Speech Therapists Provide Empirically-Supported Treatment of Speech Problems in Parkinson’s Disease
Lisa Hale, MSP, CCC-SLP
Parkinson’s disease affects 1.5 million people in the United States and 8 million worldwide. Nearly 90% of these individuals will develop a speech disorder called “hypokinetic dysarthria” (i.e., slowed speech with poor articulation) during the course of their illness.
Speech symptoms are sometimes reported as the first symptoms of Parkinson’s disease. Characteristics of speech in people with Parkinson’s disease include reduced volume, hoarse voice quality, monotone speech, poor articulation, and vocal tremor. People with Parkinson’s disease also have a reduction in lung capacity, chest wall movements, respiratory muscle activation, amount of air used to speak, and accuracy of speech sounds.
Dopamine replacement treatments (e.g., Levodopa) have demonstrated therapeutic effects on rigidity, slowed movement, freezing, and limb tremor. However, its effects on the speech symptoms of Parkinson’s disease have yielded variable results.
LSVT LOUD is an evidence-based treatment for Parkinson’s disease and other neurological disorders. It uses the theories of motor learning, skill acquisition and exercise principals to drive activity-dependent neural plasticity to produce a “healthy” loudness which is systematically trained into every day speech tasks. LSVT LOUD has been shown to enable the patient to maintain vocal loudness for up to 2 years post treatment.
The future of LSVT LOUD is to utilize computer based technology to increase the accessibility of treatment, promote home practice, augment the effects of LSVT, cut costs of treatment and support long term practice. A program that collects acoustic data and provides feedback to the patient is also in development.
As previously mentioned, although approximately 90% of individuals with Parkinson’s disease experience a speech disorder during their illness, research suggests that only 4% receive traditional speech therapy. It is recommended that individuals in the early stages of Parkinson’s disease receive speech therapy to maximize their functional improvement as well as slow or halt further progression of the disease. LSVT LOUD is an evidence-based treatment with good outcome and ongoing development to facilitate ease of utilization. If you or a loved one is interested in treatment of a speech disorder, contact your local rehabilitation facility or a speech pathologist near you.
Additional information about LSVT LOUD and related treatments can also be found at the following links:
Scientific Review of LSVT LOUD and LSVT BIG:
Peer-Reviewed Article on the Science and Practice of LSVT LOUD: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-2006-955118
Lisa Hale is an outpatient speech therapist with HealthSouth Rehabilitation Hospital in Jonesboro, Arkansas. She is a certified provider of VitalStim, Interactive Metronome, MDTP and LSVT LOUD.