ParkinSong: Outcomes of a 12-Month Controlled Trial of Therapeutic Singing Groups in Parkinson’s Disease

Abstract

Background: Parkinson's disease (PD) frequently causes progressive deterioration in speech, voice and cognitive aspects of communication. These affect wellbeing and quality of life and are associated with caregiver strain and burden. Therapeutic singing groups can ameliorate PD-related communication disorders and increase social interaction and wellbeing for caregivers and care recipients. Objective: To analyse the effects of ParkinSong group singing sessions on Parkinson's communication and wellbeing outcomes for people with PD and caregivers over 12 months. Methods: A 4-armed controlled clinical trial compared ParkinSong with active non-singing control conditions over 12 months. Two dosage levels (weekly versus monthly) were available for each condition. ParkinSong comprised high-effort vocal, respiratory and speech exercises, group singing, and social interaction. PD-specific outcomes included vocal loudness, speech intelligibility, maximum phonation time, respiratory muscle strength, and voice related quality of life (QoL). Wellbeing outcomes were also measured for caregivers and care recipients. Results: We recruited 75 people with PD and 44 caregivers who attended weekly ParkinSong, monthly ParkinSong, weekly control or monthly control groups. We found significant improvements in the primary outcome of vocal loudness (p = 0.032), with weekly singers 5.13 dB louder (p = 0.044) and monthly singers 5.69 dB louder (p = 0.015) than monthly controls at 12 months. ParkinSong participants also showed greater improvements in voice-related QoL and anxiety. Caregivers who attended ParkinSong showed greater reductions in depression and stress scores.

Speech and language therapy treatment on hypokinetic dysarthria in Parkinson disease: Systematic review and meta-analysis

“…The most frequent outcomes were loudness measured by sound pressure level 22–29 and pitch, measured by semitone standard deviation. 25,27…”

“…The study of Tamplin et al 22 compared four groups, two of them with the same SLT intervention with different frequencies. One group received treatment once a week and the other one received treatment once per month.…”

ParkinSong Online: protocol for a telehealth feasibility study of therapeutic group singing for people with Parkinson’s disease

“… 6 7 10 There is also preliminary evidence that face-to-face group singing can improve emotional wellbeing and mental health for people with Parkinson’s. 10 However, to date, only one prerecorded group singing feasibility study has been investigated in relation to Parkinson’s. 23 There is a need to examine whether live, online delivery of group singing interventions is acceptable to participants with Parkinson’s and feasible to provide.…”

“…5 Preliminary research indicates that face-toface group singing has positive effects on speech and wellbeing outcomes for people with Parkinson's. 6 7 ParkinSong is a collaborative, transdisciplinary intervention informed by music therapy, [8][9][10] speech pathology 6 10 and rehabilitation principles. 11 The conceptual framework underpinning the ParkinSong intervention draws on neurobiological understandings of the shared neural networks and structural mechanisms used during singing and speech, and principles of auditory-motor coupling, 12 where rhythmic cues are used to stimulate and organise motor function.…”

Singing for the Rehabilitation of Acquired Neurogenic Communication Disorders: Continuing the Evidence Dialogue with a Survey of Current Practices in Speech-Language Pathology

“…For example, melodic therapies based on sung speech have proven effective for language recovery in Broca’s aphasia [ 4 , 5 ]. Singing in a choir improves speech disorders in Parkinson’s disease and impacts the well-being and quality of life of participants [ 6 ]. Singing also improves several extralinguistic components with a high impact on communication disorders in dementia, including mood, orientation, long-term episodic memory, attention, executive function, working memory, and general cognition [ 7 ].…”