611, Chicago, IL, USA
| | - Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Lisa Milman
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, 84322, USA
| | - Maya L Henry
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, 2504A Whitis Ave. (A1100), 78712, Austin, TX, USA.
- Department of Neurology, Dell Medical School, University of Texas at Austin, 78712, Austin, TX, USA.
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Lowit A, Cox J, Loucas M, Grassly J, Egan A, van Brenk F, Hadjivassiliou M. ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia. Cerebellum 2023; 22:865-876. [PMID: 36001243 PMCID: PMC9399979 DOI: 10.1007/s12311-022-01462-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care-ClearSpeechTogether-is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias. METHOD This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation. RESULTS Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing. DISCUSSION ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.
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Affiliation(s)
- Anja Lowit
- School of Psychological Sciences and Health, Strathclyde University, 40 George St, Glasgow, G1 1QE, Scotland.
| | - Jessica Cox
- School of Psychological Sciences and Health, Strathclyde University, 40 George St, Glasgow, G1 1QE, Scotland
| | - Melissa Loucas
- School of Psychology and Clinical Language Sciences, Earley Gate, University of Reading, RG6 6AL, Reading, England
| | - Jennifer Grassly
- University College London, Chandler House, 2 Wakefield Street, London, WC1N 1PF, England
| | - Aisling Egan
- School of Psychological Sciences and Health, Strathclyde University, 40 George St, Glasgow, G1 1QE, Scotland
| | - Frits van Brenk
- Department of Languages, Literature and Communication, Utrecht University, Trans 10, 3512 JK, Utrecht, Netherlands
| | - Marios Hadjivassiliou
- Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, S10 2JF, England
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Battista S, Furri L, de Biagi G, Depedri L, Broggi V, Testa M. Clinical records after asynchronous and synchronous e-learning courses: a multi-method randomised controlled trial on students' performance and experience. BMC Med Educ 2023; 23:584. [PMID: 37596612 PMCID: PMC10439640 DOI: 10.1186/s12909-023-04528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 07/21/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Clinical Record (CR) writing is a fundamental skill for healthcare professionals, but the best e-learning methods for teaching it remain unstudied. Therefore, we investigated speech therapy students' differences in the quality production of CR at the placement and their experience after following asynchronous or synchronous e-learning courses. METHODS A multi-method randomised controlled trial. Fifty speech therapist students were equally and randomly divided into two groups attending asynchronous or synchronous e-learning classes to learn how to write a CR. The quality of the CR was tested through an ad hoc checklist (score 0-32) and the groups' scores were compared. The assessors and the statistician were blinded to students' group assignment. Students' experience was assessed through semi-structured interviews analysed with a reflexive thematic analysis. RESULTS No score differences between the two groups were found (Cohen's d = 0.1; 95% Confidence Interval [-0.6; 0.7]). Four themes were generated: (1) 'Different Forms of Learning Interaction', as the synchronous group reported a positive experience with being fed back immediately by the lecturer, whereas the asynchronous group reported that pushing back the question time allows for reflecting more on the learning experience; (2) 'Different Ways to Manage the Time', as the synchronous group had to stick to the lecturer's schedule and the asynchronous group felt the possibility to manage its time; (3) 'To Be or Not To Be (Present)?' due to the different experiences of having (or not) the lecturer in front of them; (4) 'Inspiring Relationships With The Peers', where both groups preferred a peer-to-peer discussion instead of contacting the lecturer. DISCUSSION Asynchronous and synchronous e-learning courses appeared equally effective in teaching CR writing. However, students perceive and experience these methods differently. The choice or blend of these methods should be based on students' needs and preferences, teacher input, as well as organisational requirements rather than solely on students' attended performance.
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Affiliation(s)
- Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
- School of Medicine and Surgery, University of Verona, Verona, Italy
| | - Laura Furri
- School of Medicine and Surgery, University of Verona, Verona, Italy
| | - Giorgia de Biagi
- School of Medicine and Surgery, University of Verona, Verona, Italy
| | - Lucia Depedri
- School of Medicine and Surgery, University of Verona, Verona, Italy
| | - Valeria Broggi
- School of Medicine and Surgery, University of Milano, Milano, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy.
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Darrot G, Gros A, Manera V, De Cara B, Faure S, Corveleyn X, Harrar-Eskinazi K. Effects of a developmental dyslexia remediation protocol based on the training of audio-phonological cognitive processes in dyslexic children with high intellectual potential: study protocol for a multiple-baseline single-case experimental design. BMC Pediatr 2023; 23:404. [PMID: 37592217 PMCID: PMC10433642 DOI: 10.1186/s12887-023-04189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children's underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children. METHODS A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study. DISCUSSION The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed. TRIAL REGISTRATION ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.
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Affiliation(s)
- Gaëlle Darrot
- Département d'Orthophonie de Nice, Faculté de Médecine, Université Côte d'Azur, Nice, France.
- Université Côte d'Azur, Laboratoire CoBTeK, Nice, France.
| | - Auriane Gros
- Département d'Orthophonie de Nice, Faculté de Médecine, Université Côte d'Azur, Nice, France
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France
| | - Valeria Manera
- Département d'Orthophonie de Nice, Faculté de Médecine, Université Côte d'Azur, Nice, France
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France
| | - Bruno De Cara
- Université Côte d'Azur, Laboratoire LAPCOS, Nice, France
| | - Sylvane Faure
- Université Côte d'Azur, Laboratoire LAPCOS, Nice, France
| | | | - Karine Harrar-Eskinazi
- Université Côte d'Azur, Laboratoire LAPCOS, Nice, France
- Hopitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire de Nice, Nice, France
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Sales NJ, Sampaio ATS, Pimentel D, de Oliveira ER, Prado-Barreto VM, d'Avila JS, Castaneda DFN, de Carvalho Barreto ID, Gurgel RQ. Pediatric Dysphonia and the Access to Voice Therapy: A Study in Speech Therapy Services Available in a Capital City in the Northeast of Brazil. J Voice 2023:S0892-1997(23)00153-4. [PMID: 37438212 DOI: 10.1016/j.jvoice.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES Defining the laryngeal and vocal alterations in the pediatric group studied in private speech therapy facilities; and estimating the time period between the problem being identified by the parents and the access to the proper provided services. METHODS A cross-sectional analytical observational research with data collected from medical records by the speech therapist of each private facility. A written form was prepared and sent to the speech therapists of the 40 existing facilities. We received 124 of them from the pediatric group being assisted in 15 of the facilities. The form included questions about gender, age, vocal complaints; general degree of dysphonia; otorhinolaryngological diagnosis of vocal fold alterations; the age that the problem was identified by the parents and the beginning of speech therapy. The larynx was examined by videonasopharyngolaryngoscopy, and voice quality by auditory-perceptual assessment. RESULTS The time period between the identification of the participant's dysphonia by the parents and the start of speech therapy was considered long (3.5years). The group showed variance in the proportion of nodule and cyst between genders. The highest prevalence of nodules occurred in boys; and the cyst in girls. Moderate general dysphonia occurred between 4 and 17years old, average age of 7years and 7months, with greater distribution between 5 and 10years of age. CONCLUSIONS The average time delay until the start of speech therapy was 3.5years, more frequently in the 5-10years group and due to nodules in boys and cysts in girls.
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Affiliation(s)
| | | | - Déborah Pimentel
- Department of Medicine, Federal University of Sergipe, UFS, Aracaju, Sergipe, Brazil.
| | | | | | | | | | | | - Ricardo Queiroz Gurgel
- Department of Medicine, Graduate in Health Sciences, Federal University of Sergipe, UFS, Aracaju, Sergipe, Brazil.
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Jaswal S, Lo J, Sithamparanathan G, Nowrouzi-Kia B. The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes-a systematic review and meta-analysis protocol. Syst Rev 2023; 12:76. [PMID: 37143097 PMCID: PMC10157558 DOI: 10.1186/s13643-023-02248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. METHODS A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. DISCUSSION The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. TRIAL REGISTRATION This systematic review has been registered with PROSPERO under registration number CRD42022297849.
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Affiliation(s)
- Sharan Jaswal
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joyce Lo
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gobika Sithamparanathan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada.
