Effect of an iOS App on Voice Therapy Adherence and Motivation

Purpose Patients commonly report difficulties adhering to voice therapy. An iOS app was developed in our lab that assists practice via reminder notifications, instructional recordings, and cepstral peak prominence analysis results. The purpose of this study was to assess the effect of such homework support modality on adherence behavior and associated motivation in a comparison of app support and written homework instructions and to assess the usability and utility of the app. Method Thirty-four individuals exhibiting adducted hyperfunction were randomized to receive either written homework instructions or the app when practicing resonant voice exercises for 3 weeks. All patients digitally audio-recorded all home practice, provided self-reported estimates of generalization, and completed weekly motivation scales. Results App support significantly increased practice frequency but did not affect self-reported generalization or motivation. Practice was significantly predicted by System Usability Scale scores. Utility of reminders and instructions were good, but cepstral peak prominence feedback was considered useful to only a subset of participants. Conclusion Interactive mobile therapy support can significantly increase practice of resonant voice homework without influencing motivation.