Objective: The purpose of the present study was to assess the effects of a device-driven treatment (SpeechVive) on respiratory and laryngeal function after 8 weeks of daily use.

Background: Current speech therapy for patients with Parkinson’s disease (PD) focuses on increasing loudness. For success with behavioral therapy at the conversational level, individuals with PD must remember to use treatment techniques consistently. We developed a device-driven treatment using the presence of noise as an external cue to naturally elicit a louder and clearer voice. A voice-activated device, the SpeechVive, delivered multi-talker babble to the patient while s/he was talking. The respiratory and laryngeal systems are integrally involved in supporting louder speech. Individuals with PD have been shown to have respiratory and laryngeal impairments. There is the potential for loudness training to result in changes to respiratory and laryngeal support for speech.

Method: Thirty-nine individuals with idiopathic PD diagnosed with hypophonia participated. Speech severity was predominantly moderate, pre-treatment. For eight weeks, patients were asked to wear the SpeechVive for 2-8 hours per day when they were communicating. The SpeechVive produced noise on voice activation by feedback from an accelerometer placed on the neck. The patient heard “multi-talker babble” noise only when they were speaking through an open ear fitting. Data were collected 2 times pre-treatment and immediately after treatment. Participants were tested first without the SpeechVive and then with the SpeechVive. Acoustic and kinematic data were collected and measured during a spontaneous speech task. Aerodynamic data were collected during a sentence production.

Results: Mixed model ANOVAs were used to assess treatment effects (p<.01). Vocal intensity was higher and utterance length was longer after treatment. Lung volume use was more typical after treatment. Vocal fold valving improved after treatment. Patients and caregivers rated communication effectiveness as higher after treatment.

Conclusion: Use of the SpeechVive for 8 weeks resulted in higher SPL, longer utterances and more efficient laryngeal and respiratory support for speech. These data show an empirical training effect and show that the SpeechVive was useful in treating speech impairments associated with PD. Data were presented at the ASHA Convention in 2014.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/changes-to-speech-production-after-speechvive-treatment-in-individuals-with-parkinsons-disease/