Feasibility and Preliminary Efficacy of Two Technology-assisted Vocal Interventions for Older Adults Living in a Residential Facility

Aaron M Johnson; Farrah Pukin; Vaishnavi Krishna; Madhura Phansikar; Sean P Mullen

doi:10.1016/j.jvoice.2022.07.019

Feasibility and Preliminary Efficacy of Two Technology-assisted Vocal Interventions for Older Adults Living in a Residential Facility

J Voice. 2022 Aug 16:S0892-1997(22)00221-1. doi: 10.1016/j.jvoice.2022.07.019. Online ahead of print.

Authors

Aaron M Johnson¹, Farrah Pukin², Vaishnavi Krishna³, Madhura Phansikar⁴, Sean P Mullen⁵

Affiliations

¹ Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine. New York, New York, United States. Electronic address: aaron.johnson@nyulangone.org.
² Department of Communicative Disorders, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, United States.
³ Department of Speech and Hearing Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois.
⁴ Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois.
⁵ Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois; Center for Social & Behavioral Science, University of Illinois at Urbana-Champaign, Urbana, Illinois; Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Champaign, Illinois.

PMID: 35985896
DOI: 10.1016/j.jvoice.2022.07.019

Abstract

Objectives/hypothesis: An increasing number of older adults are seeking behavioral voice therapy to manage their voice problems. Poor adherence to voice therapy is a known problem across all treatment-seeking populations. Given age-related physical and cognitive impairments and multiple chronic conditions, older adults are more susceptible to low adherence to behavioral therapies. The purpose of this study was to test the feasibility of an at-home, vocal training intervention for older adults without a known voice disorder living in a senior living community, as well as compare the effects of two modes of mobile health (mHealth) technology-assisted vocal training targeting vocal function and adherence in older adults.

Study design: Cohort Study (Prospective Observational Study).

Methods: Twenty-three individuals were recruited from a single residential retirement community and randomly allocated into two experimental groups. Both groups were asked to practice the Vocal Function Exercises with increasing frequency over an 8-week period. Tablets with instructions for performing the exercises were provided to all participants. The feedback group's tablets also contained an application providing real-time feedback on pitch, loudness, and duration. Acoustic and aerodynamic measures of vocal function and cognitive measures were obtained before and after the intervention. Self-reported measures of practice frequency, perceived vocal progress and changes, and motivation were obtained weekly.

Results: The feedback control group adhered to the requested practice sessions more in the latter half of the intervention (weeks 5 and 8). Vocal function measures remained stable. Overall, a pattern reflecting self-reported vocal progress and a general improvement in working memory and global cognitive functioning was observed in the feedback group.

Conclusions: This study demonstrated that an 8-week mHealth intervention is viable to facilitate vocal practice in older adults. Although vocal ability did not improve with training, results indicated that vocal performance remained stable and age-related vocal changes did not progress. Future research on implementation of mHealth applications in conjunction with behavioral voice therapy is warranted to assess adherence and improvements in vocal function in individuals with age-related voice problems.

Keywords: Voice—Vocal function exercises—Vocal training—Older adults—Presbyphonia—mHealth.