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Continuity of Early Intervention Services in New York City During the COVID-19 Pandemic
Full text linkIn response to COVID-19, the New York City Early Intervention (EI) Program rapidly transitioned from in-person to teletherapy services. We describe the timing of service resumption among children who received EI services between March 1 and March 17, 2020. The proportion of children who transitioned to teletherapy-only was 25% as of March 24, rising to 78% by July 6. By December 31, 2020, 87% of the cohort had resumed either teletherapy or in-person services. Child age, race, language, and neighborhood poverty all predicted service resumption timing. Children with a diagnosis of autism spectrum disorder were more likely to transition to teletherapy, and children with only 1-2 domains of delay were more likely to discontinue services altogether. Continuity of EI services during the COVID-19 public health emergency was a critical priority. Timely policy changes facilitated swift return to services and avoided exacerbation of the long-standing racial disparities in access to EI services
A Preliminary Investigation of the Reliability of Acoustic Parameters of Voice through Smartphone Recordings in Individuals with Dysphonia
Full text linkTelepractice offers the opportunity to receive care at home without risk of exposure to healthcare acquired infections, especially during a pandemic. Hence, establishing the reliability of the diagnosis of dysphonia via a smartphone is fundamental to providing an alternative service delivery model. A total of 20 participants participated in the study. Recordings of sentence-based voice samples were done using a standardized microphone and the software used in labs and on smartphones. Comparisons were made of acoustic and perceptual voice in real-time and recorded samples speech in persons with typical vs pathological voice. Results revealed no significant differences perceptually between real-time voice and recorded voice in individuals with typical and pathological voices. In acoustic analysis, there was no significant difference in Fundamental frequency (F0) and Auditory Voice Quality Index (AVQI) between real-time voice and recorded voice in individuals with typical and pathological voice
Evaluation of Psychometric Properties of Thai Version Telehealth Usability Questionnaire (T-TUQ)
Full text linkThis cross-sectional validation study aimed to translate, cross-culturally adapt, and investigate the psychometric properties of a Thai version of the Telehealth Usability Questionnaire (T-TUQ). Two hundred and ten Thai participants, mean age of 61.2±15.2 years, were recruited from three specialty clinics: 50 (23.8%) hematology, 70 (33.3%) movement disorders, and 90 (42.9%) general neurology. The T-TUQ was translated from the original English version to produce a Thai language version. Back translation and pilot cognitive interviews were completed. All five subscales (usefulness, ease of use, effectiveness, reliability, and satisfaction) showed excellent internal consistency (alpha >0.80), displayed by Cronbach's alpha coefficient of 0.83, 0.94, 0.86, 0.83, and 0.92, respectively. For construct validity, exploratory factor analysis revealed two dimensions from eigenvalues and scree plot, defined as utility and accessibility subscales. In conclusion, the T-TUQ could be a reliable and valid instrument to evaluate the usability of telehealth with a Thai population
Perspectives of Saudi Occupational Therapists Regarding Telerehabilitation: A Qualitative Study
Full text linkBackground: Telerehabilitation is emerging in Saudi Arabia. This study investigated occupational therapy professionals’ perspectives on using telerehabilitation in their practice. Method: Data were collected through semi-structured phone interviews conducted with nine Saudi occupational therapists. A pragmatic qualitative evaluation approach was used. Findings: Experience and perceptions of participants regarding telerehabilitation were represented as follows: awareness and knowledge of telerehabilitation; how telerehabilitation increases occupational therapy availability and access in Saudi Arabia; telerehabilitation in the pandemic; telerehabilitation is preferred; suitability of telerehabilitation in Saudi Arabia; telerehabilitation care pathways; telerehabilitation readiness in Saudi Arabia; and telerehabilitation willingness by Saudi occupational therapists. Conclusion: Saudi occupational therapists have good knowledge and awareness of telerehabilitation, and some had used it during the pandemic. They showed positive attitudes and a willingness to use telerehabilitation if appropriate technology infrastructure, official policy standards and guidelines, training, data security, and financial resources could be provided to support implementation
The Effects of Virtual Caregiver Coaching in Antigua & Barbuda on the Implementation of EMT Language Support Strategies in Naturalistic Environments
