The fourth #ResNetSLT Tweetchat of 2019 will take place on Wednesday, 24th April 7.30pm – 8.30pm (UK time).
The chat will be hosted by Milly Heelan and Chiara Vivaldi and will be based around this paper: Treating disordered speech and voice in Parkinson’s disease online: a randomized controlled non-inferiority trial by Gabriella Constantinescu, Deborah Theodoros, Trevor Russell, Elizabeth Ward, Stephen Wilson and Richard Wootton.
The Parkinson’s disease theme is chosen to link with World Parkinson’s day on 11th April this year. We aim to highlight and discuss the role of speech and language therapy in supporting people with Parkinson’s disease and consider how SLT treatment is offered across services.
The paper focuses on the use of online delivery of the Lee Silverman Voice Treatment (LSVT®), due to the intensive nature of the treatment and the difficulties that arise for people with Parkinson’s disease (PD) in accessing this treatment. This paper aims to investigate the validity and reliability of online delivery of the LSVT® for the speech and voice disorder associated with PD.
In the study, participants were divided into two groups. One group received LSVT® online and the other face-to-face. Results showed the online and face-to-face delivery for the primary outcome measure were statistically comparable and main effects for the LSVT® environment, dysarthria severity, and interaction effects were obtained for all outcomes measures. Significant improvements following the LSVT® were noted on the majority of measures.
The LSVT® was largely successfully delivered online, although some participants encountered networking and software difficulties during a few of their sessions. The majority of participants who received the online delivery were overall more than satisfied or very satisfied with the treatment.
The paper concluded that online treatment for moderate to mild hypokinetic dysarthria associated with Parkinson’s disease appears to be clinically valid and reliable. It suggests the further use of online services for people with Parkinson’s disease in order to overcome barriers to treatment access.
We look forward to hearing your thoughts and experiences of working with people with Parkinson’s Disease and/or delivering therapy online.
Here are the questions to guide our chat…
• What is your experience of delivering therapy online?
Can you share any examples? Let us know your setting and what therapy you delivered?
• The paper suggests reasons why LSVT® may be particularly suited to online delivery, for example a clear protocol and established materials.
What other therapies do you think may be suitable for online delivery and why?
• What impact do you think online delivery may have on the therapist/client relationship?
How could we counter these impacts?
• What would be your dream online therapy and why?
HERE’S THE SUMMARY OF THE CHAT …
In line with #WorldParkinsonsday, April’s #ResNetSLT tweetchat focussed on tele-therapy in the treatment and management of Parkinson’s disease. The paper was titled: Treating disordered speech and voice in Parkinson’s disease online: a randomized controlled non-inferiority trial by Gabriella Constantinescu, Deborah Theodoros, Trevor Russell, Elizabeth Ward, Stephen Wilson and Richard Wootton.
It was a lively discussion with 122 tweets during the hour! There were many more tweets after the hour too, from people catching up and contributing to the discussion further. It was great to hear from a variety of SLT’s across different settings and client groups, working in either research or clinical capacities. Everyone was very generous with sharing their experiences and ideas which made for a very practical discussion.
Some SLT’s had experiences of using tech in practice, including using apps such as @stepbystep mentioned by @KathBroomfield, @Tactustherapy apps mentioned by @heelan_phd. @Bammo related to an online therapy service, which uses a secure online system to display therapy targets and link clients and therapist – seems a great use of technology!
@RCSLTresearch pointed towards @citcen a great resource for SLT’s using computers in therapy and Aphasia Software Finder for those interested in communication therapy (Links to their websites are here for further information https://toolkit.citcen.org/ https://www.aphasiasoftwarefinder.org/)
@speechtools reported using a mix of facetime and skype to deliver therapy interventions and Katie from @RCSLTresearch reported a great example of using supported conversation training over skype. Others used skype for initial assessments, advice and observational dysphagia sessions, showing a real variety in its use. Tweets reported a mixture of face to face appointments alongside online therapy to support getting accurate baseline measures and build rapport, however @Bammo pointed out that online therapy would definitely depend on the client group!
Barriers to providing #teletherapy were similar to the ones mentioned in the paper including availability of resources including hardware and software, time to set up, reliable internet access and confidence in using this type of therapy from both professionals and clients. @Em_rehab also indicated the potential for less interdisciplinary working as a result of tele-therapy and queried whether emotional support could be provided to clients and significant others online. Many tweets indicated that clients had a positive experience of using therapy online, including dysfluency therapy delivered by @AiredaleNHSFT (A great summary of their pilot project here: https://airedalestammeringtherapy.wordpress.com/2019/03/26/stammering-therapy-evaluation-final-results/amp/)
When asked about dream online therapies ideas included:
- Clients with the technology already to hand
- Clients with prior knowledge of using technology or a helpful family member/friend available to help
- Ability to mix and match face to face or online sessions to adapt to the changing needs of the therapy progress
- Technology that could step up and step down therapy appropriately
It was agreed that we hope to see more use of technology in the future and proved to be a real exciting topic for the future of SLT delivery. Starting to deliver #teletherapy alongside face to face sessions was seen as a real starting point for the future! If your team or service has delivered other therapy online, it would be great to hear from you! Tweet us @ResNetSLT!