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
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19
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Troll C, Trapl-Grundschober M, Teuschl Y, Cerrito A, Compte MG, Siegemund M. A bedside swallowing screen for the identification of post-extubation dysphagia on the intensive care unit - validation of the Gugging Swallowing Screen (GUSS)-ICU. BMC Anesthesiol 2023; 23:122. [PMID: 37055724 PMCID: PMC10099025 DOI: 10.1186/s12871-023-02072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/29/2023] [Indexed: 04/15/2023] Open
Abstract
PURPOSE Screening for dysphagia at the intensive care unit (ICU) soon after extubation can prevent aspiration, pneumonia, lower mortality, and shorten re-feeding interval. This study aimed to modify the Gugging Swallowing Screen (GUSS), which was developed for acute stroke patients, and to validate it for extubated patients in the ICU. METHODS In this prospective study, forty-five patients who had been intubated for at least 24 h were recruited consecutively at the earliest 24 h after extubation. The modified GUSS-ICU was performed twice by two speech and language therapists independently. Concurrently, gold standard the flexible endoscopic evaluation of swallowing (FEES) was performed by an otorhinolaryngologist. Measurements were conducted within a three-hour period; all testers were blinded to each other's results. RESULTS According to FEES, 36 of 45 (80%) participants were diagnosed with dysphagia; 13 of those were severe, 12 moderate, and 11 mild. Compared to FEES, the GUSS-ICU predicted dysphagia well (area under the curve for the initial rater pair: 0.923, 95% CI 0.832-1.000 and 0.923, 95% CI 0.836 -1.000 for the second rater pair). The sensitivity was 91.7% (95% CI 77.5-98.3%) and 94.4% (95% CI 81.3-99.3%); the specificity was 88.9% (51.8-99.7%) and 66.7% (29.9-92.5%); the positive predictive values were 97.1% (83.8-99.5%) and 91.9% (81.7-96.6%), and the negative predictive values were 72.7% (46.8-89%) and 75% (41.9-92.6%) for the first and second rater pairs, respectively. Dysphagia severity classification according to FEES and GUSS-ICU correlated strongly (Spearman's rho: 0.61 for rater 1 and 0.60 for rater 2, p < 0.001). Agreement by all testers was good (Krippendorffs Alpha: 0.73). The interrater reliability showed good agreement (Cohen`s Kappa: 0.84, p < 0.001). CONCLUSION The GUSS-ICU is a simple, reliable, and valid multi-consistency bedside swallowing screen to identify post-extubation dysphagia at the ICU. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04532398,31/08/2020.
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Affiliation(s)
- Claudia Troll
- Department of Therapies, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
| | | | - Yvonne Teuschl
- Department for Clinical Neurosciences and Preventive Medicine, University for Continuing Education Krems, Dr.-Karl-Dorrek-Strasse 30, 3500, Krems, Austria
| | - Adrien Cerrito
- Bern University of Applied Sciences Health, Department of Health Professions, Murtenstrasse 10, 3008, Bern, Switzerland
| | | | - Martin Siegemund
- Intensive Care Unit, Department Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
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20
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Smith JD, McConville K, Tiner MK, Baldner EF, Rosenberg M, Kupfer RA, Hogikyan ND, Morrison RJ. Examining Use and Effectiveness of Teletherapy for Patients with Dysphonia. J Voice 2023:S0892-1997(23)00034-6. [PMID: 36863957 DOI: 10.1016/j.jvoice.2023.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE(S)/HYPOTHESIS Virtual therapy (teletherapy) for patients with dysphonia has become ubiquitous in the COVID-19 era. However, barriers to widespread implementation are evident, including unpredictable insurance coverage attributed to limited evidence supporting this approach. In our single-institution cohort, our objective was to show strong evidence for use and effectiveness of teletherapy for patients with dysphonia. STUDY DESIGN Single institution, retrospective cohort study. MATERIAL AND METHODS This was an analysis of all patients referred for speech therapy with dysphonia as primary diagnosis from 4/1/2020 to 7/1/2021 and in whom all therapy sessions were delivered in a teletherapy format. We collated and analyzed demographics and clinical characteristics and adherence to the teletherapy program. We assessed changes in perceptual assessments and vocal capabilities (GRBAS, MPT), patient-reported outcomes (V-RQOL), and metrics of session outcomes (complexity of vocal tasks, carry-over of target voice) pre- and post-teletherapy using student's t test and chi-square test. RESULTS Our cohort included 234 patients (mean [SD] age 52 [20] years) residing a mean (SD) distance of 51.3 (67.1) miles from our institution. The most common referral diagnosis was muscle tension dysphonia (n = 145, 62.0% patients). Patients attended a mean (SD) of 4.2 (3.0) sessions; 68.0% (n = 159) of patients completed four or more sessions and/or were deemed appropriate for discharge from teletherapy program. Statistically significant improvements were seen in complexity and consistency of vocal tasks with consistent gains in carry-over of target voice for isolated tasks and connected speech. CONCLUSIONS Teletherapy is a versatile and effective approach for treatment of patients with dysphonia of varying age, geography, and diagnoses.
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Affiliation(s)
- Joshua D Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Katherine McConville
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Margaret K Tiner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Ford Baldner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Marci Rosenberg
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Robbi A Kupfer
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Norman D Hogikyan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Robert J Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA.
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21
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Balzer J, Jung A, Gerhard J, Reinecke S, Mijic M, Fichtmüller A, Jahjah A, Eggert M, Koch M, Ernst K, Haring R. Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review. Z Evid Fortbild Qual Gesundhwes 2023; 176:1-11. [PMID: 36702639 DOI: 10.1016/j.zefq.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/27/2022] [Accepted: 11/11/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the "EBP status quo" is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany. METHODS The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria. RESULTS Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed "sufficient" evidence for content validity, three questionnaires showed "sufficient" evidence for reliability, two questionnaires showed "sufficient" evidence for structural validity as well as internal consistency, and nine questionnaires showed "sufficient" evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested. DISCUSSION Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with "sufficient" content validity and, in addition, "sufficient" reliability or "sufficient" internal consistency. CONCLUSION Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.
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Affiliation(s)
- Julia Balzer
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Andrés Jung
- Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Lübeck, Germany.
| | - Janina Gerhard
- Gesellschaft für psychosoziale Einrichtungen gGmbH, Mainz, Germany
| | - Sarah Reinecke
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Marko Mijic
- Ludwig-Maximilians-Universität München, Friedrich-Baur-Institut / Neurologische Klinik und Poliklinik, LMU Klinikum, Munich, Germany
| | - Andrea Fichtmüller
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | | | - Marieke Eggert
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Maren Koch
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Kathrin Ernst
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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22
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Good A, Earle E, Vezer E, Gilmore S, Livingstone S, Russo FA. Community Choir Improves Vocal Production Measures in Individuals Living with Parkinson's Disease. J Voice 2023:S0892-1997(22)00391-5. [PMID: 36642592 DOI: 10.1016/j.jvoice.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Parkinson's disease (PD) is a neurodegenerative disease leading to motor impairments and dystonia across diverse muscle groups including vocal muscles. The vocal production challenges associated with PD have received considerably less research attention than the primary gross motor symptoms of the disease despite having a substantial effect on quality of life. Increasingly, people living with PD are discovering group singing as an asset-based approach to community building that is purported to strengthen vocal muscles and improve vocal quality. STUDY DESIGN/METHODS The present study investigated the impact of community choir on vocal production in people living with PD across two sites. Prior to and immediately following a 12-week community choir at each site, vocal testing included a range of vocal-acoustic measures, including lowest and highest achievable pitch, duration of phonation, loudness, jitter, and shimmer. RESULTS Results showed that group singing significantly improved some, though not all, measures of vocal production. Group singing improved lowest pitch (both groups), duration (both groups), intensity (one group), and jitter (one group) and shimmer (both groups). CONCLUSIONS These findings support community choir as a feasible and scalable complementary approach to managing vocal production challenges associated with PD.
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Affiliation(s)
- Arla Good
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario.
| | | | - Esztella Vezer
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario
| | - Sean Gilmore
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario
| | - Steven Livingstone
- Department of Computer Science, Ontario Tech University, Oshawa, Ontario
| | - Frank A Russo
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario
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23
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Varelas EA, Hwang C, Brown S, Chang J, Sataluri M, Kirke D, Courey M, Goldberg L. Standardized Behavioral Treatment Improves Chronic Cough. J Voice 2023:S0892-1997(22)00369-1. [PMID: 36642591 DOI: 10.1016/j.jvoice.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Neurogenic Laryngeal Hypersensitivity (NLH) refers to a constellation of upper airway symptoms thought to be caused by a disturbance in afferent and/or efferent neural pathways creating an exaggerated hypersensitive laryngeal response. There is evidence to support behavioral therapy as treatment for improving symptoms from laryngeal motor dysfunction to sensory disturbance. This study aims to determine if there is significant symptomatic improvement in patients with NLH who received non-pharmacologic behavioral treatment performed by trained SLPs. STUDY DESIGN A retrospective review. METHODS A review of all patients with NLH from 2017 to 2020 was performed at a tertiary care voice and swallowing center. Subjects with persistent symptoms despite maximal medical management were considered for inclusion. Newcastle Laryngeal Hypersensitivity Questionnaire (NLHQ) was completed by patients before and after undergoing therapy by one of three trained SLPs. Posttherapy improvement was determined by utilizing the NLHQ's minimal clinically important difference of 1.7 points. RESULTS A total of 81 patients were included in this study. Study participants included 61 women and 20 men with an average age of 60.64±14.05 years. There was a statistically significant difference between the pre and post therapy scores amongst all patients when treated by each individual SLP and all three SLPs combined (P < 0.008). There was a clinically significant change in 66% of all patients, 76% of which presented with abnormal NLHQ scores, and 14% who presented with normal NLHQ scores. CONCLUSIONS A standardized behavioral treatment protocol for patients with symptoms consistent with NLH is effective in improving symptoms in a large majority of patients. When following a standardized protocol SLPs can obtain similar results for their patients.