Full text linkThis single-case multiple baseline design investigation set out to determine the effectiveness of using a telepractice service delivery model to coach caregivers in Antigua & Barbuda in the use of Enhanced Milieu Teaching (EMT) language support strategies with a child with language impairment. A slightly modified version of the Teach-Model-Coach-Review (TMCR) method was used during virtual instruction to train a caregiver on the language support strategies of environmental arrangement, matched turns, expansions, and time delay with milieu prompting. The caregiver attended sessions three times a week for up to 45 minutes for four weeks. The results of this study indicated a positive relationship between the intervention and caregiver use of strategies. The caregiver demonstrated increased responsiveness to the child’s communication attempts and exhibited the use of language support strategies across activities. This study suggests that telepractice can be an effective service delivery model for providing coaching to caregivers
Rehabilitation After Total Laryngectomy: An Integrated Protocol Remotely Delivered During COVID-19
Full text linkThe aim of this paper was to evaluate the results of an integrated treatment delivered remotely to laryngectomized patients with voice prosthesis. Eighteen laryngectomized patients were treated remotely in groups co-led by a speech therapist and a psychologist ("Online Group"). The results were compared with those of 17 patients ("In-Person Group") previously studied. The two groups obtained comparable results on all parameters of the INFVo perceptual rating scale, in the DEP, ANX, PHO and HOS areas of the Symptom Check List-90-Revised questionnaire, and in the areas investigated by the WHOQOL-B questionnaire. The "In-Person Group" obtained statistically better results on the Italian Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire. Although the in-person treatment favored the acceptance of the new voice and the development of conversational skills, telerehabilitation guaranteed an adequate level of assistance in terms of voice acquisition, prevention of anxiety and depression, and recovery of a good QoL
The Effect of Telerehabilitation on Physical Fitness and Depression/Anxiety in Post-COVID-19 Patients: A Randomized Controlled Trial
Full text linkAim: The aim of this research was to evaluate the impact of a telerehabilitation program on physical fitness, muscle strength, and levels of depression and anxiety in post-COVID-19 patients. Methods: Thirty-two individuals recovered from COVID-19 (48.20±12.82 years) were allocated into either a telerehabilitation (TG n=16) or control (CG n=16) group. Physical fitness, handgrip strength, depression and anxiety levels were assessed before and after an 8-week intervention. Results: There was a significant improvement in muscle strength in both groups. Physical fitness significantly increased compared to the CG at the end of the intervention. Levels of anxiety and depression significantly decreased after the intervention when compared to the CG. Conclusion: Eight weeks of functional telerehabilitation training is a viable and efficient way to rehabilitate patients affected by COVID-19, as it improved physical conditioning and mental health
The Confounding Influence of Older Age in Statistical Models of Telehealth Utilization
Full text linkOlder age is a potentially confounding variable in models of telehealth utilization. We compared unified and stratified logistic regression models using data from the 2021 National Health Interview Survey. A total of 27,626 patients were identified, of whom 38.9% had utilized telehealth. Unified and stratified modeling showed a number of important differences in their quantitative estimates, especially for gender, Hispanic ethnicity, heart disease, COPD, food allergies, high cholesterol, weak or failing kidneys, liver conditions, difficulty with self-care, the use of mobility equipment, health problems that limit the ability to work, problems paying bills, and filling a recent prescription. Telehealth utilization odds ratios differ meaningfully between younger and older patients in stratified modeling. Traditional statistical adjustments in logistic regression may not sufficiently account for the confounding influence of older age in models of telehealth utilization. Stratified modeling by age may be more effective in obtaining clinical inferences
Hybrid e-rehabilitation services: SMART-system for remote support of rehabilitation activities and services
Full text linkOne of the most effective solutions in medical rehabilitation assistance is remote patient / person-centered rehabilitation. Rehabilitation also needs effective methods for the “Physical therapist – Patient – Multidisciplinary team” system, including the statistical processing of large volumes of data. Therefore, along with the traditional means of rehabilitation, as part of the “Transdisciplinary intelligent information and analytical system for the rehabilitation processes support in a pandemic (TISP)” in this paper, we introduce and define: the basic concepts of the new hybrid e-rehabilitation notion and its fundamental foundations; the formalization concept of the new Smart-system for remote support of rehabilitation activities and services; and the methodological foundations for the use of services (UkrVectores and vHealth) of the remote Patient / Person-centered Smart-system. The software implementation of the services of the Smart-system has been developed