Development of a Korean Medicine-Integrated Voice Training Protocol for Patients with Parkinson’s Disease in Korea

Objectives: This study aimed to develop a Korean medicine-integrated voice training protocol (KM-VOICE) for Korean patients with Parkinson’s disease (PD) by integrating contemporary voice rehabilitation approaches with traditional Korean medicine concepts of breathing, phonation, and emotional regulation.Methods: A narrative literature review was conducted to identify voice, speech, singing, and respiratory interventions used in patients with PD. Domestic databases and PubMed were searched, and the identified intervention methods and training components were categorized according to their characteristics. These findings were reviewed in conjunction with traditional Korean medicine literature, and the final protocol was developed through expert consultation.Results: KM-VOICE was developed as an eight-session protocol comprising three phases and 11 training components. The three phases were the Doyin-Angyo Method (導引按蹻法), Five-Sound Singing Method (五音歌詠法), and Naqi Breathing Regulation Method (納氣調息法). The protocol was structured to progress from respiratory and physical preparation to phonation, articulation, and emotional vocal expression, followed by respiratory regulation. Training components included Taesikbub (胎息法), acupoint and orofacial relaxation, Lung-Doyinbub (肺臟導引法), Five-Zang Five-Sound Method (五臟五音法), Seven-Emotion Harmony Method (七情和音法), Sinmyeong Phonation Method (神明發聲法), and Jung-Nam Phonation Method (仲南發聲法). Components were progressively introduced during Sessions 1-4 and reinforced during Sessions 5-8. Maximum phonation time was incorporated as an assessment and feedback measure of respiratory-phonatory coordination.Conclusions: KM-VOICE provides a structured framework integrating traditional Korean medicine concepts with contemporary voice rehabilitation approaches for patients with PD. Further clinical studies are needed to evaluate its feasibility, safety, adherence, and effects on voice, speech, and respiratory outcomes.