What is it about?
Nearly 90% of individuals with Parkinson disease (PD) will develop speech disorders that often diminish quality of life. One of the earliest and most common problems is reduced vocal loudness which makes individuals difficult to hear and understand. This was the first speech research to compare two forms of intensive speech treatment specifically designed to improve reduced vocal loudness in PD: 1) one treatment focused on improving respiratory support for speech and 2) the other focused on improving voice. Forty-five individuals with PD participated in 16 sessions of treatment in one month. Greater improvements were measured for individuals who participated in the treatment focusing on voice.
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Photo by Jaddy Liu on Unsplash
Why is it important?
This study provided the first evidence that intensive speech treatment focusing on voice could make significant improvements in speech in PD. Furthermore, this study was the first to implement a randomized control trial (RCT) design (the gold standard of evidence) to address a critical and challenging problem for the PD community. In addition to the measures of speech and voice, patient and family reports were positive as demonstrated in the video provided below (See Resources: Pre and post speech therapy video).
Perspectives
The evidence provided by this study formed the foundation for the next 20 years of our research in speech treatment for Parkinson disease. Based on the outcomes of this study, we went on to follow and report on this group of patients at one year (See Resources: LSVT one year) and two years (See Resources: LSVT two years) after treatment. Two years after one month of treatment, individuals with PD who received treatment focusing on voice in this initial study maintained their significant treatment outcomes. This is the first long-term evidence for efficacious speech treatment for PD. Through these studies, we learned many lessons about speech in PD and the underlying bases for the speech disorder in PD. Those lessons have helped us evolve the voice treatment (which is now known as LSVT LOUD) which is being delivered by 16,000 clinicians in over 60 countries and is supported by two additional RCTs (See Resources: 2001 & 2018).
Lorraine Ramig
University of Colorado
Read the Original
This page is a summary of: Comparison of Two Forms of Intensive Speech Treatment for Parkinson Disease, Journal of Speech Language and Hearing Research, December 1995, American Speech-Language-Hearing Association (ASHA), DOI: 10.1044/jshr.3806.1232.
You can read the full text:
Resources
LSVT one year
The purpose of this study was to evaluate the long-term (12 months) effects of two forms of speech treatment on the speech and voice deficits that occur in Parkinson's disease.
LSVT two years
To assess long term (24 months) effects of the Lee Silverman voice treatment (LSVT®)
RCT 2001
Changes in Vocal Loudness Following Intensive Voice Treatment (LSVT) in Individuals With Parkinson’s Disease: A Comparison with Untreated Patients and Normal Age-Matched Controls
RCT 2018
This randomized controlled trial evaluated two speech treatments for PD. Primary outcome was sound pressure level (SPL) in reading and spontaneous speech, and secondary outcome was participant‐reported Modified Communication Effectiveness Index (CETI‐M), evaluated at baseline, 1, and 7 months.
Pre and post speech therapy video
This video clip is of a woman with Parkinson disease immediately before and after receiving LSVT LOUD speech therapy.
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