title: Voice telerehabilitation in Parkinson's disease.
abstract: Parkinson's disease (PD) is a neurodegenerative condition associated with motor, neuropsychological, sensorial, and vocal symptoms. It has been suggested that eventual obstacles faced by many patients to reach speech therapy rehabilitation centers could be overcome with the use of synchronous telerehabilitation (real time) approach employing communication technologies.
  
  
  OBJECTIVE
  To investigate the efficacy of vocal telerehabilitation in PD patients.
  
  
  METHODS
  Twenty patients diagnosed with PD and with vocal complaints participated in this study. Patients were evaluated by videoconference (Adobe Connect 8) before and after treatment. Evaluation method consisted of perceptual analysis of vocal quality measured by the GRBASI scale. Treatment was conducted following the extended version of Lee Silverman method (LSVT-X). At the end of treatment all patients were requested to fill a questionnaire to assess their experience with telerehabilitation.
  
  
  RESULTS
  Analysis revealed decrease in magnitude of voice quality changes after the intervention, indicating improvement of vocal pattern. All patients reported satisfaction and preference for telerehabilitation compared to face-to-face rehabilitation, as well as positive perception of audio and video. Some technological adversities have been identified but did not prevent the approaches to assessment and treatment.
  
  
  CONCLUSIONS
  Present results suggest that telerehabilitation methods can be considered as an effective treatment for speech symptoms associated with PD and can be indicated to patients presenting limited access to speech therapy centers and technological readiness.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Alice Estevo
authors.initials: AE
authors.lastname: Dias
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: João Carlos Papaterra
authors.initials: JC
authors.lastname: Limongi
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Egberto Reis
authors.initials: ER
authors.lastname: Barbosa
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Wu Tu
authors.initials: WT
authors.lastname: Hsing
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000534:rehabilitation*; D017060:Patient Satisfaction; D011788:Quality of Life; D015203:Reproducibility of Results; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods*; D013066:Speech-Language Pathology; D018709:Statistics, Nonparametric; D000069350:Telerehabilitation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology / Q000534:rehabilitation*; D014833:Voice Quality