Effect of speech therapy and pharmacological treatment in prosody of parkinsonians

Abstract

Objective: Parkinsonian patients usually present speech impairment. The aim of this study was to verify the influence of levodopa and of the adapted Lee Silverman Vocal Treatment 1 method on prosodic parameters employed by parkinsonian patients. Method: Ten patients with idiopathic Parkinson's disease using levodopa underwent recording of utterances produced in four stages: expressing attitudes of certainty and doubt and declarative and interrogative modalities. The sentences were recorded under the effect of levodopa (on), without the effect of levodopa (off); before and after speech therapy during the on and off periods. Results: The speech therapy and its association with drug treatment promoted the improvement of prosodic parameters: increase of fundamental frequency measures, reduction of measures of duration and greater intensity. Conclusion: The association of speech therapy to medication treatment is of great value in improving the communication of parkinsonian patients.

Utilization of rehabilitation therapy services in Parkinson disease in the United States

“…While PT makes up a large portion of rehabilitation therapies use in patients with PD, studies on the efficacy of OT and ST in the treatment and management of PD have also been done, showing improvements in quality of life, dysarthria, and hypophonia. 2,3,7,9 Up to 89% of patients with PD have speech disorders, yet in this study, only 14.6% received ST consultation or treatment. 18 Likewise, falls are a common indication for PT referral, and occur in up to 68% of patients with PD, 19 but only 14.2% of our cohort received PT/OT.…”

“…Evidence for the efficacy of rehabilitation therapies in the treatment and management of Parkinson disease (PD) has been expanding, demonstrating improvements in function, activities of daily living, speech volume, and quality of life. [1][2][3][4][5][6][7][8][9][10][11] As a result, current American Academy of Neurology (AAN) quality measures for PD treatment advocate for the regular assessment of the need for physical therapy (PT), occupational therapy (OT), and speech therapy (ST). 12 Similar guidelines exist globally, motivating research on the utilization of rehabilitation therapies in PD in other countries (e.g., Germany, United Kingdom, the Netherlands).…”

Lee Silverman Voice Treatment for dysarthria in patients with Parkinson’s disease: a systematic review and meta‐analysis

“…Over the years, various therapies have been applied to solve dysarthria in PD. A study showed that new behavioral treatment techniques of speech and language therapy seemed to be more effective in improving vocal loudness and speech intelligibility in patients with PD [51][52][53][54] and they also maintained a long-term effect [55]. Patients with PD also have impairment of facial expression [56,57], swallowing and tongue function.…”

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: a pilot randomised controlled trial (PD COMM pilot)

“…Drug therapy has only modest effects on prosodic aspects of parkinsonian speech, so other therapeutic measures such as speech and language therapy (SLT) could play a role in treatment. [ 5 ] Conventional SLT is tailored to individual patients’ needs and may include: diaphragmatic breathing, pacing/rate control, word-finding strategies, and voice/articulation exercises. [ 6 ] One technique that has been used in PD is attention to effort, where the speaker is asked to produce a loud voice and focus their effort on attaining, monitoring, and maintaining this.…”