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Affiliation(s)
- Eleni A Varelas
- Division of Laryngology, Department of Otolaryngology- Head and Neck Surgery, Mount Sinai Health System, New York, New York.
| | - Chaewon Hwang
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Sarah Brown
- Division of Laryngology, Department of Otolaryngology- Head and Neck Surgery, Mount Sinai Health System, New York, New York
| | - Joseph Chang
- The Permanente Medical Group, Department of Head and Neck Surgery, Kaiser Permanente Santa Clara, Santa Clara, California
| | - Medha Sataluri
- Northwestern Medicine, Department of Otolaryngology, Chicago, Illinois
| | - Diana Kirke
- Division of Laryngology, Department of Otolaryngology- Head and Neck Surgery, Mount Sinai Health System, New York, New York
| | - Mark Courey
- Division of Laryngology, Department of Otolaryngology- Head and Neck Surgery, Mount Sinai Health System, New York, New York
| | - Leanne Goldberg
- Division of Laryngology, Department of Otolaryngology- Head and Neck Surgery, Mount Sinai Health System, New York, New York
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24
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Borges TGV, Muniz CR, Ferreira FR, Brendim MP, Muxfeldt ES. Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea. Eur Arch Otorhinolaryngol 2023; 280:443-453. [PMID: 36098863 PMCID: PMC9469056 DOI: 10.1007/s00405-022-07612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/11/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate (i) the outcome of swallowing therapy program on the rehabilitation of oropharyngeal dysphagia in resistant hypertensive patients with obstructive sleep apnea (OSA) and (ii) the association between the clinical and anthropometric characteristics of these individuals and this outcome. METHODS This was a prospective interventional study in which resistant hypertensives diagnosed with OSA by polysomnography and dysphagia by fiberoptic endoscopic evaluation of swallowing (FESS) participated. All participants underwent a FEES and assessment of the risk of dysphagia (Eating Assessment Tool, EAT-10) and swallowing-related quality of life (Swal-QoL) before and after the intervention. The therapeutic program was performed daily by the participants, with weekly speech-therapist supervision for eight weeks, including the following strategies: Masako, chin tuck against resistance, and expiratory muscle training. RESULTS A total of 26 (78.8%) of the participants exhibited improvement in the degree of dysphagia in the intervention outcome. After the intervention, there was a statistically significant improvement in the level of penetration-aspiration (p = 0.007), the degree of pharyngeal residue (p = 0.001), the site of onset of the pharyngeal phase (p = 0.001), and the severity of dysphagia (p = 0.001) compared to before intervention. The EAT-10 score was 2 (0-6) before and 0 (0-3) after intervention (p = 0.023). Swal-QoL had a score on the symptom frequency domain of 92.8 (75-100) before and 98.2 (87.5-100) after intervention (p = 0.002). CONCLUSIONS Resistant hypertensive patients with OSA showed improved swallowing performance after swallowing therapy program.
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Affiliation(s)
- Thalyta Georgia Vieira Borges
- Program in Internal Medicine, Department of Internal Medicine, School of Medicine, Universidade Federal do Rio de Janeiro - UFRJ, 3º andar - Hypertension Program - ProHArt, Rua Professor Rodolpho Paulo Rocco, 255 - Ilha Do Fundão, Rio de Janeiro, Rio de Janeiro 21941-590 Brazil
| | - Carla Rocha Muniz
- Program in Internal Medicine, Department of Internal Medicine, School of Medicine, Universidade Federal do Rio de Janeiro - UFRJ, 3º andar - Hypertension Program - ProHArt, Rua Professor Rodolpho Paulo Rocco, 255 - Ilha Do Fundão, Rio de Janeiro, Rio de Janeiro 21941-590 Brazil
| | - Flavia Rodrigues Ferreira
- Program in Internal Medicine, Department of Internal Medicine, School of Medicine, Universidade Federal do Rio de Janeiro - UFRJ, 3º andar - Hypertension Program - ProHArt, Rua Professor Rodolpho Paulo Rocco, 255 - Ilha Do Fundão, Rio de Janeiro, Rio de Janeiro 21941-590 Brazil
| | - Mariana Pinheiro Brendim
- Speech-Language Pathology Department, School of Medicine, Universidade Federal do Rio de Janeiro - UFRJ, 4º andar - Speech-Language Pathology Clinic, Rua Professor Rodolpho Paulo Rocco, 255 - Ilha do Fundão, Rio de Janeiro, 21941-590 Brazil
| | - Elizabeth Silaid Muxfeldt
- Program in Internal Medicine, Department of Internal Medicine, School of Medicine, Universidade Federal do Rio de Janeiro - UFRJ, 3º andar - Hypertension Program - ProHArt, Rua Professor Rodolpho Paulo Rocco, 255 - Ilha Do Fundão, Rio de Janeiro, Rio de Janeiro 21941-590 Brazil
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25
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Papanikolaou K, Nasios G, Nousia A, Siokas V, Messinis L, Dardiotis E. Noninvasive Brain Stimulation in Primary Progressive Aphasia: A Literature Review. Adv Exp Med Biol 2023; 1425:567-574. [PMID: 37581830 DOI: 10.1007/978-3-031-31986-0_55] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Primary progressive aphasia (PPA) is a gradually progressive clinical syndrome in which the first and predominant symptoms involve language and/or speech production that interfere with daily activities. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) appear to have a beneficial impact on many neurodegenerative pathologies. The current review investigated the impact of rTMS and tDCS on PPA patients. English language articles that have been published in the databases PubMed, and Scopus from 2007 to 2022 were included. Fifteen single-case or small-group studies were analyzed and presented. The majority of the literature findings point toward that the application of rTMS or tDCS may have a positive effect in improving symptoms such as verb production, action naming, phonemic-verbal fluency, grammatical comprehension, written spelling, and semantic features. In conclusion, our review provides additional evidence supporting that both types of stimulation may improve linguistic deficits, especially if they combined, speech therapy.
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Affiliation(s)
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Anastasia Nousia
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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26
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Apukhtina V, Neoh MJY, Dimitriou D, Soloviova T, Esposito G. Implementation of speech therapy with persons with intellectual disabilities in Ukraine during May-June 2022. Res Dev Disabil 2023; 132:104376. [PMID: 36459825 DOI: 10.1016/j.ridd.2022.104376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Intellectual disability (ID) is a condition that requires complex systematic special support, including speech therapy. Speech therapists in Ukraine face professional challenges in working with persons with ID in the conditions of the military conflict with the Russian Federation. This qualitative study offers a representation of the situation of speech therapy practice in Ukraine in May-June 2022, and the impact of military conflict on persons with ID and their families. METHODS The current study made use of an adaptation of the five-step IPSE approach. Ten Ukrainian speech therapists were interviewed. Due to subjective and objective reasons arising from the current situation in Ukraine, data collection through sampling was limited. RESULTS A general framework based on two central axes of experience was applied in the data analysis. The two axes are: 1) Speech therapy of persons with ID in Ukraine and 2) Impact of the military situation on speech therapy in Ukraine. The following key categories of the speech therapy experience were discussed: 1) Therapeutic Activities, 2) Clients, 3) Challenges and 4) Emotional wellbeing. The results are presented for each category and discussed in terms of both central axes of experience. Additional considerations of the speech therapy experience in Ukraine that were raised during the interviews are also briefly discussed. CONCLUSIONS Our results indicate the problem of organizing speech therapy assistance for persons with ID from Ukraine during the analysed period. The consequences of the situation in the country on speech therapists, people with ID, and their families are discussed highlighting difficulties, challenges as well as emerging positive attitudes.
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Affiliation(s)
- Viktoriia Apukhtina
- Department of Social Pedagogy and Psychology, Zaporizhzhiia National University, Ukraine; Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Michelle Jin Yee Neoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, United Kingdom.
| | - Tetiana Soloviova
- Department of Social Pedagogy and Psychology, Zaporizhzhiia National University, Ukraine
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Italy
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Esfandbod A, Rokhi Z, Meghdari AF, Taheri A, Alemi M, Karimi M. Utilizing an Emotional Robot Capable of Lip-Syncing in Robot-Assisted Speech Therapy Sessions for Children with Language Disorders. Int J Soc Robot 2023; 15:165-183. [PMID: 36467283 PMCID: PMC9684761 DOI: 10.1007/s12369-022-00946-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
This study scrutinizes the impacts of utilizing a socially assistive robot, the RASA robot, during speech therapy sessions for children with language disorders. Two capabilities were developed for the robotic platform to enhance children-robot interactions during speech therapy interventions: facial expression communication (containing recognition and expression) and lip-syncing. Facial expression recognition was conducted by training several well-known CNN architectures on one of the most extensive facial expressions databases, the AffectNet database, and then modifying them using the transfer learning strategy performed on the CK+ dataset. The robot's lip-syncing capability was designed in two steps. The first step was concerned with designing precise schemes of the articulatory elements needed during the pronunciation of the Persian phonemes (i.e., consonants and vowels). The second step included developing an algorithm to pronounce words by disassembling them into their components (including consonants and vowels) and then morphing them into each other successively. To pursue the study's primary goal, two comparable groups of children with language disorders were considered, the intervention and control groups. The intervention group attended therapy sessions in which the robot acted as the therapist's assistant, while the control group only communicated with the human therapist. The study's first purpose was to compare the children's engagement while playing a mimic game with the affective robot and the therapist, conducted via video coding. The second objective was to assess the efficacy of the robot's presence in the speech therapy sessions alongside the therapist, accomplished by administering the Persian Test of Language Development, Persian TOLD. According to the first scenario, playing with the affective robot is more engaging than playing with the therapist. Furthermore, the statistical analysis of the study's results indicates that participating in robot-assisted speech therapy (RAST) sessions enhances children with language disorders' achievements in comparison with taking part in conventional speech therapy interventions.
