Abstract
BackgroundThe need for efficacy in voice rehabilitation in patients with Parkinson's disease is well established. Given difficulties traveling from home to treatment centers, the use of telerehabilitation may represent an invaluable tool for many patients.ObjectiveTo analyze the influence of cognitive performance on acceptance of telerehabilitation.MethodsFifty patients at stages 2-4 on the Hoehn-Yahr scale, aged 45-87 years old, with cognitive scores of19-30 on the Mini-Mental State Examination, and 4-17 years of education were enrolled. All patients were submitted to evaluation of voice intensity pre and post in-person treatment with the Lee Silverman Voice Treatment (LSVT) and were asked to fill out a questionnaire regarding their preferences between two options of treatment and evaluating basic technological competence.ResultsComparisons between pre and post-treatment values showed a mean increase of 14dBSPL in vocal intensity. When asked about potential acceptance to participate in future telerehabilitation, 38 subjects agreed to take part and 12 did not. For these two groups, 26% and 17% self-reported technological competence, respectively. Agreement to engage in remote therapy was positively associated with years of education and cognitive status.ConclusionResponses to the questionnaire submitted after completion of traditional in-person LSVT showed that the majority of patients (76%) were willing to participate in future telerehabilitation. Age, gender, disease stage and self-reported basic technological skills appeared to have no influence on the decision, whereas other factors such as cognitive status and higher school education were positively associated with acceptance of the new therapy approach.
Highlights
Speech and voice disorders in Parkinson’s disease (PD) are classified as hypokinetic dysarthria and characterized by gradual deterioration of intelligibility of verbal communication.[1]
There appears to be a correlation between the degree of dysarthria and other factors such as motor status, disease progression and cognitive functions.[11,12]
It is estimated that less than 5% of PD patients have engaged in speech rehabilitation,[13] the most common reasons for non-adherence being physical limitations, lack of companion, long travel distances and financial costs.[14]
Summary
Speech and voice disorders in Parkinson’s disease (PD) are classified as hypokinetic dysarthria and characterized by gradual deterioration of intelligibility of verbal communication.[1]. All patients were submitted to evaluation of voice intensity pre and post in-person treatment with the Lee Silverman Voice Treatment (LSVT) and were asked to fill out a questionnaire regarding their preferences between two options of treatment and evaluating basic technological competence. When asked about potential acceptance to participate in future telerehabilitation, 38 subjects agreed to take part and 12 did not. For these two groups, 26% and 17% self-reported technological competence, respectively. Gender, disease stage and self-reported basic technological skills appeared to have no influence on the decision, whereas other factors such as cognitive status and higher school education were positively associated with acceptance of the new therapy approach.
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