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

Objective: 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.

Serious game: 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.

Methods: 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.

Results: 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.

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