The Effects of Telerehabilitation in Patients with Voice Disorders: A Systematic Review and Meta-Analysis

Objectives: 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. Conclusion: 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.