Digital outcome measures in orofacial myofunctional therapy
Toward auditable, telepractice-ready, and clinically anchored assessment
DOI:
https://doi.org/10.67463/w9vkca18Keywords:
orofacial myofunctional therapy, digital outcome measures, telepractice, facial movement analysis, swallowing assessment, auditabilityAbstract
Objective: To examine how digital outcome measures may strengthen assessment in orofacial myofunctional therapy (OMT) and to propose a practical framework for moving the field beyond observer-dependent reporting toward auditable, clinically anchored endpoints suitable for telepractice.
Data sources: Recent direct and adjacent literature was prioritized, with emphasis on studies and reviews addressing OMT, telepractice, web-based structured assessment, facial video analysis, clinical acoustic markers, instrumented swallowing technologies, digital swallowing care, and governance issues related to automated audiovisual data.
Eligibility criteria: Evidence was retained when it clarified at least one of three questions: which OMT domains are most amenable to digital capture; which adjacent methods are plausibly transferable to OMT assessment; and which methodological conditions are required for digital endpoints to improve reproducibility rather than merely add technical novelty.
Methods of synthesis: This critical narrative review was updated through March 2026. Direct OMT studies and adjacent rehabilitation literature were appraised separately and synthesized through a three-tier evidence model linked to an endpoint-construction pathway: clinical target, elicited task, acquisition conditions, variable extraction, clinical anchoring, and reproducibility testing.
Main findings: Direct evidence supports structured telepractice workflows, web-enabled assessment scaffolds, and longitudinal patient-reported monitoring; however, it does not yet establish a validated core set of digital OMT endpoints. Adjacent literature provides firmer methodological support for disciplined video-derived facial variables, constrained signal interpretation, clinically benchmarked instrumentation, and explicit governance procedures. The most defensible near-term targets are lip competence and oral resting posture, facial symmetry and movement coordination, task-evoked perioral dynamics, swallowing-adjacent behavior, and longitudinal patient-reported monitoring.
Conclusion: Progress will depend less on expanding digital feature inventories than on prospectively testing small, condition-sensitive endpoint sets under controlled acquisition, transparent analytical pipelines, explicit clinical anchors, and reproducibility checks across raters, sessions, devices, and sites.
References
Shortland HA, Hewat S, Vertigan A, Webb G. Orofacial myofunctional therapy and myofunctional devices used in speech pathology treatment: a systematic quantitative review of the literature. Am J Speech Lang Pathol. 2021;30(1):301-17. doi:10.1044/2020_AJSLP-20-00245. DOI: https://doi.org/10.1044/2020_AJSLP-20-00245
Stefani CM, de Almeida de Lima A, Stefani FM, Kung JY, Flores-Mir C, Compton SM. Effectiveness of orofacial myofunctional therapy in improving orofacial function and oral habits: a scoping review. Can J Dent Hyg. 2025;59(1):59-72.
Capacho EER, Bossa CPD, Campos MDC, Rincon-Yanez D, Rangel-Navia H, Bianchini EMG. Telemedicine-supported structured orofacial myofunctional therapy model for obstructive sleep apnea: patients' report outcomes measurements. Respir Med. 2025;249:108460. doi:10.1016/j.rmed.2025.108460. DOI: https://doi.org/10.1016/j.rmed.2025.108460
Rodríguez-Alcalá C, Rodríguez-Alcalá L, Ignacio-García JM, Plaza G, Gozal D, Baptista P, et al. Telemedicine-delivered myofunctional therapy remodels upper airway anatomy in obstructive sleep apnea: a prospective controlled study. J Clin Sleep Med. 2026;22:12. doi:10.1007/s44470-025-00008-0. DOI: https://doi.org/10.1007/s44470-026-00053-3
