Remote Speech Rehabilitation for Dysarthria in Parkinson's Disease

Overseen By Yunjung Kim, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Florida State University

Disqualifiers: Low cognitive score, Other voice disorders, Recent speech therapy, No family support

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 16

Duration: 4 weeks

32 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of remote speech rehabilitation for dysarthria in Parkinson's disease?

Research shows that online speech therapy can be as effective as traditional face-to-face therapy for improving speech in people with Parkinson's disease. Studies have found that remote speech treatments can lead to significant improvements in speech clarity and voice quality, and patients often prefer the convenience of online sessions. ^{1 2 3 4 5}

Is remote speech rehabilitation safe for people with Parkinson's disease?

Remote speech rehabilitation, including online speech therapy and telepractice, has been used safely for people with Parkinson's disease and other neurological conditions. Studies show it is as effective as traditional face-to-face therapy, and patients have reported satisfaction with the treatment. ^{1 2 3 4 5}

How is remote speech rehabilitation for dysarthria in Parkinson's disease different from other treatments?

Remote speech rehabilitation allows patients to receive speech therapy from their own homes using online communication technologies, making it more accessible and convenient compared to traditional face-to-face therapy. This approach can be just as effective as in-person sessions and helps overcome obstacles like travel difficulties for patients with Parkinson's disease. ^{1 4 5 6 7}

What is the purpose of this trial?

This study develops and conduct a small-scale clinical trial study in which the linguistic and cultural diversity of the participants is considered. Speech therapy and counseling services are provided to both patients with Parkinson\'s disease and their caregivers.

Research Team

Yunjung Kim

Principal Investigator

Florida State University

Eligibility Criteria

This trial is for individuals with dysarthria, a speech disorder often associated with Parkinson's Disease. It aims to help those who face challenges in accessing traditional speech therapy due to linguistic and cultural barriers. Caregivers are also included to receive support.

Inclusion Criteria

Native speaker of Korean

I have been diagnosed with Parkinson's disease.

I am between 25 and 85 years old.

Exclusion Criteria

Have no family members to participate in the project.

A score of 23 or below on the Korean Montreal Cognitive Assessment

I have a voice or speech disorder not caused by Parkinson's disease.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive remote speech therapy and counseling, including 16 sessions over four weeks and daily home practice

4 weeks

16 sessions (remote)

Follow-up

Participants are monitored for improvements in speech intelligibility and well-being

6 months

Treatment Details

Interventions

• Remote speech rehabilitation

Trial Overview The study is testing remote speech rehabilitation services tailored for diverse populations. It focuses on providing accessible speech therapy and counseling that accounts for the participants' language and culture.

Participant Groups

Group I: Intervention: Behavioral, remote speech rehabilitation and counseling Experimental Treatment 1 Intervention

Speech therapy will replicate the dose prescribed by many treatment programs including LSVT LOUD, LSVT ARTIC and Be Clear, consisting of 16 sessions of 50-60 minutes duration delivered over four weeks. Participants will also be set 15 to 20 minutes of daily home practice. Family education/training will take place once a week over 4 weeks, including two components: family counseling (30 min) and family conversation training (30 min). Family counseling aims to increase the PD families' knowledge about PD in general and to identify goals and potential solutions to problems which cause emotional turmoil. Family conversation training which aims to increase the PD families' knowledge about PD-related communication problems and to raise awareness of their communication patterns, and to support the development of functional strategies. All activities will remotely occur (using Zoom).

Group II: No Intervention:Waitlist control Active Control 1 Intervention

No intervention programs (speech therapy, counseling) will be provided.

Remote speech rehabilitation is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Telepractice for:

• Speech disorders
• Language disorders
• Swallowing disorders
• Parkinson's disease-related speech issues

Approved in European Union as Telespeech for:

• Speech disorders
• Language disorders
• Swallowing disorders
• Neurological speech impairments

Approved in Canada as Online Speech Therapy for:

• Speech disorders
• Language disorders
• Swallowing disorders
• Pediatric speech impairments

Who Is Running the Clinical Trial?

Florida State University

Lead Sponsor

Trials

234

Recruited

41,100+

Findings from Research

The E-learning-based speech therapy (EST) application allows patients with dysarthria to engage in intensive speech training at home, complementing traditional face-to-face therapy and enabling independent maintenance of speech quality after therapy ends.

