Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Telemed J E Health. 2011 Nov;17(9):688-95. doi: 10.1089/tmj.2011.0034. Epub 2011 Sep 1.
Dysphagia (a swallowing disorder) is known to occur in numerous clinical populations, but unfortunately because of issues accessing speech pathology services, not all patients are able to receive dysphagia intervention and rehabilitation services in a timely manner. Existing research supports the use of telehealth technology for providing various aspects of speech pathology service; however, to date there is limited evidence to support the utilization of telerehabilitation in the assessment and management of dysphagia. The aim of this research was to provide pilot information on the basic feasibility and validity of conducting dysphagia assessments via telerehabilitation.
Ten simulated patients, actors portraying patients with a range of swallowing difficulties, were used rather than actual patients to minimize any potential patient risk from unidentified aspiration. Dysphagia was assessed simultaneously by a face-to-face (FTF) and telerehabilitation speech pathologist (T-SP). Each simulated patient was assessed using a Clinical Swallowing Examination (CSE) protocol that was modified to suit a telerehabilitation environment. The CSE was administered with the support of an assistant via an Internet-based videoconferencing telerehabilitation system using a bandwidth of 128 kilobits per second.
Results revealed high to excellent levels of agreement between the T-SP and the FTF-SP across all parameters of the CSE. Agreement for aspiration risk was excellent.
The pilot data indicate that the current model of administering a CSE via telerehabilitation has potential to be a feasible and valid method for the remote assessment of swallowing disorders.
吞咽障碍（一种吞咽障碍）已知发生在许多临床人群中，但不幸的是，由于获得言语病理学服务的问题，并非所有患者都能及时接受吞咽障碍干预和康复服务。现有研究支持使用远程医疗技术提供言语病理学服务的各个方面；然而，迄今为止，尚无证据支持在吞咽障碍的评估和管理中使用远程康复。本研究的目的是提供通过远程康复进行吞咽障碍评估的基本可行性和有效性的初步信息。
使用了 10 名模拟患者（即扮演吞咽困难患者的演员），而不是实际患者，以最大程度地降低任何因未识别的吸入而对患者造成的潜在风险。面对面（FTF）和远程康复言语病理学家（T-SP）同时对吞咽障碍进行评估。每位模拟患者均使用经修改以适应远程康复环境的临床吞咽检查（CSE）方案进行评估。在 128 千比特每秒的带宽下，使用基于互联网的视频会议远程康复系统，在助手的支持下进行 CSE 测试。
结果显示，T-SP 和 FTF-SP 在 CSE 的所有参数上均具有高度到极好的一致性。对吸入风险的一致性非常好。
初步数据表明，通过远程康复进行 CSE 的当前模式具有成为远程吞咽障碍评估的可行且有效的方法的潜力。
