INT J LANG COMMUN DISORD, JANUARY –FEBRUARY 2011, VOL. 46, NO. 1, 1–16 Research Report Treating disordered speech and voice in Parkinson’s disease online: a randomized controlled non-inferiority trial Gabriella Constantinescu†, Deborah Theodoros†, Trevor Russell†, Elizabeth Ward†, Stephen Wilson‡ and Richard Wootton§ †School of Health and Rehabilitation Sciences University of Queensland, Brisbane, Australia ‡School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia §Scottish Centre for Telehealth, Aberdeen, UK (Received 28 September 2009; accepted 8 April 2010) Abstract Background: Telerehabilitation may be a feasible solution to the current problems faced by people with Parkinson’s disease in accessing speech pathology services. Aim: To investigate the validity and reliability of online delivery of the Lee Silverman Voice Treatment (LSVT  ) for the speech and voice disorder associated with Parkinson’s disease. Method & Procedures: Thirty-four participants with Parkinson’s disease and mild-to-moderate hypokinetic dysarthria took part in the randomized controlled non-inferiority laboratory trial and received the LSVT  in either the online or the face-to-face environment. Online sessions were conducted via two personal computer- based videoconferencing systems with real-time and store-and-forward capabilities operating on a 128 kbit/s Internet connection. Participants were assessed pre- and post-treatment on acoustic measures of mean vocal sound pressure level, phonation time, maximum fundamental frequency range, and perceptual measures of voice, articulatory precision and speech intelligibility. Outcomes & Results: Non-inferiority of the online LSVT  modality was confirmed for the primary outcome measure of mean change in sound pressure level on a monologue task. Additionally, non-significant main effects for the LSVT  environment, dysarthria severity, and interaction effects were obtained for all outcomes measures. Significant improvements following the LSVT  were also noted on the majority of measures. The LSVT  was successfully delivered online, although some networking difficulties were encountered on a few occasions. High participant satisfaction was reported overall. Conclusions & Implications: Online treatment for hypokinetic dysarthria associated with Parkinson’s disease appears to be clinically valid and reliable. Suggestions for future research are outlined. Keywords: Parkinson’s disease, telerehabilitation, Internet-based treatment, Lee Silverman Voice Treatment (LSVT  ), voice therapy. What this paper adds What is already known on this subject Recent proof-of-concept studies have touched on the feasibility of online delivery of the LSVT  to people with Parkinson’s disease. However, further large-scale studies are needed to demonstrate the full potential of online treatment. What this study adds This study has demonstrated the validity and reliability of the online delivery of the LSVT  to people with Parkinson’s disease. It lends further support to the use of online services for people with Parkinson’s disease in order to overcome barriers to treatment access. Address correspondence to: Gabriella Constantinescu, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane 4072, Australia; e-mail: gabriella@hearandsaycentre.com.au International Journal of Language & Communication Disorders ISSN 1368-2822 print/ISSN 1460-6984 online c  2010 Royal College of Speech & Language Therapists DOI: 10.3109/13682822.2010.484848