ABSTRACT
Introduction: The COVID-19 pandemic rapidly and drastically required the shift of healthcare services from face-to- face delivery to telepractice modalities. This was a key strategy to maintain and complement healthcare services disrupted by the pandemic, revealing the need for a higher emphasis on telepractice in speech-language- hearing services. We synthesized existing evidence on the effectiveness of speech-language teleinterventions delivered via videoconferencing to users of augmentative and alternative communication (AAC) devices. Patients and methods: A systematic literature search was conducted in ten electronic databases, from inception until August 2021. Included were speech-language teleinterventions delivered by researchers and/or clinicians via videoconferencing to users of AAC systems, without restrictions on chronological age and clinical diagnosis. Quality of the included studies was appraised using the Downs and Brown's checklist, and risk of bias was assessed using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I). Results: Six teleinterventions involving 25 participants met inclusion criteria. Five studies used a single-subject design and one was a cohort study. Interventions included active consultation (n = 2), functional communication training (n = 2), brain computer interface (n = 1), and both tele-and on-site intervention (n = 1). All teleinterventions reported an increase in participants' independent use of AAC systems during the training sessions compared to baseline, and an overall high satisfaction and treatment acceptability. Conclusion: Speech-language teleinterventions for users of AAC systems show a great potential of a successful method of service delivery. Future teleintervention studies with larger sample sizes and more robust methodology are strongly encouraged to allow generalization of results across different populations.
ABSTRACT
OBJECTIVE: To investigate the peripheral nerve and muscle function electrophysiologically in patients with persistent neuromuscular symptoms following Coronavirus disease 2019 (COVID-19). METHODS: Twenty consecutive patients from a Long-term COVID-19 Clinic referred to electrophysiological examination with the suspicion of mono- or polyneuropathy were included. Examinations were performed from 77 to 255 (median: 216) days after acute COVID-19. None of the patients had received treatment at the intensive care unit. Of these, 10 patients were not even hospitalized. Conventional nerve conduction studies (NCS) and quantitative electromyography (qEMG) findings from three muscles were compared with 20 age- and sex-matched healthy controls. RESULTS: qEMG showed myopathic changes in one or more muscles in 11 patients (55%). Motor unit potential duration was shorter in patients compared to healthy controls in biceps brachii (10.02 ± 0.28 vs 11.75 ± 0.21), vastus medialis (10.86 ± 0.37 vs 12.52 ± 0.19) and anterior tibial (11.76 ± 0.31 vs 13.26 ± 0.21) muscles. All patients with myopathic qEMG reported about physical fatigue and 8 patients about myalgia while 3 patients without myopathic changes complained about physical fatigue. CONCLUSIONS: Long-term COVID-19 does not cause large fibre neuropathy, but myopathic changes are seen. SIGNIFICANCE: Myopathy may be an important cause of physical fatigue in long-term COVID-19 even in non-hospitalized patients.