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Affiliation(s)
- Alireza Esfandbod
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Zeynab Rokhi
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Ali F. Meghdari
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
- Fereshtegaan International Branch, Islamic Azad University, Tehran, Iran
| | - Alireza Taheri
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Minoo Alemi
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
- Department of Humanities, West Tehran Branch, Islamic Azad University, Tehran, Iran
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Sikka K. Parent's Perspective on Teletherapy of Pediatric Population with Speech and Language Disorder During Covid-19 Lockdown in India. Indian J Otolaryngol Head Neck Surg 2022; 75:14-20. [PMID: 36571100 PMCID: PMC9758453 DOI: 10.1007/s12070-022-03310-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Aim: The pandemic COVID-19 led to the sudden imposition of lockdown and travel restrictions worldwide, that made tele practice one of the most viable options for various hospitals and healthcare centres. The present study aimed at exploring the parental perspective on teletherapy, for children having speech and language delay, during the covid-19 pandemic lockdown. Material & method: A total of 100 parents with children with speech and language delays and who have undergone a minimum of five teletherapy sessions at a tertiary care hospital during the COVID-19 pandemic lockdown were recruited. A questionnaire with 12 close-ended questions was administered over the phone call to know the parent's perspective on the impact of teletherapy and its benefits. The responses obtained were tabulated and calculated for percentage response to each question. Result: Around 95% of parents reported improved motivation for speech-language therapy for their child due to teletherapy during the COVID-19 pandemic lockdown, and 96% of parents were satisfied with receiving teletherapy services during the COVID-19 pandemic lockdown. Furthermore, 90% of parents found teletherapy is more cost-effective than in-person therapy, but 88% believe face-to-face consultation is also required after some time (approx. after six months). Conclusion: The overall result suggested that parents had a positive attitude towards the teletherapy sessions. They reported the therapy sessions to be very effective and compliant, and it can be an efficient alternative with more structured implementation. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03310-y.
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Affiliation(s)
- Kapil Sikka
- All India Institute of Medical Sciences, New Delhi, Delhi India
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Govender S, Vallabhjee AL, Charles CR, Roesch D, Balton S. Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa. Int J Telerehabil 2022; 14:e6517. [PMID: 38026559 PMCID: PMC10681049 DOI: 10.5195/ijt.2022.6517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient-centered care.
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Affiliation(s)
- Shelissa Govender
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Annika L. Vallabhjee
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Chenay R. Charles
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Darike Roesch
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sadna Balton
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
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Ali I, Hussain RT, Wagay FA, Ahmad R. Muscle Tension Dysphonia: Experience from a Conflict Zone. Indian J Otolaryngol Head Neck Surg 2022; 74:2082-2087. [PMID: 36452805 PMCID: PMC9702440 DOI: 10.1007/s12070-020-02007-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022] Open
Abstract
We sought to explore the frequency of stress among OPD attending Kashmiri public diagnosed as muscle tension dysphonia (MTD) and determine the subjective consequences of voice therapy in management of muscle tension dysphonia. 72 subjects that attended to ENT and HNS OPD with change of voice were prospectively evaluated and also underwent an extensive otolaryngological examination. Patients identified as MTD were provided a questionnaire which was split into 3 parts: First part dealt with the identification of the subject (age, geography, gender, profession) and also provided evaluation of perceived anxiety using Perceived Stress Scale-10. In the next part the individuals needed to assess their vocal quality based on parameters of GRBAS 4-point score scale before and also after the treatment. In the final component the subjects also needed to answer the VHI-10 (Voice Handicap Index) and also the outcome was compared with those acquired at the assessment before the beginning of the treatment. The mean age of the cohort was 30.31 ± 07.43 (age range, 12-71) and every subject was an indigenous Kashmiri. As expected, vast majority of subjects were females (43 patients). In the pooled information set, women had numerically higher PSS-10 scores than males. For women, the typical stress score was M = 18.6 and for men the average stress score was M = 16.65. In a healthy population, the typical PSS stress score is described to be 13.7 (SD = 6.6) for women and 12.1 (SD = 5.9) for men. At the Wilcoxon test for paired data, we observed a significant difference between the VHI pretreatment (mean = 19.7) and VHI post-treatment, that's at time of the research (mean = 9.73; P = 0.017). The grade (G) was assessed in terms of improvement of the vocal quality as opposed with before treatment and also the individuals demonstrated a high level of satisfaction (mean = 0.65). When looking at roughness (R) as well as breathiness (B), the individuals remember that their speech is seldom rough (mean = 0.62) and also less breathy (median = 0.44). Patients likewise noted improvement in other variables of GRBAS scale. Stress is persistent, pervasive and nearly unavoidable in contemporary life. The decades old perplexing and mind baffling pandemonium hovering around the Kashmiri population has had a tremendous impression on the psychological development of people in this region. A careful conclusion is the fact that emotional stress might play a major role in the upkeep of MTD. MTD has to be approached in a multidisciplinary environment in which closer cooperation between a laryngologist, a speech language pathologist and also a psychologist is likely.
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Affiliation(s)
- Ihsan Ali
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Raj Tajamul Hussain
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Fayaz Ahmad Wagay
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
| | - Rauf Ahmad
- Department of Otorhinolaryngology, Government Medical College, Srinagar, J&K India
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Sarin V, Chatterjee A, Kakkar V, Juneja A. Evaluation of Tongue Functions After Free Flap Reconstruction. Indian J Otolaryngol Head Neck Surg 2022; 74:2398-2403. [PMID: 36452650 PMCID: PMC9701944 DOI: 10.1007/s12070-020-02177-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022] Open
Abstract
Squamous cell carcinoma of the tongue is the most common malignancy of the oral cavity, the lateral border being the commonest site. The treatment strategies mandate surgery followed by appropriate reconstruction as the first line of management. There are many suitable methods of reconstruction of tongue defects after surgery, but the principle of an ideal reconstruction method should provide not only satisfactory structural cosmesis, but also good restoration of function. We present our experience with the skin lined free flaps reconstruction for defects of the tongue and floor of mouth, and present analyses of the functional outcomes of reconstruction. This prospective longitudinal study included 93 patients and was conducted in a tertiary care center in Punjab. All patients underwent free flap reconstruction after tumor removal. The functional outcome of the tongue following reconstruction was evaluated 9 months after the completion of treatment. Functions were assessed and matched with sexes and age-matched normal individuals. The data obtained were analyzed by the student 't' test and the p values < 0.05 were considered statistically significant. The duration of swallowing in patients with FRF flap and ALT flap when compared to the normative was significant (< 0.05). There were changes in configuration and volume of the oral cavity after surgery which generates resonant and articulatory alterations, thus the intelligibility of the patient's speech is lowered. There is also a restriction in the tongue movements and reduction in the sensations of the reconstructed part of the tongue. Both the free ALT flap and the FRF flap can provide acceptable functional restoration of the tongue after radical tumor resection.
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Affiliation(s)
- Vanita Sarin
- Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Arpita Chatterjee
- Department of Audiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Vikas Kakkar
- Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Ateev Juneja
- Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
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Metzeld D, Seebens Y, Helbig S. [COVID-19 hygiene measures at an inpatient CI therapy center for children from the parents' perspective]. HNO 2022. [PMID: 35821425 DOI: 10.1007/s00106-022-01193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, all essential treatment must adhere to strict health and hygiene protocols. New measures have been introduced in CI treatment centres in order to safely accommodate families and continue to provide effective follow-up CI therapy for children implanted with CIs. OBJECTIVES The aim of this study was to document, over the course of the pandemic, how patients' parents viewed the likelihood and danger of infection and how necessary they thought the newly implemented protocols were. MATERIALS AND METHODS All parents of children implanted with CIs who participated in therapy at the CIC treatment centre between August and November 2020 (N = 255) were requested to fill out a questionnaire anonymously following their stay. RESULTS 255 questionnaires were distributed, 83 (32.5%) of which were filled out. During the course of the study, there was an increase in the parents' perceived risk of infection. Simultaneously, fewer parents felt well protected at the CIC. According to parents, the new hygiene protocols at the CIC did not negatively affect treatment. However, many parents noted that their interactions with other patient families had been better prior to introduction of the hygiene protocols. CONCLUSIONS The CIC`s hygiene protocols were well received. However, data analysis over the course of the study suggests that hygiene protocols were not sufficient to prevent fear of infection in light of increasing rate of infection.
