Abstract：
OBJECTIVE: To compare the effects of telerehabilitation (TR) and face-to-face rehabilitation (FTF) methods on the outcomes of adults with voice disorders and to analyze the effectiveness of TR.
METHODS: Following Boolean Logic, a search strategy was devised, combining subject terms and keywords based on the interventions and populations outlined in the inclusion criteria. We searched PubMed, Cochrane Library, Embase, Web of Science, Scopus, CNKI, Wanfang, CQVIP databases, and manually screened academic conference papers, journal articles, and gray literature to identify eligible randomized controlled trials (RCTs) on remote voice therapy. Two researchers assessed the risk of bias in the included studies using the risk of bias assessment tool for RCTs outlined in the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.
RESULTS: Five trials with a total of 233 patients with voice disorders were included in the study after screening. The results revealed a significant difference in Jitter change values (mean difference [MD]=-0.12, 95%CI [-0.23,-0.01], P = 0.04) between TR and FTF, maximum phonation time (MD=0.76, 95%CI [-0.60,2.13], P = 0.27), Shimmer (MD=-0.04, 95%CI [-0.11,0.03], P = 0.27), voice handicap index (MD=0.87, 95%CI [-1.77,3.50], P = 0.52), and GRBAS(G) (MD=-0.00, 95%CI [-0.01,0.01], P = 0.99) had no significant difference.
CONCLUSIONS: TR demonstrates comparable efficacy to FTF in voice treatment and is associated with higher levels of patient satisfaction, making it a viable and effective therapeutic modality. However, given the limited sample size analyzed in this study, further validation of this conclusion necessitates additional RCTs with larger sample sizes. Furthermore, researchers should remain cognizant of the constraints associated with TR and consistently refine treatment protocols to enhance the efficacy of voice therapy.
METHODS: Following Boolean Logic, a search strategy was devised, combining subject terms and keywords based on the interventions and populations outlined in the inclusion criteria. We searched PubMed, Cochrane Library, Embase, Web of Science, Scopus, CNKI, Wanfang, CQVIP databases, and manually screened academic conference papers, journal articles, and gray literature to identify eligible randomized controlled trials (RCTs) on remote voice therapy. Two researchers assessed the risk of bias in the included studies using the risk of bias assessment tool for RCTs outlined in the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.
RESULTS: Five trials with a total of 233 patients with voice disorders were included in the study after screening. The results revealed a significant difference in Jitter change values (mean difference [MD]=-0.12, 95%CI [-0.23,-0.01], P = 0.04) between TR and FTF, maximum phonation time (MD=0.76, 95%CI [-0.60,2.13], P = 0.27), Shimmer (MD=-0.04, 95%CI [-0.11,0.03], P = 0.27), voice handicap index (MD=0.87, 95%CI [-1.77,3.50], P = 0.52), and GRBAS(G) (MD=-0.00, 95%CI [-0.01,0.01], P = 0.99) had no significant difference.
CONCLUSIONS: TR demonstrates comparable efficacy to FTF in voice treatment and is associated with higher levels of patient satisfaction, making it a viable and effective therapeutic modality. However, given the limited sample size analyzed in this study, further validation of this conclusion necessitates additional RCTs with larger sample sizes. Furthermore, researchers should remain cognizant of the constraints associated with TR and consistently refine treatment protocols to enhance the efficacy of voice therapy.
摘要：
目的：比较远程康复（TR）和面对面康复（FTF）方法对患有语音障碍的成年人的预后的影响，并分析TR的有效性。
方法：遵循布尔逻辑，设计了搜索策略，根据纳入标准中概述的干预措施和人群，结合主题词和关键词。我们搜索了PubMed,科克伦图书馆,Embase,WebofScience,Scopus,CNKI,万方,CQVIP数据库,人工筛选学术会议论文，期刊文章,和灰色文献，以确定合格的远程语音治疗随机对照试验（RCTs）。两名研究人员使用《Cochrane干预措施系统评价手册5.1.0版》中概述的随机对照试验偏倚风险评估工具评估了纳入研究的偏倚风险。
结果：5项试验共233名嗓音障碍患者在筛查后纳入研究。结果显示抖动变化值存在显著差异(平均差[MD]=-0.12,95CI[-0.23,-0.01],TR和FTF之间的P=0.04），最大发声时间(MD=0.76，95CI[-0.60，2.13]，P=0.27),微光（MD=-0.04，95CI[-0.1,0.03]，P=0.27),嗓音障碍指数(MD=0.87，95CI[-1.77，3.50]，P=0.52),和GRBAS（G）（MD=-0.00，95CI[-0.01，0.01]，P=0.99)无显著性差异。
结论：TR在嗓音治疗中表现出与FTF相当的疗效，并且与更高的患者满意度相关。使其成为可行和有效的治疗方式。然而,鉴于本研究分析的样本量有限，进一步验证该结论需要更多样本量的RCT.此外，研究人员应认识到与TR相关的限制因素,并不断改进治疗方案,以提高嗓音治疗的疗效.
方法：遵循布尔逻辑，设计了搜索策略，根据纳入标准中概述的干预措施和人群，结合主题词和关键词。我们搜索了PubMed,科克伦图书馆,Embase,WebofScience,Scopus,CNKI,万方,CQVIP数据库,人工筛选学术会议论文，期刊文章,和灰色文献，以确定合格的远程语音治疗随机对照试验（RCTs）。两名研究人员使用《Cochrane干预措施系统评价手册5.1.0版》中概述的随机对照试验偏倚风险评估工具评估了纳入研究的偏倚风险。
结果：5项试验共233名嗓音障碍患者在筛查后纳入研究。结果显示抖动变化值存在显著差异(平均差[MD]=-0.12,95CI[-0.23,-0.01],TR和FTF之间的P=0.04），最大发声时间(MD=0.76，95CI[-0.60，2.13]，P=0.27),微光（MD=-0.04，95CI[-0.1,0.03]，P=0.27),嗓音障碍指数(MD=0.87，95CI[-1.77，3.50]，P=0.52),和GRBAS（G）（MD=-0.00，95CI[-0.01，0.01]，P=0.99)无显著性差异。
结论：TR在嗓音治疗中表现出与FTF相当的疗效，并且与更高的患者满意度相关。使其成为可行和有效的治疗方式。然而,鉴于本研究分析的样本量有限，进一步验证该结论需要更多样本量的RCT.此外，研究人员应认识到与TR相关的限制因素,并不断改进治疗方案,以提高嗓音治疗的疗效.
