Gamification of Tube Phonation: A Feasibility Study for Voice Therapy Practice

This study aimed to turn home vocal exercise for people with voice problems into an engaging experience through gamification. A serious game designed for tube phonation was developed, and its effectiveness in encouraging adherence to prescribed vocal exercises was evaluated in healthy older adults.

The serious game is a slot machine game displayed on a tablet, connected to an Internet of Things (IoT) device and an accelerometer with a straw for tube phonation. It detects phonation by measuring the amplitude and frequency of the vibratory wave of a straw wall. The tablet connects to the IoT device via Bluetooth. When users maintain tube phonation for a specified duration, the slot machine reels start spinning. Users can stop the reels using buttons on the tablet, and their scores are calculated and stored.

Sixteen participants (eight males and eight females) with a mean age of 68.6 years were divided into control and experimental groups. For 1 week, all participants practiced tube phonation at home, with instructions to complete three sets of 15 5-second tube phonations daily. The experimental group used the proposed game system, while the control group did not. An IoT device recorded phonation durations for both groups. Participants completed a postexperiment questionnaire.

The experimental group successfully maintained tube phonation durations exceeding 5 seconds throughout the week, while the control group's durations varied, often falling below 5 seconds. However, both groups believed that they had followed the phonation instructions. In the survey, the experimental group expressed a more positive attitude toward long-term home vocal exercises.

The serious game shows promise for promoting correct and consistent daily vocal exercises among patients, and is a valuable approach to voice rehabilitation.