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Potentials of Telehealth Devices for Speech Therapy in Motor Disorder

Introduction:

Rapidly evolving technology influences our daily lives. In particular information and communication technologies allow us to communicate faster and more globally than ever before. In this article, the possibilities of technological developments in healthcare, particularly for patients with Huntington’s disease (HD), will be explored. Patients with HD often struggle with speech intelligibility, a measure of how comprehensible speech is, or the degree to which speech can be understood., because as brain cells deteriorate in HD, problems may develop in the following three areas: motor control (movement); cognitive (thinking); and behavior. Speech and swallowing problems, due to muscle weakness and loss of coordination, arise when the motor control centers are affected. Cognitive problems include memory, sequencing, new learning ability and problem solving.

Telehealth and Speech Language Pathology

Telehealth is defined as the use of telecommunication technologies both to provide health care services and to enable access to medical information for training and educating health care professionals and consumers. Telehealth applications, could provide solutions to overcome barriers of access to therapy services caused by factors such as decreasing financial resources, shortage of professionals and increasing numbers of patients. Thus, telehealth concerns both mobile and computer’s applications of information and communication technologies, enabling the retrieval, recording, management and transmission of information to support health care.

Studies have suggested that online speech training for patients with motor disorder, specifically patients with Parkinson’s disease, turned out to be effective. In one study, ten patients used videoconferences during a four-week program of intensive training, involving 16 therapy sessions. Patients’ conversational monologue and prompted reading was recorded both before and after treatment Comparison of sound pressure level, pitch measurements and perceptual ratings from audio recordings revealed significant improvements. This study shows that remote diagnosis and treatment of speech in patients with motor disorder has vital benefits, in particular for patients who are less mobile and easily fatigued due to their deteriorated physical condition.

 

E-learning based Speech Therapy

Another study developed an E-learning based Speech Therapy (EST) in 2010. The therapy aims at patients with speech disorders resulting from acquired neurological impairment such as stroke or Huntington’s disease. Particularly in the chronic phase of the patients’ HD, once in-clinic therapy sessions are no longer an option, the lack of speech practice results in diminished speech. An important benefit of EST is to enable the patient to follow a specialized speech-training program in the patients’ home environment. Not only does E-learning reduce time energy and costs normally involved with speech training, the convenience the EST offers allows the patient to attend more therapy and practice speech could often lead to better speech outcomes.

A case study that evaluated EST included 20 patients with Parkinson’s disease suggests that EST is indeed a powerful web-based speech training device with potential efficacy for patients with movement disorder. The patients had completed face-to-face sessions with speech therapist and were able to conduct the training program that the patient was already familiar with, independently. The patients’ speech intelligibility had significantly improved as measured by the percentage correctly transcribed words given to the patient in a random sequence. After 4 weeks without practice, the patient’s speech intelligibility declined. Thus, while EST is a powerful tool, patients must also practice speech or continue with EST lessons in order to maintain speech quality.

In conclusion, these studies show that Telehealth devices can significantly improves speech intelligibility in patients with Parkinson’s disease. This finding is relevant for patients with HD because patients with HD also face troubles related to speech intelligibility. With this in mind, hopefully there will be more development in Telehealth devices that further can improve the quality of life HD patients.

 

Resources:

If interested, here are some of the resources you can look into for telehealth devices on speech intelligibility.

http://integrisok.com/speech-telepractice

http://presencelearning.com/resources/online-speech-therapy-research-summary/

http://www.med-speech.com/product-category/telehealth-skype-sessions/

 

Sources:

Beijer, Lilian J., Toni C.m. Rietveld, Vera Hoskam, Alexander C.h. Geurts, and Bert J.m. De Swart. “Evaluating the Feasibility and the Potential Efficacy of E-Learning-Based Speech Therapy (EST) as a Web Application for Speech Training in Dysarthric Patients with Parkinson’s Disease: A Case Study.” Telemedicine and E-Health 16.6 (2010): 732-38. Web.

Bilney, B., M. E. Morris, and A. Perry. “Effectiveness of Physiotherapy, Occupational Therapy, and Speech Pathology for People with Huntington’s Disease: A Systematic Review.” Neurorehabilitation and Neural Repair 17.1 (2003): 12-24. Web.

Hill, A., and D. Theodoros. “Research into Telehealth Applications in Speech-language Pathology.” Journal of Telemedicine and Telecare 8.4 (2002): 187-96. Web.

Shelton, R. L. “The Genetics of Huntington’s Disease.” Perspectives on Speech Science and Orofacial Disorders 13.2 (2003): 7-12. Web.