Lee Silverman Voice Treatment to Improve Speech in Parkinson’s Disease: A Systemic Review and Meta-Analysis

Abstract

Background. Speech changes occur in the early stages of Parkinson’s disease (PD) and cause communication difficulties, leading to social isolation. Lee Silverman voice treatment (LSVT) is a speech therapy approach designed to improve patients’ language and voice capabilities. Objective. The effectiveness of the LSVT was compared with that of other speech interventions or no treatment to evaluate PD patients with dysarthria. Design. Systematic review with meta-analysis of randomized trials. Data Sources: PubMed, Embase, Cochrane Library, CNKI, and SinoMed library were searched from inception to December 2021 related to PD and LSVT. Method. Abstracts were screened and reviewed against the eligibility criteria (intervention group participants were PD assessed based on LSVT (LSVT Loud) and randomized control). Result. Ten randomized controlled trials were identified on speech symptoms in patients with PD. Compared with the respiratory therapy (RET) exercise, or no training group, a significant improvement was detected in the sound press level (SPL) after immediate treatment during the reading of vowel and rainbow passages and an increase in semitone standard deviation (STSD). Furthermore, the LSVT training significantly increased the participants’ scores on unified Parkinson’s disease rating scale (UPDRS-III) and speech intelligibility. Conclusion. This meta-analysis demonstrated the efficacy of LSVT in increasing vocal loudness and functional communication among individuals with PD. However, most studies included participants with mild-moderate PD. Thus, additional randomized controlled trials (RCTs) with large sample sizes are needed to validate the efficacy of LSVT in patients with different progressions of PD, including severe PD.

Attitudes Toward Telehealth Services Among People Living With Parkinson's Disease: A Survey Study

“…This finding is critical given that disorders of speech and swallowing in PD result in significant decrements to health and quality of life but have also been found to be amenable to improvements with targeted SLP intervention. 13,14 In addition, recent work has identified that SLP services delivered via telehealth are feasible and efficacious in the treatment of Parkinson's disease. [15][16][17] In a recent study by Chan and colleagues, 17 intensive voice therapy sessions delivered over smartphone videoconferencing were perceived to be an equivalent alternative to traditional face-to-face in 70% of participants.…”

Rehabilitating Cough Dysfunction in Parkinson's Disease: A Randomized Controlled Trial

“…These differences in airway‐protective treatment outcomes between the EMST and smTAP groups point to differences in the mechanistic targets of treatment (ie, strength‐ vs. skill‐based training), with EMST leading to greater improvements in MEP but smTAP resulting in greater improvements in voluntary and reflex cough function. The value of skill‐based training for individuals with PD is further supported by studies demonstrating improvement in speech and gait 49,50 . For the smTAP group, the improvements in voluntary and reflex cough function to levels indicative of improved airway clearance are of clear health impact, especially given that these individuals have dysphagia.…”

“…The value of skill-based training for individuals with PD is further supported by studies demonstrating improvement in speech and gait. 49,50 For the smTAP group, the improvements in voluntary and reflex cough function to levels indicative of improved airway clearance are of clear health impact, especially given that these individuals have dysphagia. This study supports the consideration of skillbased training approaches for cough rehabilitation in individuals with PD and dysphagia.…”

How I treat Parkinson's disease

“…Recent meta-analysis demonstrated the efficacy of the Lee Silverman Voice Treatment in increasing vocal loudness and functional communication among individuals with PD 69 . Speech language therapy (SLT) has potential benefits for PD dysphagia 70 .…”