Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 12, 2024
Date Accepted: Dec 30, 2024
Feasibility and Satisfaction of a Smartphone Application-based Voice and Speech Training Program for Parkinson’s Disease: A Preliminary Rater-blinded Single Arm Pretest-Posttest Study
ABSTRACT
Background:
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.
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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