Therapists can remotely create personalized training programs and monitor patient progress, while the EST system also collects valuable data on dysarthric speech for future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

E-learning-based speech therapy: a web application for speech training. Beijer, LJ., Rietveld, TC., van Beers, MM., et al.[2010]

A study involving 10 adults with dysarthria showed that an Internet-based telehealth application for assessing motor speech disorders achieved a 90% agreement in overall severity ratings compared to face-to-face assessments.

The online assessment demonstrated a high level of reliability, with 74% of the Frenchay Dysarthria Assessment variables showing 70-100% agreement, indicating that telehealth could be a viable option for evaluating speech disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of motor speech disorders online: a pilot study. Theodoros, D., Russell, TG., Hill, A., et al.[2019]

A survey of 63 speech-language pathologists (SLPs) revealed that while 82.5% were interested in using telepractice to deliver services to people with Parkinson's disease, only 23.1% were currently providing these services online.

Most SLPs viewed telepractice as a suitable method for delivering speech-language services, but significant barriers and a need for guidelines and software resources were identified to improve its implementation and sustainability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech-language pathologists' perceptions of the use of telepractice in the delivery of services to people with Parkinson's disease: A national pilot survey. Swales, M., Theodoros, D., Hill, AJ., et al.[2021]

Telerehabilitation using modern information and telecommunication technologies is as effective as traditional face-to-face rehabilitation for improving motor function and communication deficits in stroke and Parkinson's disease patients.

Two proof of concept studies showed that online interactive telespeech therapy for conditions like aphasia and dysarthrophonia can be successfully conducted at home, eliminating the need for patient transfers and making rehabilitation more accessible.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Home-based telerehabilitation after stroke]. Keidel, M., Vauth, F., Richter, J., et al.[2018]

The online delivery of the Lee Silverman Voice Treatment (LSVT) for a patient with Parkinson's disease resulted in significant improvements in vocal sound pressure levels and speech intelligibility, demonstrating its efficacy.

The patient expressed high satisfaction with the online treatment format and preferred it over traditional face-to-face sessions, indicating that remote delivery of LSVT is both feasible and effective.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based speech treatment for Parkinson's disease delivered remotely: a case report. Constantinescu, GA., Theodoros, DG., Russell, TG., et al.[2022]

A study involving 34 participants with Parkinson's disease demonstrated that online delivery of the Lee Silverman Voice Treatment (LSVT®) is as effective as face-to-face sessions for improving speech and voice disorders, confirming its clinical validity and reliability.

Participants showed significant improvements in various speech measures after online treatment, and overall satisfaction with the online format was high, suggesting that telerehabilitation can be a viable option for accessing speech pathology services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treating disordered speech and voice in Parkinson's disease online: a randomized controlled non-inferiority trial. Constantinescu, G., Theodoros, D., Russell, T., et al.[2022]

A study involving 20 Parkinson's disease patients showed that vocal telerehabilitation significantly improved vocal quality, as measured by the GRBASI scale, indicating its efficacy in treating speech symptoms.

Patients expressed high satisfaction with the telerehabilitation approach, preferring it over traditional face-to-face therapy, which suggests it could be a valuable option for those with limited access to rehabilitation centers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Voice telerehabilitation in Parkinson's disease. Dias, AE., Limongi, JC., Barbosa, ER., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

E-learning-based speech therapy: a web application for speech training. [2010]

2. England pubmed.ncbi.nlm.nih.gov

Assessment of motor speech disorders online: a pilot study. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Speech-language pathologists' perceptions of the use of telepractice in the delivery of services to people with Parkinson's disease: A national pilot survey. [2021]

4. Germany pubmed.ncbi.nlm.nih.gov

[Home-based telerehabilitation after stroke]. [2018]

5. England pubmed.ncbi.nlm.nih.gov

Home-based speech treatment for Parkinson's disease delivered remotely: a case report. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Treating disordered speech and voice in Parkinson's disease online: a randomized controlled non-inferiority trial. [2022]

7. Brazil pubmed.ncbi.nlm.nih.gov

Voice telerehabilitation in Parkinson's disease. [2022]