Peter Michael John Nolan, University of Portsmouth, Portsmouth, United Kingdom Julia Johnson, King's College Hospital, London, United Kingdom Roger Eglin*, University of Portsmouth, Portsmouth, United Kingdom K Ray-Chaudhuri, King's College Hospital, London, United Kingdom Track: Research Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2013-09-25

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Background: A speech and language therapy m Health application is being developed for people with Parkinson’s and dysarthria. Approximately 70% of people with Parkinson’s encounter difficulties with communication. The majority of these will have lost the implicit cues that enable them to monitor speech volume, and speech becomes progressively quieter. They are referred to Speech Therapy, but therapists’ time is finite and there can typically be six or 12 months between scheduled appointments. Additionally, the current treatment with the most efficacy data, Lee Silverman Voice Treatment (LSVT), is very time-intensive, requiring 16 hourly treatment sessions spread over four weeks.

Objective: The application’s aim is to provide volume feedback visually, so that users have an explicit cue to aid volume regulation. There are two application components: one that simply provides visual feedback and nothing else; the other is a training element providing content for vocal practice, and encouragement to speak louder. The study’s objectives were to test the application with people with Parkinson’s, and to examine volume outcomes and engagement with the application over an extended usage period. The prediction was that people with Parkinson’s, generally older adults, can learn to use a smartphone application as part of their therapy.

Methods: Fifty-nine people with Parkinson’s were introduced to the application and to either an iPhone or iPod device running it. They were then left with the device and application, for an average of 9.2 days, before being met again for collection. Participants were advised that they might like to use the application three times per day, but that they could use it as much or as little as they wanted – if they found it very interesting they might use it many more times, or if they found it less interesting or simply forgot to use it that was left up to them. Usage data was then collected by the application itself, tracking whenever it was used, how long for, and the mean volume for each usage trial.

Results: There was no difference between usage of the application’s two components [F(1, 58) = 1.516, p = 0.223]. Combining usage of both components the application was used a mean of 3.09 times per day. The results revealed some application development issues with capturing all available data created during usage, including some volume information. Some data loss was of volume information recorded by the application. Available data showed a significant volume increase between the first and second halves of the period a participant had the device [F(1, 45) = 4.955, p = 0.031].

Conclusions: Use of this vocal loudness feedback application led to increased speech volume in people with Parkinson’s while using this method. The participants became more proficient using the application over time. The combined usage of the application components was at roughly the rate suggested by the researchers, which is encouraging for future engagement with remote therapy. Data collected by the application could also provide Speech Therapists with insight into patient progress between appointments, highlighting potential support needs.