School of Health and Rehabilitation Sciences University of Queensland, Brisbane, Australia.
Int J Lang Commun Disord. 2011 Jan-Feb;46(1):1-16. doi: 10.3109/13682822.2010.484848.
Telerehabilitation may be a feasible solution to the current problems faced by people with Parkinson's disease in accessing speech pathology services.
To investigate the validity and reliability of online delivery of the Lee Silverman Voice Treatment (LSVT®) for the speech and voice disorder associated with Parkinson's disease.
METHOD & PROCEDURES: Thirty-four participants with Parkinson's disease and mild-to-moderate hypokinetic dysarthria took part in the randomized controlled non-inferiority laboratory trial and received the LSVT® in either the online or the face-to-face environment. Online sessions were conducted via two personal computer-based videoconferencing systems with real-time and store-and-forward capabilities operating on a 128 kbit/s Internet connection. Participants were assessed pre- and post-treatment on acoustic measures of mean vocal sound pressure level, phonation time, maximum fundamental frequency range, and perceptual measures of voice, articulatory precision and speech intelligibility.
OUTCOMES & RESULTS: Non-inferiority of the online LSVT® modality was confirmed for the primary outcome measure of mean change in sound pressure level on a monologue task. Additionally, non-significant main effects for the LSVT® environment, dysarthria severity, and interaction effects were obtained for all outcomes measures. Significant improvements following the LSVT® were also noted on the majority of measures. The LSVT® was successfully delivered online, although some networking difficulties were encountered on a few occasions. High participant satisfaction was reported overall.
CONCLUSIONS & IMPLICATIONS: Online treatment for hypokinetic dysarthria associated with Parkinson's disease appears to be clinically valid and reliable. Suggestions for future research are outlined.
远程康复可能是解决帕金森病患者获取言语病理学服务当前面临的问题的可行方案。
调查在线提供李·西尔弗曼嗓音治疗（LSVT®）治疗帕金森病相关语音和嗓音障碍的有效性和可靠性。
34 名帕金森病和轻中度运动障碍性构音障碍患者参与了这项随机对照非劣效性实验室试验，他们在在线或面对面环境中接受了 LSVT®治疗。在线课程通过具有实时和存储转发功能的两个基于个人计算机的视频会议系统进行，使用 128 kbit/s 的互联网连接。在治疗前后，参与者接受了语音学测量（平均嗓音声压级、发声时间、最大基频范围）和语音学评估（嗓音、构音清晰度和言语可懂度）。
在线 LSVT®模式的非劣效性得到了确认，主要结局指标是独白任务中的声压级平均变化。此外，LSVT®环境、构音障碍严重程度和交互作用的主要效应对于所有结果测量均无统计学意义。LSVT®治疗后，大多数测量结果也显著改善。LSVT®在线治疗成功，但在少数情况下出现了一些网络连接问题。总体报告参与者满意度高。
在线治疗帕金森病相关运动障碍性构音障碍具有临床有效性和可靠性。概述了未来研究的建议。
