Effects of Intensive Voice Treatment on Perceived Swallowing Abilities in Parkinson's Disease: Clinical Case Series

Abstract

<h3>Research Objectives</h3> The purpose of this study was to determine the change in perception of swallowing abilities in patients with Parkinson's disease (PD) after completion of an intensive voice therapy program as evidenced by self-rated perception scales and interview data. <h3>Design</h3> A prospective mixed methods case study design. <h3>Setting</h3> Hospital based outpatient speech language pathology clinic. <h3>Participants</h3> Four PD patients with varying medical histories, therapeutic needs, and clinical presentations. <h3>Interventions</h3> The Lee Silverman Voice Treatment (LSVT LOUD) program which uses high effort exercises for improved voice production. The program requires completion per protocol, daily homework and carryover assignments. <h3>Main Outcome Measures</h3> The voice handicap index (VHI), the perceptual rating scale, and the dysphagia handicap index (DHI), interview forms that are part of the voice program, and additional interview questions related to this project. <h3>Results</h3> Changes from pre- and post- LSVT LOUD sessions for voice, dysphagia, and communication abilities as measured by all self-rated scales and interview data. The physical (sensations of choking), emotional (fear of choking), and functional (avoidance of eating) perceptions as measured by the DHI were improved. Each patient, regardless of medical history or treatment program format, reported improved emotional perceptions of their swallowing problems. This was consistent even for those patients without changes to their diet consistency status. <h3>Conclusions</h3> The incorporation of a dysphagia perception self-rating scale may contribute to improved outcomes even for those PD patients not seeking out dysphagia treatment specifically. Other benefits may include clarifying the treatment plan by ensuring to address all issues, education for the patient in regard to their dysphagia concerns, and education for the family by expanding the objective measures to include subjective perceptions which may help explain the scope of the disability. <h3>Author(s) Disclosures</h3> Nothing to disclose.