Tele-voice therapy. Application of the tele-medicine paradigm to speech therapy for dysphonia: A systematic review

Abstract

Objective

Over the last decades, tele-rehabilitation has been gaining popularity in speech and language disorders. To date, studies on tele-speech therapy have been focused mostly on speech and/or communication disorders. However, only a minority of the available investigations delved into voice disorders. The main aim of this review has been to summarize and critically analyze the available evidence on tele-rehabilitation in voice disorders.

Methods

A search of the English literature was conducted in PubMed, Scopus and Web of Science.

Original reports were included investigating the feasibility and efficacy of tele-speech therapy in human patients with dysphonia and reporting pre- and post-treatment outcomes. Studies with no objective outcomes or a small case series (fewer than 10 participants) were ruled out.

Results

482 articles were retrieved. After duplicates' removal, and title/abstract screening, 20 potentially relevant articles remained. After subsequent full-text screening, only 6 articles were included.

Conclusion

Despite their methodological heterogeneity and small sample size, the available studies seem to support tele-speech therapy as an effective tool for selected dysphonia patients. In particular, remote therapy may be proposed to overcome logistical issues, potentially increasing patients' adherence, especially in case of rehabilitation programs requiring no direct contact or manipulation (e.g. Lee Silverman Voice Treatment for Parkinson's disease). Moreover, hybrid in-person and remote approaches may be proposed as flexible solutions to administer a patient-tailored rehabilitation program, potentially maximizing the benefits of both settings. However, to develop stronger evidence-based practices, large-scale prospective controlled studies are required (preferably in a multi-center setting).