Feasibility, Satisfaction and Effectiveness of a Smartphone Application-based Voice and Speech Training Program for Parkinson’s Disease: Single Arm Pretest-Posttest Study (Preprint)

Abstract

The majority of people with Parkinson's disease experience difficulties with voice and speech with disease progression, which leads to speech therapy. However, given their increasingly limited mobility, face-to-face speech therapy might be inaccessible. These accessibility issues can be addressed by an mHealth app.

This study was conducted to examine the feasibility, satisfaction, and effectiveness of a smartphone-based application for voice and speech therapy in patients with Parkinson's disease.

A single-arm, rater-blinded, pretest-posttest study was conducted between September to November, 2023. PD patients with voice and speech problems who have no problem with using Android smartphone were recruited. Participants downloaded the researcher-developed mHealth app on their smartphone and participated in a patient-tailored 5-week home-based speech training program. To verify feasibility, adherence was monitored and satisfaction was assessed by a phone survey at the end of the app use. Acoustic analysis and auditory-perceptual assessments were evaluated for effectiveness.

Thirty patients were initially recruited, but two of them withdrew. Twenty-five participants completed all the training sessions while three dropped out. The adherence was above 90% in twenty participants, 70-90% in four and below 70% in four. Satisfaction was 75% among the twenty-four people who participated in the survey. Significant improvement were observed in all acoustic measures and in the speech -language pathologist’s auditory-perceptual assessments after app use. The maximum phonation time increased from 11.15 seconds before use to 14.01 seconds after use (P =.003). The average vocal intensity increased from 71.59dB before use to 73.81dB after use in both sustained phonation and reading tasks (P<.001). Improvements in voice quality were observed in all components of the GRBAS(P <.001). In addition, 58.33% of participants in the survey reported improved voice after app use.

This study demonstrates that home-based, self-training speech therapy provided through an mHealth app can be a feasible solution for patients with Parkinson's disease.