Telehealth Voice Therapy Using Telecommunications Technology Research Article
Research Article  |   November 01, 2003
Telehealth
 
Author Affiliations & Notes
  • Pauline A. Mashima, MS
    Tripler Army Medical Center, Honolulu, HI
  • Deborah P. Birkmire-Peters
    Tripler Army Medical Center, Honolulu, HI
  • Mark J. Syms
    Tripler Army Medical Center, Honolulu, HI
  • Michael R. Holtel
    Tripler Army Medical Center, Honolulu, HI
  • Lawrence P. A. Burgess
    Tripler Army Medical Center, Honolulu, HI
  • Leslie J. Peters
    Tripler Army Medical Center, Honolulu, HI
  • Contact author: Pauline A. Mashima, MS, Speech Pathology Clinic, Otolaryngology Service, Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Road, Tripler AMC, HI 96859-5000.
    Contact author: Pauline A. Mashima, MS, Speech Pathology Clinic, Otolaryngology Service, Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Road, Tripler AMC, HI 96859-5000.×
  • Corresponding author: E-mail: Pauline.Mashima@haw.tamc.amedd.army.mil
  • * Currently affiliated with the John A. Burns School of Medicine, University of Hawaii, Honolulu
    Currently affiliated with the John A. Burns School of Medicine, University of Hawaii, Honolulu×
  • ** Currently affiliated with Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ
    Currently affiliated with Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Telepractice & Computer-Based Approaches / Research Articles
Research Article   |   November 01, 2003
Telehealth
American Journal of Speech-Language Pathology, November 2003, Vol. 12, 432-439. doi:10.1044/1058-0360(2003/089)
History: Received August 5, 2002 , Accepted April 25, 2003
 
American Journal of Speech-Language Pathology, November 2003, Vol. 12, 432-439. doi:10.1044/1058-0360(2003/089)
History: Received August 5, 2002; Accepted April 25, 2003
Web of Science® Times Cited: 43

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.

Acknowledgments
This research was supported by a grant from the Department of Defense, Pacific Telehealth, and Technology Hui. We gratefully acknowledge the patients who participated in this study and the assistance of Dorothy Craven, Patricia Beal, Maile Singson, Sean Wong, Mark Ching, Lisa Okinaga, John Draude, Jonna Zane, Diane Paul-Brown, Gloriajean Wallace, Lois Weiss, Dan Kelly, and Leslie Whitaker.
The views expressed in this article are those of the authors and do not reflect the official policy or position of the U.S. Department of the Army, U.S. Department of Defense, or the U.S. Government.
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