Mills Jodie, Duffy Orla, Pedlow Katy, Kernohan George
School of Health Sciences, Faculty of Life and Health Sciences, University of Ulster, Belfast, United Kingdom.
School of Nursing, Faculty of Life and Health Sciences, University of Ulster, Belfast, United Kingdom.
JMIR Rehabil Assist Technol. 2025 Sep 2;12:e75044. doi: 10.2196/75044.
People living with Parkinson disease (PD) often experience low speech volume and reduced intelligibility. Research suggests that common voice-assisted technology (VAT) devices, like Amazon Alexa and Google Home, can encourage individuals to modify their speech, speaking more clearly, slowly, and loudly. This highlights the potential of VAT as a therapeutic clinical tool in speech and language therapy (SLT). However, while VAT is emerging as a novel health care technology, gaps exist regarding understanding speech and language therapists' (SaLTs) experiences using these devices in clinical practice for PD-related speech and voice difficulties.
This research set out to explore various experiences of using VAT to address hypokinetic dysarthria, secondary to PD, from a range of stakeholder perspectives. This paper specifically focuses on clinical insights from SaLTs.
SaLTs with prior experience of using smart speakers in clinical practice with people with speech or voice difficulties were invited to participate in focus groups or interviews. Between September and December 2024, seven SaLTs participated in semistructured focus groups or interviews using a topic guide. Discussions were informed by published evidence. Results were transcribed and analyzed using a framework analysis approach and were managed through NVivo software (Lumivero).
Four main themes were identified across the groups: (1) potential for VAT in SLT, (2) managing therapeutic beige flags, (3) empowering SaLTs to become digitally enabled practitioners, and (4) envisioning the future of VAT in SLT.
This study recognizes VAT's potential as a therapeutic tool that may improve volume, clarity, intelligibility of speech, and facilitate at-home practice for people with PD. However, before VAT can be widely implemented, considerations around data privacy, device limitations, and practical integration into clinical care must be addressed. Future research is proposed to design solutions to address usability challenges for both clients and clinicians. Finally, this paper offers key clinical recommendations for the development of a therapeutic VAT tool for speech and voice difficulties in SLT.
帕金森病（PD）患者常出现音量低和清晰度下降的情况。研究表明，常见的语音辅助技术（VAT）设备，如亚马逊Alexa和谷歌Home，可以促使个体改变他们的说话方式，说得更清晰、缓慢且大声。这凸显了VAT作为言语和语言治疗（SLT）中一种治疗性临床工具的潜力。然而，尽管VAT正成为一种新型医疗技术，但在理解言语和语言治疗师（SaLTs）在临床实践中使用这些设备治疗与PD相关的言语和嗓音困难方面仍存在差距。
本研究旨在从一系列利益相关者的角度探索使用VAT解决继发于PD的运动减少型构音障碍的各种体验。本文特别关注SaLTs的临床见解。
邀请有在临床实践中使用智能音箱治疗言语或嗓音困难患者经验的SaLTs参加焦点小组或访谈。在2024年9月至12月期间，7名SaLTs使用主题指南参加了半结构化焦点小组或访谈。讨论参考了已发表的证据。结果进行了转录，并使用框架分析方法进行分析，通过NVivo软件（Lumivero）进行管理。
各小组共确定了四个主要主题：（1）VAT在SLT中的潜力，（2）管理治疗中的警示信号，（3）使SaLTs成为具备数字能力的从业者，（4）展望VAT在SLT中的未来。
本研究认识到VAT作为一种治疗工具的潜力，它可能改善PD患者的音量、清晰度、言语可懂度，并促进家庭练习。然而，在VAT能够广泛实施之前，必须解决数据隐私、设备限制以及实际融入临床护理等方面的问题。建议未来开展研究以设计解决方案，应对客户和临床医生面临的可用性挑战。最后，本文为开发用于SLT中言语和嗓音困难的治疗性VAT工具提供了关键临床建议。
