Validation of a telerehabilitation system for the assessment of communication and swallowing function following laryngectomy

Following surgical removal of the larynx (laryngectomy) patients require specialist speech pathology services for many years post surgery, however, gaining access to these services is often difficult for rural patients. The research team lead by Dr Liz Ward, Jane White, Dr Trevor Russell, and Dr Deborah Theodoros is exploring the feasibility of assessing the speech and swallowing function of remote laryngectomy patients via a telerehabilitation system. Initial research with 20 participants (Phase 1, 2005-2006), revealed a high level of agreement between the on-line and clinical assessment for the majority of aspects under evaluation. Patient satisfaction with the system was high and clinicians were highly supportive of the potential of the system. However specific limitations were encountered. In particular, these involved inability to obtain optimal views of the entire oral cavity, stoma or voice prosthesis in-situ due to static web cameras and the lack of direct lighting. Current research (Phase 2, 2007-2008) being conducted by this team extends on from the pilot study, to examine a new version of the telehealth system, incorporating flexible web cameras and lighting sources. It is hypothesised that with these modifications, the on-line system will be able to achieve comprehensive clinical information that is comparable to a standard clinical assessment. Phase 3 (planned 2008), will involve a remote clinical trial using a portable version of the telerehabilitation system, in order to determine any barriers to the implementation of the system into clinical care.