Experiences of Persons With Parkinson’s Disease Engaged in Group Therapeutic Singing

Stegemöller, Elizabeth L.; Hurt, Tera R.; O’Connor, Margaret; Camp, Randie D.; Green, Chrishelda W; Williams, Ebony K

doi:10.1093/jmt/thx012

Cited by 17 publications

(37 citation statements)

References 41 publications

(46 reference statements)

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“…In general terms, pwPD appear positive about SLT and/or voice treatment. [54][55][56]62,64,65,78 However, it seems as though emotional factors and long-term maintenance issues are rarely addressed in current treatment programs. 54,56 Similarly, practical issues such as fatigue related to traveling to sessions, treatment cost, and waiting list times are rarely considered.…”

Section: Resultsmentioning

confidence: 99%

“…PwPD commonly report the importance of peer support (meeting others with PD) during treatment. 54,64,67,78 For example, the participants in Simberg et al's 64 15-day treatment study emphasized the positive effect of peer support during the course which had combined one-to-one and group therapy. This is highly relevant feedback since the LSVT LOUD treatment approach delivered in a one-to-one context (face-to-face or remotely) is used more frequently than any other voice treatment approach for pwPD in many countries.…”

Section: Pwpd Perspectives Regarding Speaking and Voice Treatmentmentioning

confidence: 99%

“…This is highly relevant feedback since the LSVT LOUD treatment approach delivered in a one-to-one context (face-to-face or remotely) is used more frequently than any other voice treatment approach for pwPD in many countries. Stegemoller et al 78 reported findings from an 8 -week group program delivered by a music therapist to 20 pwPD, with a focus on voice exercises and singing. PwPD found the group fun, enjoyed the social aspect of meeting others with PD, and valued an outlet independent of family members and close friends.…”

Section: Pwpd Perspectives Regarding Speaking and Voice Treatmentmentioning

confidence: 99%

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<p>Voice treatment in Parkinson’s disease: patient perspectives</p>

Gillivan-Murphy¹,

Miller²,

Carding³

2019

JPRLS

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Speech and voice changes are a central feature of the symptom complex of people with Parkinson's disease (pwPD). Speaking is a social activity involving the pwPD, family, and the wider communicative context. Sensory-motor, cognitive-linguistic, and affective changes in Parkinson's disease (PD) combine to alter communication, impacting on psychosocial quality-of-life, leading to risks of social withdrawal and increased depression and anxiety. The underlying pathophysiology of speech, voice, and communication difficulties in pwPD is multi-factorial and complex. Sensory-motor changes in the respiratory, phonatory, and articulatory subsystems, underscaling of effort, and central processing problems are further affected by broader cognitive-linguistic difficulties, and non-speech motor deficits. Many studies show that, when pwPD are asked to rate their own voice and how it functions in everyday situations, they show increased voice-related disability and negative impact relative to healthy controls. Voice treatment is integral to improving communication in pwPD. Studies show positive benefits from the perspective of pwPD and carers. Treatment approaches vary from one-to-one to group interventions, a singular focus on increasing loudness to more general voice exercises, and choral singing. The nature and underlying pathophysiology of speech, voice, and communication changes in pwPD are reviewed before exploring the effects of voice treatment programs and pwPD and carer perceptions of their effect. Larger scale, better powered, controlled trials of intervention for voice and speech that measure clinically and socially relevant outcomes are finally underway. Future research should also focus on issues of treatment compliance, practicality (for service delivery and use), and long-term follow-up outcomes. The role of carers in longer-term maintenance represents a further important area of exploration.

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Section: Resultsmentioning

confidence: 99%

Section: Pwpd Perspectives Regarding Speaking and Voice Treatmentmentioning

confidence: 99%

Section: Pwpd Perspectives Regarding Speaking and Voice Treatmentmentioning

confidence: 99%

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<p>Voice treatment in Parkinson’s disease: patient perspectives</p>

Gillivan-Murphy¹,

Miller²,

Carding³

2019

JPRLS

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“…Our group has shown that group therapeutic singing (GTS) improved respiratory control, swallow, and quality of life (Stegemöller et al, 2016 , 2017a ). The singing groups were enjoyable for participants as they offered a way to relieve stress and have fun (Stegemöller et al, 2017b ). Participants also viewed the groups as an avenue to express their concerns about having PD and build camaraderie with other people with PD (Stegemöller et al, 2017b ).…”

Section: Introductionmentioning

confidence: 99%

“…The singing groups were enjoyable for participants as they offered a way to relieve stress and have fun (Stegemöller et al, 2017b ). Participants also viewed the groups as an avenue to express their concerns about having PD and build camaraderie with other people with PD (Stegemöller et al, 2017b ). Taken together, this suggests that the inclusion of music into the treatment plan for persons with PD may be a viable strategy to target multiple motor symptoms as well as improve mood and quality of life.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Group Therapeutic Singing on Cortisol and Motor Symptoms in Persons With Parkinson's Disease

Stegemöller

Zaman

Shelley

et al. 2021

Front. Hum. Neurosci.

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The inclusion of music into the treatment plan for persons with Parkinson's disease (PD) may be a viable strategy to target multiple motor symptoms. However, potential mechanisms to explain why music has an impact on multiple motor symptoms in persons with PD remain understudied. The purpose of this study was to examine the acute effects of 1 h of group therapeutic singing (GTS) on physiological measures of stress and clinical motor symptoms in persons with PD. We posit that improvement in motor symptoms after GTS may be related to stress reduction. Seventeen participants with PD completed 1 h of GTS and eight participants completed 1 h of a quiet reading (control session). Cortisol was collected via passive drool immediately before and after the singing and control session. The Unified Parkinson's Disease Rating Scale (UPDRS) Part-III (motor examination) was also video-recorded immediately before and after the singing and control session and scored by two raters masked to time and condition. Secondary outcome measures for quality of life, depression, and mood were collected. Results revealed no significant change in cortisol or motor UPDRS scores, as well as no significant relationship between cortisol and motor UPDRS scores. There was a trend for the singing group to report feeling less sad compared to the control group after the 1-h session (effect size = 0.86), and heart rate increased in the singing group while heart rate decreased in the control group after the 1-h session. These results suggest that an acute session of GTS is not unduly stressful and promotes the use of GTS for persons with PD. Multiple mechanisms may underlie the benefits of GTS for persons with PD. Further exploring potential mechanisms by which singing improves motor symptoms in persons with PD will provide greater insight on the therapeutic use of music for persons with PD.

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ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia

et al. 2022

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Background Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias. Method This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation. Results Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing. Discussion ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.

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Experiences of Persons With Parkinson’s Disease Engaged in Group Therapeutic Singing

Abstract: This study provided greater insight into how a therapeutic singing program may benefit participants and positively impact their lives.

Cited by 17 publications

References 41 publications

<p>Voice treatment in Parkinson’s disease: patient perspectives</p>

<p>Voice treatment in Parkinson’s disease: patient perspectives</p>

The Effects of Group Therapeutic Singing on Cortisol and Motor Symptoms in Persons With Parkinson's Disease

ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia

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