The Health Profile of People Living with Parkinson?s Disease Managed in a Comprehensive Care Setting

Morris, Meg E.; Murphy, Anna; Watts, Jennifer J.; Jolley, Damien; Campbell, Donald; Soh, Sze‐Ee; Said, Catherine M; Iansek, Robert

doi:10.4172/2329-8847.1000135

Cited by 2 publications

(3 citation statements)

References 34 publications

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“…Exercises can include respiration, phonation and articulation exercises; behavioural strategies to reduce prosodic abnormalities; therapeutic devices, such as sound amplifiers; delayed auditory feedback; wearable intensity biofeedback devices; and the use of augmentative and alternative communication approaches (Sackley et al., 2018; Schulz & Grant, 2000). The number of evidence‐based treatment options for speech and language problems in people with PD is limited (Morris et al., 2015). Lee Silverman voice treatment (LSVT) is an evidence‐based behavioural treatment to improve the vocal loudness and speech articulation in patients with PD (Ramig et al., 2001).…”

Section: Introductionmentioning

confidence: 99%

Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three‐arm randomised controlled trial

Mohseni

Mohamadi

Habibi

et al. 2023

Intl J Lang & Comm Disor

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BackgroundAlthough speech and voice disorders are common in Parkinson's disease (PD), there is insufficient evidence to support the effectiveness of behavioural speech therapies in these patients.AimsThis study aimed to examine the effects of a new tele‐rehabilitation program, a combining of conventional speech therapy and singing intervention, on voice deficits in patients with PD.Methods & ProceduresThis study was a three‐armed, assessor‐masked, randomised controlled trial. Thirty‐three people with PD were randomly assigned to the combination therapy, conventional speech therapy, or singing intervention group. This study followed the Consolidated Standards of Reporting Trials guidelines for non‐pharmacological treatment. Each patient participated in 12 tele‐rehabilitation sessions over 4 weeks. The combination therapy group received speech and singing interventions simultaneously (respiratory, speech, voice, and singing exercises). Voice intensity as a primary outcome and the voice handicap index (VHI), maximum frequency range, jitter and shimmer as secondary outcomes were evaluated 1 week before the first intervention session, 1 week after the last intervention session and 3 months after the last evaluation.Outcomes & ResultsThe results of repeated measures analysis of variance showed a significant main effect of time on all outcomes in all three groups after treatment (p < 0.001). There was a significant group effect for voice intensity (p < 0.001), VHI (p < 0.001), maximum frequency range (p = 0.014) and shimmer (p = 0.001). The combination therapy group demonstrated a significant outperformance in the VHI and shimmer than the speech therapy (p = 0.038) and singing intervention (p < 0.001) groups. The results of this study also indicated that combination therapy group compared to singing intervention group had a larger effect on voice intensity (p < 0.001), shimmer (p < 0.001) and maximum frequency range (p = 0.048).Conclusions & ImplicationThe results demonstrated that combining speech therapy with a singing intervention delivered through tele‐rehabilitation might be more effective in improving voice problems in patients with PD.What this paper addsWhat is already known on the subject Parkinson's disease (PD) is a neurological disorder that frequently causes disturbances in speech and voice, which negatively affect patients’ quality of life. Although speech difficulties occur in 90% of patients with PD, evidence‐based treatment options for speech and language problems in these patients are limited. Therefore, further studies are required to develop and assess evidence‐based treatment programs.What this study adds The findings of this study showed that a combination therapy program including conventional speech therapy approaches and individual singing intervention provided through tele‐rehabilitation may have a greater effect on the improvement of voice problems in people with PD compared to speech therapy and singing intervention alone.What are the clinical implications of this work? Tele‐rehabilitation combination therapy is an inexpensive and enjoyable behavioural treatment. The advantages of this method are that it is easy to access, appropriate for many stages of voice problems in PD, requires no prior singing training, encourages voice health and self‐management and maximises treatment resources available to people with PD. We believe that the results of this study can provide a new clinical basis for treatment of voice disorders in people with PD.

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Section: Introductionmentioning

confidence: 99%

Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three‐arm randomised controlled trial

Mohseni

Mohamadi

Habibi

et al. 2023

Intl J Lang & Comm Disor

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“…There are wide individual differences in the rate of disease progression and the combination of movement disorders and non‐motor symptoms over time, adding complexity to the design of programs to prevent falls and associated injuries in people with PD 9 . In some individuals, there can be attentional deficits, sensory dysfunction or behavioral changes which interact with the motor decline 10–13 . Disease progression can also be accompanied by cognitive impairment, weakness, and fluctuations in relation to PD medications, complicating strategies to manage falls and other symptoms 14 .…”

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confidence: 99%

“… 9 In some individuals, there can be attentional deficits, sensory dysfunction or behavioral changes which interact with the motor decline. 10 , 11 , 12 , 13 Disease progression can also be accompanied by cognitive impairment, weakness, and fluctuations in relation to PD medications, complicating strategies to manage falls and other symptoms. 14 The extent of pathology and the neural reserve available to compensate for basal ganglia dysfunction also need to be taken into account when implementing fall prevention programs.…”

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confidence: 99%

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Camicioli

Morris

Pieruccini‐Faria

et al. 2023

Movement Disord Clin Pract

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BackgroundPeople living with Parkinson's disease (PD) have a high risk for falls.ObjectiveTo examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults.MethodsA Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention.ResultsA recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi‐domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels.ConclusionEffective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.This article is protected by copyright. All rights reserved.

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The Health Profile of People Living with Parkinson?s Disease Managed in a Comprehensive Care Setting

Cited by 2 publications

References 34 publications

Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three‐arm randomised controlled trial

Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three‐arm randomised controlled trial

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

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