Objective: The purpose of this study was to develop and validate wearable technology to improve vocal intensity in patients with Parkinson’s Disease.

Background: Parkinson’s disease (PD) severely impacts communication in 70-90% of patients. Behavioral voice therapy can be effective in Parkinson’s-related voice and speech disorders by increasing vocal loudness and improving speech intelligibility. However, success in treatment is dependent on an intensive intervention schedule. This treatment burden, combined with reduced ability of patients with Parkinson’s to self-monitor voice leads to a high rate of symptomatic relapse following treatment.

Method: Our multi-disciplinary, multi-institutional team created a low-profile headset device that can isolate, monitor, and analyze vocal output for time and loudness and provide haptic biofeedback in the form of vibration to the wearer when minimum threshold intensity targets are not met. In this study, we tested the device in 8 patients with PD during a 60-minute treatment session. Each session consisted of 30 minutes with and 30 minutes without speech pathologist’s feedback on vocal intensity. Intensity change and time between cues to increase intensity were measured and analyzed for differences between baseline and each condition.

Results: There were no significant differences (p = 0.25) in time between cues to increase intensity in the SLP assisted condition compared to the device condition. There was no significant difference for change in vocal intensity in decibels between the SLP assisted condition and the device assisted condition (p = 0.66). When groups were split by disease severity, those with mild to moderate PD required significantly fewer intensity cues and increased vocal intensity significantly more than those with severe PD for both the SLP and device-assisted conditions (p<.001).

Conclusion: Patients with mild to moderate PD respond positively to the haptic feedback provided by an individually calibrated low profile headset. This technology may serve as a helpful adjunct to standard-of-care voice therapy. Current studies are investigating if the addition of the device in voice therapy improves outcomes including a reduction in treatment time and relapse.

Fig 1: human subject wearing SAMMS device

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MDS Abstracts - https://www.mdsabstracts.org/abstract/development-and-validation-of-personal-technology-to-treat-hypophonia-in-patients-with-parkinsons-disease/