Teledelivery of Aural Rehabilitation to Improve Cochlear Implant Outcomes

Abstract

Objective(s)This randomized controlled study evaluated the effectiveness of a Telehealth Aural Rehabilitation (TeleAR) training protocol to improve outcomes for adult cochlear implant (CI) users.MethodsThis was a multisite clinical study with participants randomized to either an AR treatment or active control group. The AR protocol consisted of auditory training (words, sentences, and speech tracking), informational counseling, and communication strategies. The control group participants engaged in cognitive stimulation activities (crosswords, sudoku, etc.). Each group completed 6 weekly 90‐min individual treatment sessions delivered remotely. Twenty postlingually deafened adult CI users participated. Assessments were completed pretreatment and 1 week and 2 months posttreatment.ResultsRepeated‐measures ANOVA and planned contrasts were used to compare group performance on AzBio Sentences, Hearing Handicap Inventory (HHI), Client Oriented Scale of Improvement (COSI), and Glasgow Benefit Inventory (GBI). The two groups were statistically equivalent on all outcome measures at pre‐assessment. There was a statistically significant main effect of time for all measures. Improvement over time was observed for participants in both groups, with greater improvement seen for the AR than the CT group on all outcome measures. The AR group showed medium to large effect sizes on all measures over time, suggesting clinically significant outcomes.ConclusionThis randomized controlled study provides evidence of improved speech recognition and psychosocial outcomes following 6 weeks of TeleAR intervention. For adult post‐lingually deafened CI users, including those >3 months post‐activation, AR treatment can leverage neuroplasticity to maximize outcomes.Level of Evidence2 Laryngoscope, 2023

Systematic review of patient and service outcome measures of remote digital technologies for cochlear implant and hearing aid users

“…The Downs and Black Checklist for Measuring Study Quality was used to investigate individual risk of bias and study quality for the included publications (Downs and Black, 1998). Ten studies were rated as good quality (Ferguson et al, 2016;Cullington et al, 2018;Gomez and Ferguson, 2020;Tao et al, 2020;Venail et al, 2021;Henshaw et al, 2022;Brewer et al, 2023;Coco et al, 2023;Maidment et al, 2023;Malmberg and Hagberg, 2023), seven as poor quality (de Graaff et al, 2016(de Graaff et al, , 2018Maidment et al, 2019;Schepers et al, 2019;Ratanjee-Vanmali et al, 2020;Carner et al, 2023;Çelikgün and Büyükkal, 2023) and the remaining 32 studies were rated as fair quality. The Downs and Black results are available in Supplementary material 4.…”