Rehabilitation of Airway Protection in Individuals With Movement Disorders: A Telehealth Feasibility Study.
Rehabilitation of Airway Protection in Individuals With Movement Disorders: A Telehealth Feasibility Study.
复制标题
运动障碍患者气道保护的康复：远程医疗可行性研究。
DOI：
10.1044/2022_ajslp-22-00063
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发表时间：
2022
影响因子：
2.6
通讯作者：
Troche,MichelleS
中科院分区：
文献类型：
--
作者：
Sevitz,JordannaS;Borders,JamesC;Dakin,AveryE;Kiefer,BriannaR;Alcalay,RoyN;Kuo,Sheng-Han;Troche,MichelleS
目的：呼吸道保护性缺陷（吞咽和咳嗽）极大地降低了健康和生活质量，是神经退行性运动障碍的普遍后果。呼气肌力训练（埃姆斯特）和咳嗽技能训练（CST）是改善气道保护的两种治疗方法;然而，许多患者无法获得这些治疗。远程保健可能会改善获得保健的机会，但通过远程保健进行这些治疗是否可行和有效仍是未知数。本研究旨在确定实际的可行性和初步治疗效果的埃姆斯特和CST通过telehealth.MethodTwenty运动障碍的参与者完成了4周的埃姆斯特和2周的CST，包括两个临床医生指导的治疗会议，通过远程医疗和3天的家庭实践，每周。计算每种治疗的可行性。实际可行性定义为完成治疗（埃姆斯特或CST）并在30分钟疗程/时间内获得相关结局指标-埃姆斯特的最大呼气压（pMEP）和CST的呼气峰流速（PEFR）的代表。对可能影响可行性的会话因素进行了检查。结果获得pMEP和完全埃姆斯特的时间为17.48 min，获得PEFR和完全CST的时间为17.69 min，pMEP、单次自主咳嗽PEFR、和序贯性自主咳嗽PEFR从术前增加，结论：研究结果表明，埃姆斯特和CST的交付是可行的，通过远程医疗和产量改善pMEP和PEFR。这对于扩大气道保护性干预措施的服务提供和减少神经退行性运动障碍患者的医疗保健差异具有重要意义。补充材料https：doi.org/10.23641/asha.21357669
PurposeAirway protective deficits (swallowing and cough) greatly reduce health and quality of life and are a pervasive consequence of neurodegenerative movement disorders. Expiratory muscle strength training (EMST) and cough skill training (CST) are two treatment approaches to improve airway protection; however, many patients are unable to access these treatments. Telehealth may improve access to care, but it remains unknown whether these treatments are feasible and efficacious via telehealth. This study aimed to determine the practical feasibility and preliminary treatment effect of EMST and CST via telehealth.MethodTwenty participants with movement disorders completed 4 weeks of EMST and 2 weeks of CST, including two clinician-directed treatment sessions via telehealth and 3 days of home practice per week. Feasibility was calculated for each treatment. Practical feasibility was defined as completing treatment (EMST or CST) and obtaining the relevant outcome measures—a proxy of maximum expiratory pressure (pMEP) for EMST and peak expiratory flow rate (PEFR) for CST—within a 30-min session/period. Session factors that may have influenced feasibility were examined. Preliminary treatment effect was defined as changes in pMEP and PEFR.ResultsTime taken to obtain pMEP and complete EMST was 17.48 min, and time taken to obtain PEFR and complete CST was 17.69 min. pMEP, single voluntary cough PEFR, and sequential voluntary cough PEFR increased from pre- to posttreatment.ConclusionsFindings suggest that the delivery of EMST and CST is feasible via telehealth and yield improvements to pMEP and PEFR. This has important implications for expanding service delivery of airway protective interventions and reducing health care disparities in people with neurodegenerative movement disorders.Supplemental Materialhttps://doi.org/10.23641/asha.21357669