Delivering the Lee Silverman Voice Treatment (LSVT) by web camera: a feasibility study

Background: Speech disorders are a feature of Parkinson's disease, typically worsening as the disease progresses. The Lee Silverman Voice Treatment (LSVT) was developed to address these difficulties. It targets vocal loudness as a means of increasing vocal effort and improving coordination across the subsystems of speech. Aims: Currently LSVT is not widely available, and there are practical difficulties associated with the delivery of an intensive treatment in an environment of resource constraints in the National Health Service (NHS). Delivery of LSVT over the World-Wide Web may address some of these difficulties. Methods Procedures: A feasibility study is reported in which three individuals with speech disorders resulting from Parkinson's disease received LSVT over the Internet, using broadband connection and a web camera. Participants were seen face to face for every fourth session in order to build a personal relationship, measure vocal sound pressure level (SPL) during treatment, and to review and prepare homework tasks. All other sessions were delivered over the Internet. Outcomes Results: Broadly similar treatment gains were found between individuals treated over the Internet and those treated face to face. Gains were maintained or improved at an assessment two months after the treatment. Conclusions Implications: This study demonstrates that delivery of LSVT over the Internet is feasible, and that a larger trial would be appropriate to establish cost and treatment effectiveness.