Ataide MCG, Bernardi FA, Marques PMA, de Felício CM. Web version of the protocol of the orofacial myofunctional evaluation with scores: usability and learning. CoDAS. 2023;35(2):e20220026. doi:10.1590/2317-1782/20232022026. DOI: https://doi.org/10.1590/2317-1782/20232022026
de Felício CM, Ferreira CLP. Protocol of orofacial myofunctional evaluation with scores. Int J Pediatr Otorhinolaryngol. 2008;72(3):367-75. doi:10.1016/j.ijporl.2007.11.012. DOI: https://doi.org/10.1016/j.ijporl.2007.11.012
Boshart CA, James S, Fisher PK. Guidelines for successful online service delivery in orofacial myology. Int J Orofac Myol Myofunct Ther. 2020;46(1):59-76. doi:10.52010/ijom.2020.46.1.6. DOI: https://doi.org/10.52010/ijom.2020.46.1.6
Amaral MS, Furlan RMMM, Almeida-Leite CM, Motta AR. Orofacial myofunctional speech-language-hearing teletherapy program focusing on chewing and swallowing in temporomandibular disorders. Rev CEFAC. 2025;27(3):e1524. doi:10.1590/1982-0216/20252731524. DOI: https://doi.org/10.1590/1982-0216/20252731524s
Guarin DL, Taati B, Abrahao A, Zinman L, Yunusova Y. Video-based facial movement analysis in the assessment of bulbar amyotrophic lateral sclerosis: clinical validation. J Speech Lang Hear Res. 2022;65(12):4667-78. doi:10.1044/2022_JSLHR-22-00072. DOI: https://doi.org/10.1044/2022_JSLHR-22-00072
Schultz BG, Vogel AP. A tutorial review on clinical acoustic markers in speech science. J Speech Lang Hear Res. 2022;65(9):3239-63. doi:10.1044/2022_JSLHR-21-00647. DOI: https://doi.org/10.1044/2022_JSLHR-21-00647
Malandraki GA, Hahn Arkenberg R, Mitchell SS, Bauer Malandraki JL. Telehealth for dysphagia across the life span: using contemporary evidence and expertise to guide clinical practice during and after COVID-19. Am J Speech Lang Pathol. 2021;30(2):532-50. doi:10.1044/2020_AJSLP-20-00252. DOI: https://doi.org/10.1044/2020_AJSLP-20-00252
Wong DWC, Wang J, Cheung SMY, Lai DKH, Chiu ATS, Pu D, et al. Current technological advances in dysphagia screening: systematic scoping review. J Med Internet Res. 2025;27:e65551. doi:10.2196/65551. DOI: https://doi.org/10.2196/65551
Shin B, Lee SH, Kwon K, Lee YJ, Crispe N, Ahn SY, et al. Automatic clinical assessment of swallowing behavior and diagnosis of silent aspiration using wireless multimodal wearable electronics. Adv Sci (Weinh). 2024;11(34):e2404211. doi:10.1002/advs.202404211. DOI: https://doi.org/10.1002/advs.202404211
Hwang NK, Yoon TH, Chang MY, Park JS. Dysphagia rehabilitation using digital technology: a scoping review. J Evid Based Med. 2025;18(1):e70009. doi:10.1111/jebm.70009. DOI: https://doi.org/10.1111/jebm.70009
Alter IL, Dias C, Briano J, Rameau A. Digital health technologies in swallowing care from screening to rehabilitation: a narrative review. Auris Nasus Larynx. 2025;52(4):319-26. doi:10.1016/j.anl.2025.05.002. DOI: https://doi.org/10.1016/j.anl.2025.05.002
Elbaum B, Perry LK, Sarangoulis CM, Goodman KW, Messinger DS, Cejas I. The use of automated digital data in speech, language, and hearing research: confronting a new ethical landscape. J Speech Lang Hear Res. 2025;68(8):4087-93. doi:10.1044/2025_JSLHR-24-00819. DOI: https://doi.org/10.1044/2025_JSLHR-24-00819
Mahato K, Saha T, Ding S, Sandhu SS, Chang AY, Wang J. Hybrid multimodal wearable sensors for comprehensive health monitoring. Nat Electron. 2024;7:735-50. doi:10.1038/s41928-024-01247-4. DOI: https://doi.org/10.1038/s41928-024-01247-4
Gonçalves L, Silva D, Galdino KS. Mapping botulinum toxin injection sites and automated unit totalization in orofacial harmonization: a session-based web module for standardized, traceable clinical imaging. Derecho y Cambio Social. 2026;23(88):e4842. doi:10.54899/DCS.V23I88.4842. DOI: https://doi.org/10.54899/dcs.v23i88.4842
Švec JG, Granqvist S. Guidelines for selecting microphones for human voice production research. Am J Speech Lang Pathol. 2010;19(4):356-68. doi:10.1044/1058-0360(2010/09-0091). DOI: https://doi.org/10.1044/1058-0360(2010/09-0091)
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