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Mulfari D, La Placa D, Rovito C, Celesti A, Villari M. Deep learning applications in telerehabilitation speech therapy scenarios. Comput Biol Med 2022; 148:105864. [PMID: 35853398 DOI: 10.1016/j.compbiomed.2022.105864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/05/2022] [Accepted: 07/02/2022] [Indexed: 11/21/2022]
Abstract
Nowadays, many application scenarios benefit from automatic speech recognition (ASR) technology. Within the field of speech therapy, in some cases ASR is exploited in the treatment of dysarthria with the aim of supporting articulation output. However, in presence of atypical speech, standard ASR approaches do not provide any reliable result in terms of voice recognition due to main issues, including: (i) the extreme intra and inter-speakers variability of the speech in presence of speech impairments, such as dysarthria; (ii) the absence of dedicated corpora containing voice samples from users with a speech disability to train a state-of-the-art speech model, particularly in non-English languages. In this paper, we focus on isolated word recognition for native Italian speakers with dysarthria and we exploit an existing mobile app to collect audio data from users with speech disorders while they perform articulation exercises for speech therapy purposes. With this data availability, a convolutional neural network has been trained to spot a small number of keywords within atypical speech, according to a speaker dependent method. Finally, we discuss the benefits of the trained ASR system in tailored telerehabilitation contexts intended for patients with dysarthria who can follow treatment plans under the supervision of remote speech language pathologists.
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Fujiki RB, Fujiki AE, Thibeault S. Factors impacting therapy duration in children and adolescents with Paradoxical Vocal Fold Movement (PVFM). Int J Pediatr Otorhinolaryngol 2022; 158:111182. [PMID: 35594796 DOI: 10.1016/j.ijporl.2022.111182] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Paradoxical Vocal Fold Movement (PVFM) may cause airway restriction and resulting dyspnea in the pediatric population. Therapy with a speech-language pathologist (SLP) is the primary treatment for children and adolescents diagnosed with Paradoxical Vocal Fold Movement (PVFM). This study examined treatment duration and factors predicting number of therapy sessions required. METHODS Data were drawn from the University of Wisconsin-Madison Voice and Swallow Clinics Outcome Database. One hundred and twelve children and adolescents were included in this study. Participants were diagnosed with PVFM, followed for therapy with a SLP, and were subsequently discharged from therapy with successful outcomes. Extracted data included number of therapy sessions, PVFM symptoms, patient demographics, medical history, and comorbid diagnoses. Regression was used to determine factors predicting therapy duration. RESULTS Patients completed an average of 3.4 therapy sessions before discharge. Comorbid behavioral health diagnosis (β = 1.96, t = 3.83, p < .01) and a history of upper airway surgeries (β = 1.26, t = 2.615, p = .01) were significant predictors of the number of therapy sessions required before discharge; both factors significantly increased therapy duration. Age, symptom trigger-type, reflux symptoms, and dysphonia did not predict therapy duration. Overall, our regression model accounted for 42% of the variance in number of sessions required (r2 = 0.42). CONCLUSIONS On average, 3.4 sessions of therapy with an SLP resolved PVFM symptoms. Children with a behavioral health diagnosis required an average of 5.45 sessions and those with a history of upper airway surgery an average of 4.3 sessions. Future work should examine the relationship between behavioral health care and PVFM treatment, as well as how PVFM treatment efficiency can be maximized.
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Matos KC, de Oliveira VF, de Oliveira PLC, Carvalho FA, de Mesquita MRM, da Silva Queiroz CG, Marques LM, Lima DLN, Carvalho FMM, Braga-Neto P. Combined conventional speech therapy and functional electrical stimulation in acute stroke patients with dyphagia: a randomized controlled trial. BMC Neurol 2022; 22:231. [PMID: 35733098 PMCID: PMC9215026 DOI: 10.1186/s12883-022-02753-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stroke is the main cause of oropharyngeal neurogenic dysphagia. Electrostimulation has been used as a therapeutic tool in these cases. However, there are few studies that prove its effectiveness. We evaluated the effect of functional electrostimulation as a complement to conventional speech therapy in patients with dysphagia after a stroke in a stroke unit. METHODS We performed a clinical, randomized, and controlled trial divided into intervention group (IG) (n = 16) and control group (CG) (n = 17). All patients were treated with conventional speech therapy, and the IG also was submitted to the functional electrotherapy. Primary outcomes were Functional Oral Ingestion Scale (FOIS) and Swallowing videoendoscopy (FEES). The degree of dysphagia was scored in functional, mild, moderate and severe dysphagia according to FEES procedure. Dysphagia Risk Evaluation Protocol (DREP) was considered a secondary outcome. RESULTS There was a significant difference regarding FOIS scores after 5 days of intervention in groups. Both groups also showed a tendency to improve dysphagia levels measured by FEES, although not statistically significant. Improvements on oral feeding was seen in both groups. No significant differences between groups before and after the intervention were detected by DREP scores. Electrical stimulation did not show additional benefits beyond conventional therapy when comparing outcomes between groups. CONCLUSION Conventional speech therapy improved oral ingestion even regardless the use of electrostimulation in a stroke unit. TRIAL REGISTRATION This research was registered in ClinicalTrials.gov (Identifier: NCT03649295 ) in 28/08/2018 and in the Brazilian Registry of Clinical Trials (ReBEC) (Register Number: RBR-56QK5J), approval date: 18/12/2018. HGF Ethics Committee Approval Number: N. 2.388.931.
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Affiliation(s)
- Klayne Cunha Matos
- Speech Therapy Service, Hospital Geral de Fortaleza, Fortaleza, Brazil.,Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | | | | | | | - Levi Mota Marques
- Otorhinolaryngology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil
| | | | - Fernanda Martins Maia Carvalho
- Medical Sciences Post-Graduation Program, Universidade de Fortaleza, Fortaleza, Brazil.,Neurology Department, Hospital Geral de Fortaleza, Fortaleza, Brazil
| | - Pedro Braga-Neto
- Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, Brazil. .,Center of Health Sciences, Universidade Estadual do Ceará, Fortaleza, Brazil.
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Boisnault M, Gros A, Boisnault P, Nesmes M, Askenasy F, Solla F, Fernandez A. Connaissances des médecins généralistes sur les modalités de prescription de l'orthophonie. Rev Epidemiol Sante Publique 2022; 70:103-108. [PMID: 35562295 DOI: 10.1016/j.respe.2022.03.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 07/30/2021] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION General practitioners are the first prescribers of speech therapy in France, a country in which speech therapists can practice only on medical prescription. The objective of this study was to measure general practioner's knowledge on means of prescribing speech therapy. METHOD Cross-sectional study by self-questionnaires for general practitioners and residents in general practice in France. The test assessed five types of knowledge conducive to correct prescription of speech therapy: requirements for prescription, indications, prescription wording, ages of treatment eligibility, and reimbursement. The questionnaires were tested on an expert population, whose median score was used as a cut-off to separate doctors who knew the modalities of speech therapy prescription from those whose knowledge was insufficient. The characteristics differentiating the two groups were compared by multiple logistic regression. RESULTS Five hundred and three general practitioners and five hundred and two residents in general medicine were included; 82.3% of the physicians having written a thesis and 86.2% of the residents had insufficient knowledge of the modalities of speech therapy prescription. Age, number of years since acquisition of a medical diploma and urban practice all had a negative impact on general practitioners' knowledge of speech therapy. CONCLUSION French general practitioners' knowledge of speech therapy prescription seems insufficient. It is consequently necessary to improve the initial and continuing training of doctors. Collaborative work between general practitioners and speech therapists should be carried on, developed and strengthened.
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Affiliation(s)
- M Boisnault
- Département universitaire d'Orthophonie de Nice; Orthophoniste libérale
| | - A Gros
- Université Côte d'Azur, CoBTek, FRIS, Nice, France
| | - P Boisnault
- Société française de médecine générale, Issy- les-Moulineaux, France
| | | | - F Askenasy
- Université Côte d'Azur, CoBTek, FRIS, Nice, France; Service universitaire de psychiatrie de l'enfant et de l'adolescent, Hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France
| | - F Solla
- University Department of Pediatric Orthopedic Surgery, Children's Hospitals of Nice Chu-Lenval, Nice, France
| | - A Fernandez
- Université Côte d'Azur, CoBTek, FRIS, Nice, France; Service universitaire de psychiatrie de l'enfant et de l'adolescent, Hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France.
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Pompa-Craven P, Tierman E, Martino J, Lotfizadeh AD. Caregiver Satisfaction with Delivery of Telehealth Autism Services. Adv Neurodev Disord 2022; 6:196-205. [PMID: 35531083 PMCID: PMC9058747 DOI: 10.1007/s41252-022-00256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The purpose of this study was to assess satisfaction with telehealth interventions for a large nonprofit organization that transitioned interventions for individuals with autism spectrum disorder (ASD) to telehealth during a pandemic. Services provided via telehealth included applied behavior analysis (ABA), speech and language, and occupational therapies. A secondary survey evaluated reasons for declining telehealth services. METHODS A survey was administered to 10,567 families who were receiving autism interventions. A total of 440 respondents answered all the questions on the survey, and their results were included in this study. A secondary survey was administered to 223 individuals who declined to have telehealth autism interventions. RESULTS There was not a clinically meaningful difference in satisfaction across service types. Although all ratings were in the high range, caregivers ranked speech therapists as more dependable than ABA therapists, and this difference was statistically significant. The findings suggested that the majority of caregivers were generally satisfied with services provided in a telehealth format. For those who declined services, the majority indicated a discomfort with the use of technology. CONCLUSIONS The participants of telehealth autism interventions reported high general satisfaction and indicated an improvement in their quality of life. Results provide suggestive evidence that increased satisfaction of telehealth services may allow for further acceptability and access for participants. Future research should evaluate participant and clinician satisfaction with telehealth versus in-person interventions.
