Voice therapy for Parkinson’s disease via smartphone videoconference in Malaysia: A preliminary study

Abstract

Introduction Intensive voice therapy is one of the best evidence-based treatments to improve speech and voice difficulties to individuals with Parkinson’s disease (PD). However, accessibility to intensive voice therapy is highly challenging in Malaysia due to the lack of voice specialised speech-language therapists. This study examined the feasibility of using smartphone videoconference to deliver intensive voice therapy to individuals with PD in Malaysia. Methods Intensive voice therapy was delivered to 11 adults with PD using a smartphone videoconference method via WhatsApp Messenger freeware. The therapy consisted of 12 sessions over four weeks and focused on increasing vocal loudness. Outcomes were assessed using objective, perceptual and quality-of-life measures pre and post treatment. Participant satisfaction with the telerehabilitation method was obtained via the Smartphone-Based Therapy Satisfaction Questionnaire. Results Significant gains were reported for sound pressure level in sustained vowels and monologue. Perceptual ratings showed significant improvements in overall mean severity and loudness after treatment. Mean scores of speech intelligibility and Voice Handicap Index-10 were significantly better post treatment. Overall, participants were highly satisfied with the smartphone videoconference method. Discussion Present results suggest that the smartphone videoconference method is feasible to deliver intensive voice therapy to individuals with PD to gain better speech and voice functions. Future studies need to address the standardisation of the system protocol to optimise this novel service delivery method in Malaysia.

Feasibility of Speech Telerehabilitation for a Patient with Parkinson's Disease in a Low-Resource Country during the Pandemic: A Case Report

“…To our knowledge, there has been one published report on speech teletherapy for PD from a developing country in Asia. 24 However, in the Philippines, there is no published report on speech teletherapy. LSVT via telerehabilitation had been used and found to be effective in treating speech disorders in PD.…”

“…Significant improvements were obtained in terms of sound pressure level for sustained vowels, monologue, speech intelligibility, and voice loudness after 12 sessions within 4 weeks of telerehabilitation. 24 Praat™ is a freely downloadable and open-source computer application that analyzes, synthesizes, and manipulates speech in phonetics. 25 Through certain parameters, such as pitch defined as the range of tone (i.e., highness or lowness), shimmer (i.e., variation of amplitude or volume of the sound wave), jitter (i.e., variation of frequency or pitch of sound wave), harmonics to noise ratio (HNR), and noise to harmonics ratio (NHR), the application allows the clinician to determine abnormalities in phonation, such as hoarseness, asthenia, and limited pitch variation.…”

Management of Parkinson’s Disease in the COVID-19 Pandemic and Future Perspectives in the Era of Vaccination

“…If not available, patients should be guided to online programs that have been established for PD. A study among PD patients showed that effective speech therapy could be delivered via online consultation using a smartphone [ 30 ]. These teleconsultations and telerehabilitation services could still be maintained even in the post-COVID era, and would reduce unnecessary hospital visits, especially in those with mobility issues.…”

“…A study among PD patients showed that ef-fective speech therapy could be delivered via online consultation using a smartphone. 30 These teleconsultations and telerehabilitation services could still be maintained even in the post-COV-ID era, and would reduce unnecessary hospital visits, especially in those with mobility issues. Patients could also continue with their guided-rehabilitation programs from the comfort and safety of their homes.…”

Teleneurorehabilitation for Parkinson's Disease: A Panacea for the Times to Come?

“…[ 19 ] A small Malaysian study examined the feasibility of delivering intensive voice therapy to 11 PD patients via video-conferencing using WhatsApp. [ 9 ] 12 sessions were performed over 4 weeks. Improvement in speech loudness parameters was reported.…”