RESUMO
Purpose The purpose of this clinical focus article is to illustrate an interprofessional cognitive rehabilitation approach. Invited experts representing physical medicine and rehabilitation, clinical neuropsychology/rehabilitation psychology, registered nurse care coordination, and speech-language pathology share viewpoints from their discipline to engage in collaborative interventions with the goal of enhancing treatment outcomes. Conclusions Treating the multifactorial symptoms of concussion requires expertise from an interdisciplinary team (IDT) of professionals, contributing unique perspectives and providing integrative services to optimize rehabilitation outcomes for patients. Speech-language pathologists serve an important role on IDTs to deliver personalized, targeted therapies for prolonged or persistent postconcussion cognitive impairment.
Assuntos
Concussão Encefálica , Transtornos da Comunicação , Síndrome Pós-Concussão , Patologia da Fala e Linguagem , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Concussão Encefálica/terapia , Cognição , Humanos , Síndrome Pós-Concussão/diagnóstico , Síndrome Pós-Concussão/terapiaAssuntos
Lesões Encefálicas/reabilitação , Transtornos Cognitivos/reabilitação , Terapia Cognitivo-Comportamental/métodos , Transtornos da Comunicação/reabilitação , Transtornos da Linguagem/reabilitação , Distúrbios da Fala/reabilitação , Atenção , Lesões Encefálicas/complicações , Lesões Encefálicas/psicologia , Transtornos Cognitivos/etiologia , Transtornos da Comunicação/diagnóstico , Transtornos da Comunicação/psicologia , Medicina Baseada em Evidências , Função Executiva , Humanos , Escala de Gravidade do Ferimento , Comunicação Interdisciplinar , Transtornos da Linguagem/etiologia , Masculino , Memória , Militares , Testes Neuropsicológicos , Guias de Prática Clínica como Assunto , Distúrbios da Fala/etiologia , Resultado do Tratamento , Estados Unidos , VeteranosRESUMO
Telehealth or telepractice can alleviate shortages of speech-language pathologists, particularly in rural and underserved areas, where specialists in voice and swallowing disorders may not be available. In addition to improving access to services, telehealth offers the opportunity for patients to receive care in their natural environment, as in the case of home health care where treatment can include family members and caregivers. This article presents an overview of telehealth applications in the remote management of voice and swallowing disorders including historical background, current issues, and a brief review of clinical effectiveness studies.
Assuntos
Transtornos de Deglutição/terapia , Telemedicina/métodos , Distúrbios da Voz/terapia , Transtornos de Deglutição/diagnóstico , Feminino , Humanos , Masculino , Controle de Qualidade , Consulta Remota , Patologia da Fala e Linguagem/métodos , Resultado do Tratamento , Distúrbios da Voz/diagnósticoRESUMO
It is estimated that 10% of the world's population, approximately 650 million people, have some form of disability. Population growth, aging, and medical advances that preserve and prolong life have increased demands for health and rehabilitation services. Recent predictions indicate a shortage of speech-language pathologists and other rehabilitation specialists to provide care for individuals with disabilities. The application of telemedicine and telehealth technologies offers effective solutions to this challenge. An extensive literature review was conducted that included technical reports, websites, publications from the American Speech-Language-Hearing Association, and peer-reviewed journal articles of telehealth applications in speech-language pathology. Various applications of telehealth in speech-language pathology are described including types of technology, patient and clinician satisfaction, advantages of using telehealth, challenges and barriers to application, and future directions. This review provides a strong foundation for broader applications of telehealth technologies in this area of healthcare.
Assuntos
Transtornos da Linguagem/reabilitação , Patologia da Fala e Linguagem , Telemedicina , Humanos , Terapia da Linguagem , FonoterapiaRESUMO
Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.