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Affiliation(s)
- Paula Pompa-Craven
- Autism Services, Easterseals Southern California, 1063 McGaw Avenue, Irvine, CA 92614 USA
| | - Emily Tierman
- Autism Services, Easterseals Southern California, 1063 McGaw Avenue, Irvine, CA 92614 USA
| | - Joelle Martino
- Autism Services, Easterseals Southern California, 1063 McGaw Avenue, Irvine, CA 92614 USA
| | - Amin D. Lotfizadeh
- Autism Services, Easterseals Southern California, 1063 McGaw Avenue, Irvine, CA 92614 USA
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Msigwa SS, Li Y, Cheng XL, Cao F. Combining electroacupuncture and transcranial direct current stimulation as an adjuvant therapy enhances spontaneous conversation and naming in subacute vascular aphasia: A retrospective analysis. J Integr Med 2022; 20:244-251. [PMID: 35318944 DOI: 10.1016/j.joim.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Emerging evidence shows the effectiveness of speech and language therapy (SLT); however, precise therapeutic parameters remain unclear. Evidence for the use of adjunctive transcranial direct current stimulation (tDCS) to treat post-stroke aphasia (PSA) is promising; however, the utility of combining tDCS and electroacupuncture (EA) has not yet been analyzed. This study assessed the therapeutic consequences of EA and tDCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy (HBOT). METHODS A retrospective analysis was conducted on subacute (< 6 months) PSA patients who were divided into three groups: patients who received EA plus tDCS (acupuncture group), patients who underwent tDCS (tDCS group), and patients who experienced conventional therapy (HBOT + SLT). All subjects underwent 21 days of treatment and also received conventional treatment. The aphasia battery of Chinese (ABC) was used to score pre- and post-intervention status. RESULTS The analysis comprised 238 patients. Cerebral infarction was the most frequent stroke type (137 [57.6%]), while motor (66 [27.7%]) and global aphasia (60 [25.2%]) were the most common types of aphasia. After 21 days of intervention, the ABC scores of all patients were improved. The acupuncture group had the highest ABC scores, but only repetition, naming, and spontaneous speech were statistically improved (P < 0.01). Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and tDCS groups (P < 0.01, P = 0.037), while the acupuncture group had additional significant improvement in spontaneous conversation (P < 0.01). CONCLUSION Combining acupuncture and tDCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements. Future prospective, multi-ethnic, multi-center trials are warranted.
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Affiliation(s)
- Samwel Sylvester Msigwa
- Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China; Department of Research and Training, Mirembe National Mental Health Hospital, P. O. Box 910, Dodoma, Tanzania
| | - Yan Li
- Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China
| | - Xiang-Lin Cheng
- Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China; Department of Rehabilitation, The First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China.
| | - Fen Cao
- Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China; Department of Rehabilitation, The First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China.
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Rouadi PW, Idriss SA, Bousquet J, Laidlaw TM, Azar CR, Al-Ahmad MS, Yañez A, Al-Nesf MAY, Nsouli TM, Bahna SL, Abou-Jaoude E, Zaitoun FH, Hadi UM, Hellings PW, Scadding GK, Smith PK, Morais-Almeida M, Maximiliano Gómez R, Gonzalez Diaz SN, Klimek L, Juvelekian GS, Riachy MA, Canonica GW, Peden D, Wong GW, Sublett J, Bernstein JA, Wang L, Tanno LK, Chikhladze M, Levin M, Chang YS, Martin BL, Caraballo L, Custovic A, Ortego-Martell JA, Lesslar OJ, Jensen-Jarolim E, Ebisawa M, Fiocchi A, Ansotegui IJ. WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19. World Allergy Organ J 2022; 15:100649. [PMID: 35600836 PMCID: PMC9117692 DOI: 10.1016/j.waojou.2022.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety. Objectives The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed. Outcomes This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough.
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Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology – Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Ear, Nose and Throat Department, Dar Al Shifa Hospital, Hawally, Kuwait
| | - Samar A. Idriss
- Department of Otolaryngology – Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
- Department of Audiology and Otoneurological Evaluation, Edouard Herriot Hospital, Lyon, France
| | - Jean Bousquet
- Hospital Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany
- Macvia France, Montpellier France
- Université Montpellier, Montpellier, France
| | - Tanya M. Laidlaw
- Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital Boston, Massachusetts, USA
| | - Cecilio R. Azar
- Department of Gastroenterology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
- Department of Gastroenterology, Middle East Institute of Health (MEIH), Beirut, Lebanon
- Department of Gastroenterology, Clemenceau Medical Center (CMC), Beirut, Lebanon
| | - Mona S. Al-Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Anahi Yañez
- INAER - Investigaciones en Alergia y Enfermedades Respiratorias, Buenos Aires, Argentina
| | - Maryam Ali Y. Al-Nesf
- Allergy and Immunology Section, Department of Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | | | - Sami L. Bahna
- Allergy & Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | | | - Fares H. Zaitoun
- Department of Allergy Otolaryngology, LAU-RIZK Medical Center, Beirut, Lebanon
| | - Usamah M. Hadi
- Clinical Professor Department of Otolaryngology Head and Neck Surgery, American University of Beirut, Lebanon
| | - Peter W. Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology, Leuven, Belgium
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
- Academic Medical Center, University of Amsterdam, Department of Otorhinolaryngology, Amsterdam, the Netherlands
| | | | - Peter K. Smith
- Clinical Medicine Griffith University, Southport Qld, 4215, Australia
| | | | | | - Sandra N. Gonzalez Diaz
- Universidad Autónoma de Nuevo León, Hospital Universitario and Facultad de Medicina, Monterrey, Nuevo León, Mexico
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Georges S. Juvelekian
- Department of Pulmonary, Critical Care and Sleep Medicine at Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Moussa A. Riachy
- Department of Pulmonary and Critical Care, Hôtel-Dieu de France university Hospital, Beirut, Lebanon
| | - Giorgio Walter Canonica
- Humanitas University & Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital-IRCCS-Milano Italy
| | - David Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNC School of Medicine, USA
| | - Gary W.K. Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | - James Sublett
- Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, 9800 Shelbyville Rd, Louisville, KY, USA
| | - Jonathan A. Bernstein
- University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Immunology/Allergy Section, Cincinnati, OH, USA
| | - Lianglu Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, 100730, China
| | - Luciana K. Tanno
- Université Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, INSERM University of Montpellier, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Manana Chikhladze
- Medical Faculty at Akaki Tsereteli State University, National Institute of Allergy, Asthma & Clinical Immunology, KuTaisi, Tskaltubo, Georgia
| | - Michael Levin
- Division of Paediatric Allergology, Department of Paediatrics, University of Cape Town, South Africa
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Bryan L. Martin
- Department of Otolaryngology, Division of Allergy & Immunology, The Ohio State University, Columbus, OH, USA
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena. Cartagena de Indias, Colombia
| | - Adnan Custovic
- National Heart and Lund Institute, Imperial College London, UK
| | | | | | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Austria
- The interuniversity Messerli Research Institute, Medical University Vienna and University of Veterinary Medicine, Vienna, Austria
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Alessandro Fiocchi
- Translational Pediatric Research Area, Allergic Diseases Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Holy See
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
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Simpson HD, Duffy JR, Stierwalt JAG, Ahlskog JE, Hassan A. Speech-induced action myoclonus. Parkinsonism Relat Disord 2022; 98:41-46. [PMID: 35468498 DOI: 10.1016/j.parkreldis.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/16/2022] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Speech-induced action myoclonus may occur as a component of a generalized myoclonus syndrome. However, it may also present in isolation, or with a paucity of other findings, and be diagnostically challenging. OBJECTIVES To report a retrospective case series of restricted speech-induced action myoclonus. METHODS We reviewed cases of speech-induced action myoclonus evaluated at Mayo Clinic Rochester from 1989 to 2020. We eliminated cases where a more generalized myoclonic disorder was also present. Clinical, imaging, and electrophysiologic data were extracted. RESULTS Four cases were identified in which speech-induced action myoclonus of craniofacial muscles was the predominant clinical presentation. All described cranial muscle twitching induced by speaking, and two cases also reported speech interruptions. Diagnosis was confirmed by expert speech pathologists in all cases. Diagnostic aids included modulation with different speech tasks and speaking rates, and surface electrophysiology which confirmed craniofacial myoclonus induced by speaking tasks (three cases). Previous misdiagnosis included functional, dystonic, neuromuscular junction pathology, or hemifacial spasm. Two cases had isolated speech-induced myoclonus, and the other two had coexistent upper limb tremor. Potential etiologic factors were identified in three cases - medication (2), epilepsy (1) - while in one patient no cause was identified. One patient partially improved with anti-myoclonic medication and speech therapy. CONCLUSIONS Speech-induced action myoclonus may occur in isolation and is frequently misdiagnosed. Diagnostic aids include modulation with different speech tasks and speaking rates, and surface electrophysiology.
