Home-based speech treatment for Parkinson's disease delivered remotely: a case report

Abstract

We investigated the validity and feasibility of online delivery of the Lee Silverman Voice Treatment (LSVT) for the treatment of the speech disorder of a patient with idiopathic Parkinson's disease. The treatment was delivered in 16 sessions to the participant's home, 90 km from the speech language pathologist. A PC-based videoconferencing system was used, operating at 128 kbit/s over the public telecommunications network. The patient achieved substantial improvements in vocal sound pressure levels during sustained vowel phonation (6.13 dB), reading (12.28 dB) and conversational monologue (11.32 dB). There were improvements in the duration of sustained vowel phonation (4 s). Improvements were also perceived in the degree of breathiness and roughness in the voice, and in overall speech intelligibility in conversation. The patient was very satisfied with the audio and video quality of the conferencing, and with the online treatment overall. He reported a preference for online sessions for the future management of his condition, rather than face-to-face treatment. Remote LSVT delivery was found to be feasible and effective.

Telepractice Versus In-Person Delivery of Voice Therapy for Primary Muscle Tension Dysphonia

“…therapy. To be specific, the results are in general agreement with those from studies by Mashima et al (2003), Tindall et al (2008), and Constantinescu et al (2010a, 2010b, all of whom reported positive outcomes of delivering voice treatment for different pathologies through telepractice.…”

“…In their first study (Constantinescu et al, 2010a), the authors examined the validity of assessing speech and voice in 61 individuals with Parkinson's disease in telepractice versus in-person sessions and reported comparable results for vocal sound pressure level, phonation time, pitch range, sentence intelligibility, and communication efficiency in reading. Furthermore, the authors reported a case report (Constantinescu et al, 2010b) validating the utility of online delivery of LSVT. A patient with idiopathic Parkinson's disease was treated remotely for voice and speech impairments using LSVT and showed improvements in sound pressure levels, duration of sustained vowel production, vocal quality, and intelligibility, as well as high satisfaction with the treatment.…”

“…Significant improvement in vocal intensity post therapy was reported, and the results were in good agreement with those obtained by Ramig et al (2001) for in-person therapy. Constantinescu et al (2010aConstantinescu et al ( , 2010bConstantinescu et al ( , 2011 reported a series of studies demonstrating the utility of telepractice in voice assessment and treatment of individuals with Parkinson's disease. In their first study (Constantinescu et al, 2010a), the authors examined the validity of assessing speech and voice in 61 individuals with Parkinson's disease in telepractice versus in-person sessions and reported comparable results for vocal sound pressure level, phonation time, pitch range, sentence intelligibility, and communication efficiency in reading.…”

Telehealth Technology Applications in Speech-Language Pathology

“…A hybrid model is emerging, and SLP practitioners are combining these two technologies to overcome infrastructure shortcomings affecting the ability to make sound clinical decisions. 5,7,[11][12][13]20,21,[25][26][27][28] Telehealth infrastructure encompasses connectivity (how telecommunications are accessed) and equipment (what devices are used to enable telecommunications). Internet-based videoconferencing software enables two-way audio and video communication and is currently the primary synchronous method.…”

Pathological Voice Signal Analysis Using Machine Learning Based Approaches

“…Also, the reductions in vocal sound pressure level (vocSPL) with PD patients were investigated in (Ramig et al, 2008) (Canter, 1963) (Metter & Hanson, 1986). In most recent, Fox and Raming founded that vocSPL was 2-4 decibel lower across a variety of speech tasks with PD patients (Ramig et al, 2008) (Constantinescu, 2010).…”