Validity of Conducting Clinical Dysphagia Assessments for Patients with Normal to Mild Cognitive Impairment via Telerehabilitation
To assess the validity of conducting clinical dysphagia assessments via telerehabilitation, 40 individuals with dysphagia from various etiologies were assessed simultaneously by a face-to-face speech-language pathologist (FTF-SLP) and a telerehabilitation SLP (T-SLP) via an Internet-based videoconferencing telerehabilitation system. Dysphagia status was assessed using a Clinical Swallowing Examination (CSE) protocol, delivered via a specialized telerehabilitation videoconferencing system and involving the use of an assistant at the patient’s end of the consultation to facilitate the assessment. Levels of agreement between the FTF-SLP and T-SLP revealed that the majority of parameters reached set levels of clinically acceptable levels of agreement. Specifically, agreement between the T-SLP and FTF-SLP ratings for the oral, oromotor, and laryngeal function tasks revealed levels of exact agreement ranging from 75 to 100% (kappa = 0.36–1.0), while the parameters relating to food and fluid trials ranged in exact agreement from 79 to 100% (kappa = 0.61–1.0). Across the parameters related to aspiration risk and clinical management, exact agreement ranged between 79 and 100% (kappa = 0.49–1.0). The data show that a CSE conducted via telerehabilitation can provide valid and reliable outcomes comparable to clinical decisions made in the FTF environment.
KeywordsDeglutition Deglutition disorders Telerehabilitation Dysphagia Swallowing disorders Aspiration Clinical swallowing examination Videoconferencing
- 21.Lalor E, Brown M, Cranfield E. Telemedicine: Its role in speech and language management for rural and remote patients. ACQ Speech Pathol Australia. 2000;2(2):54–5.Google Scholar
- 34.Dieticians Association of Australia and the Speech Pathology Association of Australia Limited. Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definitions. Nutr Diet. 2007;64(S2):S53–76.Google Scholar
- 36.Logemann JA, Rademaker A, Pauloski BR, Antinoja J, Bacon M, Bernstein M, Gaziano J, Grande B, Kelchner L, Kelly A, Klaben B, Lundy D, Newman L, Santa D, Czapla M, Farquharson J, Larsen K, Lewis V, Logan H, Nitschke T, Veis S. What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients? Dysphagia. 2008;23:378–84.PubMedCrossRefGoogle Scholar