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Affiliation(s)
- Hugh D Simpson
- Division of Movement Disorders, Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Division of Speech Pathology, Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Julie A G Stierwalt
- Division of Speech Pathology, Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J Eric Ahlskog
- Division of Movement Disorders, Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Anhar Hassan
- Division of Movement Disorders, Department of Neurology, Mayo Clinic, Rochester, MN, USA.
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Maas JJL, De Vries NM, Bloem BR, Kalf JG. Design of the PERSPECTIVE study: PERsonalized SPEeCh Therapy for actIVE conversation in Parkinson's disease (randomized controlled trial). Trials 2022; 23:274. [PMID: 35395953 PMCID: PMC8990485 DOI: 10.1186/s13063-022-06160-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the effectiveness of personalized and home-based speech therapy on quality of life, intelligibility, and social participation for people with Parkinson’s disease (PD) who have a reduced intelligibility of speech. Background Speech problems in PD have a profound negative impact on social interaction and quality of life. Evidence for speech therapy in PD is growing, but more work remains needed to explore its full potential. Efficacy exists for highly intensive standardized speech treatment programs, but not all patients can comply with this rather intense intervention, especially the more severely affected ones. Here, we aim to study the effectiveness of personalized and home-based (remote) speech therapy in PD on quality of life and speech. The intervention will be supported by a dedicated speech training app. We expect that this approach will improve speech intelligibility and quality of life in patients irrespective of disease stage. Methods We will perform a single blind, randomized controlled trial, comparing 8 weeks of speech therapy to no intervention using a waiting list design. A total of 215 PD patients with problems in intelligibility will be recruited by 12 highly experienced speech therapists. All patients will be measured at baseline and after 8 weeks (primary endpoint). Additionally, the experimental group will be re-assessed one more time, after a wash-out period of 24 weeks. The control group will receive deferred treatment after 8 weeks, but without additional follow-up assessments. Our primary outcome is quality of life (as measured with PDQ-39). Secondary outcomes include speech and voice quality, intelligibility, severity of voice and speech complaints, and caregiver burden. Results The inclusion of participants has started on March 1, 2019, and is expected to be finalized on April 1, 2021. We expect to have the first results in January 2022. Conclusions We will investigate the effectiveness of speech therapy in PD. Particular strengths of our study include a randomized and single-blinded design, the personalized treatment approach, the inclusion of PD patients irrespective of disease stage or severity of the speech complaint, the long-term follow-up, the adequate power, and the use of a patient-relevant primary endpoint. This will allow us to draw firm conclusions about the effectiveness of personalized and remote speech therapy for PD patients in all disease stages. Trial registration ClinicalTrials.govNCT03963388. Registered on May 24, 2019
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Affiliation(s)
- J J L Maas
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - N M De Vries
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - B R Bloem
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J G Kalf
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
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Cassarino L, Santoro F, Gelardi D, Panerai S, Papotto M, Tripodi M, Cosentino FII, Neri V, Ferri R, Ferlito S, Modica D, Fisicaro F, Pennisi M, Bella R, Lanza G. Post-stroke aphasia at the time of COVID-19 pandemic: a telerehabilitation perspective. J Integr Neurosci 2022. [PMID: 35164444 DOI: 10.31083/j.jin2101008.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report on our remote speech therapy experience in post-stroke aphasia. The aim was to test the feasibility and utility of telerehabilitation to support future randomized controlled trials. Post-stroke aphasia is a common and disabling speech disorder, which significantly affects patients' and caregivers' health and quality of life. Due to COVID-19 pandemic, most of the conventional speech therapy approaches had to stop or "switch" into telerehabilitation procedures to ensure the safety of patients and operators but, concomitantly, the best rehabilitation level possible. Here, we planned a 5-month telespeech therapy programme, twice per week, of a patient with non-fluent aphasia following an intracerebral haemorrhage. Overall, treatment adherence based on the operator's assessments was high, and incomplete adherence for technical problems occurred very rarely. In line with the patient's feedback, acceptability was also positive, since he was constantly motivated during the sessions and the exercises performed autonomously, as confirmed by the speech therapist and caregiver, respectively. Moreover, despite the sequelae from the cerebrovascular event, evident in some writing tests due to the motor deficits in his right arm and the disadvantages typical of all telepractices, more relevant results were achieved during the telerehabilitation period compared to those of the "face-to-face" therapy before the COVID-19 outbreak. The telespeech therapy performed can be considered successful and the patient was able to return to work. Concluding, we support it as a feasible approach offering patients and their families the opportunity to continue the speech and language rehabilitation pathway, even at the time of pandemic.
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Affiliation(s)
- Laura Cassarino
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | | | | | | | | | | | | | | | | | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | - Daniela Modica
- Ospedale Maggiore di Modica, ASP Ragusa, 97015 Modica, Italy
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, 94018 Troina, Italy.,Department of Surgery and Medical-Surgery Specialties, University of Catania, 95123 Catania, Italy
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43
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Cassarino L, Santoro F, Gelardi D, Panerai S, Papotto M, Tripodi M, Cosentino FII, Neri V, Ferri R, Ferlito S, Modica D, Fisicaro F, Pennisi M, Bella R, Lanza G. Post-stroke aphasia at the time of COVID-19 pandemic: a telerehabilitation perspective. J Integr Neurosci 2022; 21:8. [PMID: 35164444 DOI: 10.31083/j.jin2101008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/09/2021] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
We report on our remote speech therapy experience in post-stroke aphasia. The aim was to test the feasibility and utility of telerehabilitation to support future randomized controlled trials. Post-stroke aphasia is a common and disabling speech disorder, which significantly affects patients' and caregivers' health and quality of life. Due to COVID-19 pandemic, most of the conventional speech therapy approaches had to stop or "switch" into telerehabilitation procedures to ensure the safety of patients and operators but, concomitantly, the best rehabilitation level possible. Here, we planned a 5-month telespeech therapy programme, twice per week, of a patient with non-fluent aphasia following an intracerebral haemorrhage. Overall, treatment adherence based on the operator's assessments was high, and incomplete adherence for technical problems occurred very rarely. In line with the patient's feedback, acceptability was also positive, since he was constantly motivated during the sessions and the exercises performed autonomously, as confirmed by the speech therapist and caregiver, respectively. Moreover, despite the sequelae from the cerebrovascular event, evident in some writing tests due to the motor deficits in his right arm and the disadvantages typical of all telepractices, more relevant results were achieved during the telerehabilitation period compared to those of the "face-to-face" therapy before the COVID-19 outbreak. The telespeech therapy performed can be considered successful and the patient was able to return to work. Concluding, we support it as a feasible approach offering patients and their families the opportunity to continue the speech and language rehabilitation pathway, even at the time of pandemic.
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Affiliation(s)
- Laura Cassarino
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | | | | | | | | | | | | | | | | | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | - Daniela Modica
- Ospedale Maggiore di Modica, ASP Ragusa, 97015 Modica, Italy
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95123 Catania, Italy
| | - Giuseppe Lanza
- Oasi Research Institute-IRCCS, 94018 Troina, Italy
- Department of Surgery and Medical-Surgery Specialties, University of Catania, 95123 Catania, Italy
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Abstract
This chapter gives a broad overview of the description and theorizing of a wide range of language disorders resulting from brain damage, commonly classified under the umbrella term "aphasia." It covers works written in Antiquity up to the 20th century. Moreover, it looks at disturbances in various language modalities such as speech, language comprehension, reading, writing, and sign language. In addition, also forms of the more recently discovered primary progressive aphasia are discussed. Finally, important developments in the history of assessment and rehabilitation of language disorders are described. To properly characterize disorders of language, these developments are discussed from the perspectives of neurology, psychology, and linguistics.
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Affiliation(s)
- Paul Eling
- Department of Psychology, Radboud University, Nijmegen, The Netherlands.
| | - Harry Whitaker
- Independent Scholar, Retired University Professor, Minnesota, MN, United States
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Escudero C, Sassi FC, de Medeiros GC, de Lima MS, Cardoso PFG, de Andrade CRF. Decannulation: a retrospective cohort study of clinical and swallowing indicators of success. Clinics (Sao Paulo) 2022; 77:100071. [PMID: 35759922 PMCID: PMC9240975 DOI: 10.1016/j.clinsp.2022.100071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/04/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To investigate the clinical and swallowing indicators related to a successful decannulation process during the hospital stay. METHODS A retrospective cohort clinical study. The study sample comprised a heterogeneous patient population who had submitted to a tracheostomy procedure in a tertiary hospital. Patients were divided into two groups (decannulated vs. non-decannulated) and compared not only in terms of demographic and clinical data but also the results of a swallowing assessment and intervention outcome. RESULTS Sixty-four patients were included in the present study: 25 (39%) who had been successfully decannulated, and 39 (61%) who could not be decannulated. Between-group comparisons indicated that both groups presented similar clinical and demographic characteristics. The groups also presented similar swallowing assessment results prior to intervention. However, significant differences were observed regarding the time to begin swallowing rehabilitation. The decannulated group was assessed nine days earlier than the non-decannulated group. Other significant differences included the removal of the alternate feeding method (72.0% of decannulated patients vs. 5.1% of non-decannulated patients) and the reintroduction of oral feeding (96.0% of decannulated patients vs. 41.0% of non-decannulated patients) and functional swallowing level at patient disclosure. The non-decannulated patient group presented higher death rates at disclosure. CONCLUSION The results of the present study indicated that the following parameters were associated with a successful decannulation process: early swallowing assessment, swallowing rehabilitation, and improvement in the swallowing functional level during the hospital stay. The maintenance of low swallowing functional levels was found to be negatively associated with successful decannulation.
