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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests remote speech therapy for individuals with Parkinson's disease who experience speech difficulties, known as dysarthria. The aim is to determine if online therapy, which includes speech exercises and family support sessions, can improve communication. Participants will either receive this remote therapy or be placed on a waitlist. Suitable candidates have Parkinson's with speech issues, speak Korean as their first language, and have access to high-speed internet. As an unphased trial, this study provides a unique opportunity to explore innovative therapy methods that could enhance communication skills.

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 prior data suggests that remote speech rehabilitation is safe for individuals with Parkinson's disease?

Research has shown that online speech therapy can be as effective as traditional in-person therapy for improving speech in people with Parkinson's disease. Studies have found that telehealth services, including speech therapy, are safe and user-friendly for patients. No major safety concerns exist with remote speech therapy. In fact, online sessions offer a practical and comfortable option for many, reducing travel stress and allowing practice in the comfort of their homes. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about remote speech rehabilitation for dysarthria in Parkinson's Disease because it offers therapy without the need for patients to travel to a clinic, which can be challenging for those with mobility issues. Unlike traditional in-person speech therapy, this method uses video conferencing tools like Zoom to deliver the same dosage of treatment, including LSVT LOUD and ARTIC programs, directly to patients at home. Additionally, it includes family education and training, which is designed to enhance communication and emotional support within the family, a component often missing from standard care. This innovative approach not only makes therapy more accessible but also integrates family involvement for a holistic treatment experience.

What evidence suggests that remote speech rehabilitation is effective for dysarthria in Parkinson's disease?

Research has shown that online speech therapy can be as effective as traditional in-person therapy for improving speech in people with Parkinson's disease. In this trial, some participants will receive remote speech rehabilitation, which includes speech therapy and counseling delivered via Zoom. Studies have found that patients who received speech therapy remotely made significant progress in their speech and communication skills. These improvements were linked to a better quality of life. Additionally, remote therapy, or telerehabilitation, allows for early and intensive treatment, which is important for managing speech problems in Parkinson's. Overall, remote speech therapy shows promise in effectively helping people with Parkinson's improve their speech. ^{1 3 6 7 8}

Who Is on the Research Team?

Yunjung Kim

Principal Investigator

Florida State University

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11415969/

Effectiveness of remotely delivered speech therapy in persons ... Patients were treated remotely by 20 experienced speech therapists. The primary outcome was disease-related quality of life at 8 weeks, assessed ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39309726/

Effectiveness of remotely delivered speech therapy in ... Patients were treated remotely by 20 experienced speech therapists. The primary outcome was disease-related quality of life at 8 weeks, assessed ...

3. withpower.com withpower.com/trial/phase-dysarthria-7-2024-ed254

Remote Speech Rehabilitation for Dysarthria in ... 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.

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1386505625000012

Exploring tele-speech therapy: A scoping review ... This scoping review explores key interventions, applications, benefits, and challenges of telespeech therapy.

5. pubs.asha.org pubs.asha.org/doi/10.1044/2015_AJSLP-15-0005

Clinical and Quality of Life Outcomes of Speech Treatment ... The benefit of telerehabilitation is directly applicable to the management of the speech disorder in PD, where intervention should be delivered early, intensive ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11234339/

Remote Delivery of Allied Health Therapies in Parkinson's ... This review summarizes the latest evidence on remotely-delivered physical therapy, occupational therapy, and speech therapy and discusses associated challenges ...

7. medrxiv.org medrxiv.org/content/10.1101/2024.04.08.24305455v1.full-text

Telehealth versus face-to-face delivery of speech language ... Evidence suggests that the telehealth provision of SLP services may be a viable alternative to their provision face-to-face, particularly to people who stutter.

8. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2019_PERSP-19-00146

Telepractice for Adult Speech-Language Pathology Services We conducted a systematic review of the literature regarding adult telepractice services (screening, assessment, and treatment) from approximately 2014 to 2019.