Using Portable Voice Accumulators to Study Transfer of Speech Outcomes Following Intervention - A Feasibility Study.

OBJECTIVES: To evaluate the process and scientific feasibility of using a portable voice accumulator (PVA) to study carry-over of treatment effects on speech and voice in people with mild-moderate Parkinson's disease. METHODS: The study was guided by the checklist in Consolidated Standards of Reporting Trials (CONSORT) 2010 statement: extension to randomized pilot and feasibility trials. Participants with Parkinson's disease were recruited within the context of a randomized controlled trial with random allocation to intervention with either HiCommunication, a program targeting speech and communication, or HiBalance, a program targeting balance and strength. Before and after intervention data was collected from standardized studio recordings of speech and registrations of voice use in daily life with the PVA VoxLog. RESULTS: Fifteen participants were included in the study and sufficient data was yielded from six of them. Reasons for insufficient data included technical issues and difficulties handling the PVA. Changes in voice sound level from pre to post intervention differed at an individual level when assessed in daily life compared to studio recordings. Registrations in daily life provided information on phonation ratio and ability to adapt voice sound level to environmental noise. CONCLUSION: This study highlights the challenges of studying intervention effects on voice use in daily life using a PVA. Improvements of test protocols in future studies are suggested. We exemplify how PVA data may generate a more detailed and ecologically valid picture of voice use complementing studio recordings of speech. Finally, we encourage technical development of more user-friendly PVAs.

Long-term effects of Lee Silverman Voice Treatment on daily voice use in Parkinson's disease as measured with a portable voice accumulator.

This study examines the effects of an intensive voice treatment focusing on increasing voice intensity, LSVT LOUD® Lee Silverman Voice Treatment, on voice use in daily life in a participant with Parkinson's disease, using a portable voice accumulator, the VoxLog. A secondary aim was to compare voice use between the participant and a matched healthy control. Participants were an individual with Parkinson's disease and his healthy monozygotic twin. Voice use was registered with the VoxLog during 9 weeks for the individual with Parkinson's disease and 2 weeks for the control. This included baseline registrations for both participants, 4 weeks during LSVT LOUD for the individual with Parkinson's disease and 1 week after treatment for both participants. For the participant with Parkinson's disease, follow-up registrations at 3, 6, and 12 months post-treatment were made. The individual with Parkinson's disease increased voice intensity during registrations in daily life with 4.1 dB post-treatment and 1.4 dB at 1-year follow-up compared to before treatment. When monitored during laboratory recordings an increase of 5.6 dB was seen post-treatment and 3.8 dB at 1-year follow-up. Changes in voice intensity were interpreted as a treatment effect as no significant correlations between changes in voice intensity and background noise were found for the individual with Parkinson's disease. The increase in voice intensity in a laboratory setting was comparable to findings previously reported following LSVT LOUD. The increase registered using ambulatory monitoring in daily life was lower but still reflecting a clinically relevant change.