| Objective:The purpose of this study was to explore the effectiveness of telepractice voice therapy on voice function in patients with laryngopharyngeal reflux disease(LPRD),and to identify a voice therapy program that is cost-effective,practical,and effective for LPRD patients with dysphonia.Methods:A total of 120 patients diagnosed with LPRD was selected from patients complaining of dysphonia in the otolaryngology,head and neck surgery clinic.These patients were then randomly allocated to three groups in the order of outpatient visits via a computer generated random number table(Group A: standard treatment group,Group B: combined face-to-face voice therapy group,Group C: combined telepractice voice therapy group).We collected and compared indices of curative effect in patients with LPRD at the 8th week and the 12 th week of treatment and the 6th week post-treatment.The data was collected on objective acoustic parameters,subjective acoustic parameters,the reflux symptom index(RSI)scale and the reflux finding score(RFS)scale.Results:1.Compared with the objective acoustic parameters,there was no significant difference in the Jitter between three groups in stage 1 and stage 2(P > 0.05),but there was a significant difference in stage 3(P < 0.05).The Jitter value in group B was significantly lower than that in group A.There was no significant difference in Shimmer among the three groups from stage 1 to stage 3(P > 0.05).In comparison with MPT and DSI among the three groups,there was no significant difference in stage 1(P > 0.05)and there were significant differences in stage 2 and stage 3(P < 0.05).The value of MPT and DSI in group B and group C were significantly higher than those in group A,and the values of MPT and DSI in group C were significantly higher than those in group B.2.Compared with the subjective acoustic parameters,there were no significant differences in the total score of RBH and VHI-P among the three groups at each stage(P >0.05).But there were significant differences in the total score of VHI among the three groups at each stage(P < 0.05).At stage 1,the value of VHI in group B and group C were significantly lower than that in group A,and the value of VHI in group C was significantly lower than that in group B.At stage 2 and stage 3,the value of VHI in group B and C were significantly lower than those in group A.In comparison with VHI-F among three groups,there was a significant difference at each stage(P < 0.05).At each stage,the value of VHIF in group B and group C were significantly lower than those in group A.By comparison with VHI-E among the three groups,there were significant differences in stage 1 and stage3(P < 0.05),and there was no significant difference in stage 2(P > 0.05).The value of VHIE in group C was significantly lower than that in group A at stage 1,and the value of VHIE in group C was significantly lower than that in group B at stage 3.3.Compared with the score of RSI among three groups,there were significant differences at each stage(P < 0.05).At stage 1,the score of RSI in group B and group C were significantly lower than that in group A,and the score of RSI in group C was significantly lower than that in group B.At stage 2 and stage 3,the score of RSI in group B and group C were significantly lower than that in group A.In comparison with the score of RFS among three groups,there were significant differences at each stage(P < 0.05).At stage1,the RFS score in group C was significantly lower than those in group A and group B.At stage 2,the RFS score in group B and group C were significantly lower than that in group A,and the RFS score in group C was significantly lower than that in group B.At stage 3,the RFS score in group C was significantly lower than those in group A and group B.4.During follow-up,the changes of all indicators varied with the change of treatment stage in the three groups(P ? 0.001).During the treatment period,Jitter,Shimmer,RBH,VHI,VHI-F,VHI-P,VHI-E,RSI,and RFS showed a significant downward with the change of treatment stage,while MPT and DSI showed a significant upward with the change of treatment stage.Comparing and observing the recurrence in each group,the MPT value in group A at stage 3 was significantly lower than that at stage 2(P < 0.05).Compared with indicators of group B,there was no significant statistical difference between stage 2 and stage 3(P > 0.05).In group C,the value of DSI at stage 3 was significantly higher than that at stage 2(P < 0.05),and the RBH,VHI-E,and RFS at stage 3 were significantly lower than those at stage 2(P < 0.05).Conclusion:Studies have shown that telepractice voice therapy is no less effective than the face-toface voice therapy for LPRD patients with dysphonia.And both voice therapies are superior to standard treatment option.Furthermore,telepractice voice therapy is more effective in improving signs of LPRD than other treatment options for LPRD patients with dysphonia.In conclusion,telepractice can be used as an alternative to face-to-face voice therapy for LPRD patients with dysphonia during special periods.But it needs to be further studied about the long-term efficacy and clinical application. |
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