Objective: To compare vocal intensity between locations (home versus clinic), treatment groups [Vibrotactile feedback (VF) only versus LSVT LOUD^® and VF], and VF status (on versus off) in individuals with Parkinson’s disease (IwPD).

Background: Hypophonia is often the initial speech symptom in IwPD. The most commonly prescribed treatment for hypophonia is Lee Silverman Voice Treatment (LSVT LOUD^®) which uses principles of motor learning to improve vocal intensity. Wearable devices are emerging in speech rehabilitation of IwPD to expand therapeutic options and to help with home practice. Wearable devices provide external cues or biofeedback to improve vocal intensity in IwPD. To date, there is no study comparing the two treatments in both clinic and home environments.

Method: Nine subjects (7 males) with idiopathic PD and mild-moderate dysphonia were randomly assigned to one of the two treatment groups. Group 1 received VF intermittently via a wearable device called Vocalog2^TM and group 2 received LSVT LOUD^® and VF. Both treatments lasted 4 weeks at the frequency of 4 days/week. Mean vocal intensity was obtained at baseline, with and without vibrotactile feedback in the two groups, and at the end of 1 month post treatment in both clinic and home environments.

Results: A repeated-measures ANOVA was used to analyze the data. Statistical significance was set at p<0.05. Vocal intensity was higher in the clinic than at home but not statistically significant.  The adjusted mean dB differed significantly between the two groups overall, with the least-squared mean dB in the VF-Only group being statistically significantly higher at 70.3 (standard error 0.6) than the LSVT + VF group at 67.9 (SE 0.7), p=0.043. However, this benefit was not maintained at the one month follow up. There was no difference in the vocal intensity with and without the vibrotactile feedback within group 1 suggesting that the device may be acting as a placebo to improve vocal intensity.

Conclusion: Vibrotactile feedback via Vocalog2^TM, a wearable device is an alternate approach to LSVT LOUD^® to improve vocal intensity in IwPD. Larger sample size and long term follow up is recommended for future studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-vibrotactile-feedback-and-lee-silverman-voice-treatment-on-vocal-intensity-in-individuals-with-parkinsons-disease-a-preliminary-study/