Abstract
Background. Lee Silverman Voice Treatment® LOUD (LSVT®) is an intensive program devised in the United States to train patients with Parkinson's disease (PD) to speak louder, at normal intensity, while keeping a good voice quality. Four weeks of LSVT® has been shown to increase vocal loudness and improve intelligibility among Japanese-speaking PD patients. However, the long-term effects of LSVT® have not been examined in these patients. Objective. This study aimed to investigate the long-term effects of LSVT® on Japanese-speaking PD patients. Methods. Twenty-one Japanese PD patients underwent a standardized course (four sessions over four consecutive days, for four weeks) of LSVT® at our hospital. Vocal loudness and intelligibility were assessed at the following three time-points: pretreatment (baseline), immediately after treatment, and at the end of the 12 month follow-up (12FU). Sound pressure levels (dB SPL) were measured during the following tasks: sustained phonation of /a/, reading a standardized text, and delivery of a monologue. Three experienced speech-language pathologists, who were blinded to patients' identities and assessment points, assessed speech intelligibility based on recorded audio samples of each participant during the reading and monologue tasks. Results. Fourteen patients were evaluated at 12FU. Changes in dB SPL from baseline to immediately after treatment were +6.5 dB, +4.2 dB, and +2.8 dB, and those from baseline until 12FU were +4.7 dB, +3.5 dB, and +2.5 dB in sustained phonation of /a/, reading a passage, and delivery of a monologue, respectively. These changes were significant (p < 0.025) in both the baseline-to-immediately-after-treatment and baseline-to-12FU intervals. Intelligibility relative to baseline was significantly improved immediately after treatment, but not at 12FU. Conclusions. LSVT® had a long-term effect on the vocal loudness of Japanese-speaking PD patients. A short-term effect was seen in intelligibility, however, there was no significant long-term effect.
Highlights
90% of Parkinson’s disease (PD) patients present with dysarthria, characterized by reduced vocal loudness, reduced intonation variability, hoarseness, increased speech rates, and improper articulation of consonants [1]
Lee Silverman Voice Treatment® LOUD (LSVT®) is an intensive program devised in the United States to train patients with PD to speak louder, at normal intensity, while keeping a good voice quality [4]
The program is in accordance with motor learning theories that focus on specificity, intensity, repetition, and saliency; LSVT® focuses solely on vocal loudness, which improves by repeated training on a single target with a maximum effort [5]
Summary
90% of Parkinson’s disease (PD) patients present with dysarthria, characterized by reduced vocal loudness, reduced intonation variability, hoarseness, increased speech rates, and improper articulation of consonants [1]. Lee Silverman Voice Treatment® LOUD (LSVT®) is an intensive program devised in the United States to train patients with PD to speak louder, at normal intensity, while keeping a good voice quality [4]. LSVT® trains patients to recognize how loudly they must speak to reach a normal volume [3]. If patients can identify the volume of their voice, the effects of LSVT® are maintained after training [6]. Lee Silverman Voice Treatment® LOUD (LSVT®) is an intensive program devised in the United States to train patients with Parkinson’s disease (PD) to speak louder, at normal intensity, while keeping a good voice quality. Four weeks of LSVT® has been shown to increase vocal loudness and improve intelligibility among Japanese-speaking PD patients. Three experienced speech-language pathologists, who were blinded to patients’ identities and assessment points, assessed speech intelligibility based on recorded audio samples of each participant during the reading and monologue tasks
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