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Affiliation(s)
- Carina Escudero
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fernanda Chiarion Sassi
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gisele Chagas de Medeiros
- Divisão de Fonoaudiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maíra Santilli de Lima
- Divisão de Fonoaudiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo Francisco Guerreiro Cardoso
- Departamento Cardiopneumologia, Disciplina de Cirurgia Torácica da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Claudia Regina Furquim de Andrade
- Divisão de Fonoaudiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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46
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Kay HG, Lipscomb B, Zhao S, Shannon C, Phillips JD. Utilization of part C early intervention services for patients with cleft palate. Int J Pediatr Otorhinolaryngol 2021; 151:110961. [PMID: 34736013 DOI: 10.1016/j.ijporl.2021.110961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the utilization of early intervention services under Part C of the 2004 Individuals with Disabilities Educational Act for children with cleft palate and to better understand barriers these patients encounter when receiving services. METHODS A retrospective chart review was performed on children under the age of 18 who were treated for cleft palate at a single tertiary care center and referred to Tennessee's Early Intervention System (TEIS) between January 2007 and December 2018. RESULTS For the 61 patients included, developmental therapy was the most common TEIS referral made (n = 408, 28%), followed by speech therapy (n = 371, 26%). Most of these services were delivered as scheduled (n = 513, 80%); some families missed appointments without notifying the provider (i.e., family no-show)(n = 101, 2%). Children referred at a younger age were more likely to receive developmental therapy (p = 0.012) and to attend their services (p = 0.027). Patients with Medicaid were more likely to have absences with prior notification (p = 0.05) and without prior notification (i.e., family no-show)(p = 0.009) than patients with other types of health insurance. CONCLUSIONS Patients with cleft palate often have complex needs; earlier referral to ancillary services may improve attendance at appointments and impact the services they receive. Socioeconomic factors may hinder patients from accessing these services even once they are referred.
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Affiliation(s)
- Hannah G Kay
- Vanderbilt University School of Medicine, Nashville, TN, USA; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brittany Lipscomb
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilin Zhao
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University, USA
| | - Chevis Shannon
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James D Phillips
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
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47
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Alighieri C, Bettens K, Vanoost L, Demuynck K, Verhaeghe S, Van Lierde K. Parents' perceptions on speech therapy delivery models in children with a cleft palate: A mixed methods study. Int J Pediatr Otorhinolaryngol 2021; 151:110958. [PMID: 34736010 DOI: 10.1016/j.ijporl.2021.110958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE This study investigated parents' perceptions on two different speech therapy delivery models in children with a CP ± L, namely an innovative high intensity speech intervention (i.e. HISI: 10 1-h sessions divided over 2 weeks) and a low intensity speech intervention (i.e. LISI: 10 1-h sessions divided over 10 weeks). METHOD Twelve parents of 12 children who received HISI (n = 6) or LISI (n = 6) were contacted with the request to participate to this study to review their opinion on the received therapy. Participation included the completion of a questionnaire containing items related to satisfaction, speech progress, intervention intensity and frequency, transfer, and need for further speech therapy. Additionally, semi-structured interviews were carried out. The interviews were analyzed using an inductive thematic approach. RESULTS There were no significant differences between the two groups in satisfaction with the "general speech therapy, "duration of one speech therapy session", "total intervention duration" and "degree of improvement of speech intelligibility". Following HISI, parents perceived more improvement in terms of spontaneous speech and better resolution of the speech disorders. The interviews revealed 3 themes of importance to the parents: (1) treatment-related expectations, (2) treatment-related burden, and (3) patient-therapist relationship. Parents in the HISI group reported two concerns: (1) the lack of variation when receiving daily intervention, and (2) the emotional burden when the child is confronted with his/her speech disorder on a daily basis. CONCLUSIONS Parents were equally satisfied with the provided intervention. Parents in the HISI group perceived more speech progress following the intervention compared to parents in the LISI group. The intensive contact with the speech pathologist enhanced the patient-therapist relationship. To support a cultural shift away from low intensity therapy delivery models, it will be important to counsel and inform parents of the benefits of HISI and to counterbalance concerns.
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Louppe E, Moritz-Gasser S, Duffau H. Language recovery through a two-stage awake surgery in an aphasic patient with a voluminous left fronto-temporo-insular glioma: case report. Acta Neurochir (Wien) 2021; 163:3115-3119. [PMID: 34275021 DOI: 10.1007/s00701-021-04932-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/26/2021] [Indexed: 12/18/2022]
Abstract
Awake surgery is difficult in glioma patients with preoperative aphasia. A 29-year-old right-handed bilingual (Spanish/English) patient experienced intractable seizures with severe language disorders due to a voluminous left fronto-temporo-insular tumor. We performed awake procedure with initial laborious language mapping, but with real-time improvement throughout the debulking, allowing preservation of the connectivity. A substantial residue was left. Postoperative cognitive rehabilitation resulted in a dramatic functional improvement, in both languages, permitting a complementary awake surgery, this time with a perfect collaboration of the patient. This multistep strategy enabled 92% of resection while enhancing quality of life with language recovery and epilepsy control.
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Affiliation(s)
- Elisa Louppe
- Department of Neurosurgery, Montpellier University Medical Center, 34295, Montpellier, France
- Institute of Functional Genomics, INSERM U-1191, University of Montpellier, 34298, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Montpellier University Medical Center, 34295, Montpellier, France
- Institute of Functional Genomics, INSERM U-1191, University of Montpellier, 34298, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Montpellier University Medical Center, 34295, Montpellier, France.
- Institute of Functional Genomics, INSERM U-1191, University of Montpellier, 34298, Montpellier, France.
- Department of Neurosurgery, Gui de Chauliac Hospital, CHU Montpellier, 80 Avenue Augustin Fliche, 34295, Montpellier, France.
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Eslami Jahromi M, Ahmadian L. Determining the effect of tele-rehabilitation on patients with stutter using the goal attainment scaling (GAS). BMC Med Inform Decis Mak 2021; 21:280. [PMID: 34641856 PMCID: PMC8507245 DOI: 10.1186/s12911-021-01642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of proper and timely patients' access to speech pathologists can affect the treatment and follow-up process; therefore, patients do not achieve the expected therapeutic goals. The aim of this study was to determine the effect of tele-rehabilitation on the stuttering patients using the goal attainment scaling (GAS). METHODS This interventional study was carried out on patients who visited the rehabilitation centers affiliated to the Jahrom Welfare Office. They underwent remote speech therapy using Skype. To evaluate the treatment outcomes of the stuttering patients, GAS was used. RESULTS The participants' speech and lingual skills improved using videoconferencing. The mean score of total GAS for patients was 53.08. Of 112 health goals, patients reached the expected or higher than expected levels in 78 goals. CONCLUSIONS Rehabilitation through video conferencing was effective for patients with stuttering, improved their speech, and decreased their stuttering. Since, application of remote rehabilitation services can provide regular access to healthcare services, it can lead to improving patient treatment provide more frequent and faster treatment follow-up.
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Affiliation(s)
- Maryam Eslami Jahromi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Ahmadian
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haft-bagh Highway, PO Box: 7616913555, Kerman, Iran.
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Icht M. Improving speech characteristics of young adults with congenital dysarthria: An exploratory study comparing articulation training and the Beatalk method. J Commun Disord 2021; 93:106147. [PMID: 34461556 DOI: 10.1016/j.jcomdis.2021.106147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This exploratory study compared the effects of two speech therapy approaches on speech characteristics of young adults with congenital dysarthria resulting from various etiologies: a) articulation training focusing on consonant articulation exercises at various levels (isolation, syllables, and words), and b) the Beatalk method, based on human beatboxing, i.e., producing various instrumental sounds in an a-cappella musical context. Both interventions were designed to increase participants' speech intelligibility. METHODS Twelve adults with congenital dysarthria and reduced speech intelligibility participated in treatment groups for eight weeks. Six participants were assigned to the articulation training group, and six to the Beatalk group. Intelligibility of single words and continuous speech, voice measures, and oral-diadochokinesis rates were measured before and after the treatment. RESULTS The results showed that the Beatalk intervention yielded a significant overall pre- to post-treatment effect. Specifically, it resulted in gains in articulatory accuracy and intelligibility for single words. Improvements were not noted following articulation training. CONCLUSIONS The results present initial evidence of the positive effect of the Beatalk method as an intervention tool for adults with congenital dysarthria. This relatively easy-to-learn technique shows promise, as it involves intense and repetitive production of speech sounds while controlling rhythm and breathing in an enjoyable context.
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Affiliation(s)
- Michal Icht
- Department of Communication Disorders, Ariel University 40700, Israel.
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