COMPARISON OF 2 FORMS OF INTENSIVE SPEECH TREATMENT FOR PARKINSONS-DISEASE

This study investigated the effect of two forms of intensive speech tr eatment, (a) respiration (R) and (b) voice and respiration (Lee Silver man Voice Treatment [LSVT]), on the speech and voice deficits associat ed with Idiopathic Parkinson disease. Forty-five subjects with Idiopat hic Parkinson disease completed extensive pretreatment neurological, o tolaryngological, neuropsychological, and speech assessments. All subj ects completed 16 sessions of intensive speech treatment, 4 times a we ek for 1 month. Pre- and post-treatment measures included intensity an d maximum duration during sustained vowel phonation. Intensity, habitu al fundamental frequency, fundamental frequency variability, and utter ance and pause duration were measured during reading of the ''Rainbow Passage'' and conversational monologue as well. Family and subject sel f-ratings were completed pre- and post-treatment for the perceptual va riables loudness, monotonicity, hoarseness, overall intelligibility, a nd initiation of conversation. Significant pre- to-post-treatment impr ovements were observed for more variables and were of greater magnitud e for the subjects who received the voice and respiration treatment (L SVT). Only subjects who received the LSVT rated a significant decrease post-treatment on the impact of Parkinson disease on their communicat ion. Correlations between descriptive prognostic variables (i.e., stag e of disease, speech/voice severity rating, depression, and time since diagnosis) and magnitude Of treatment-related change indicated these factors did not significantly predict treatment effectiveness. These f indings suggest that intensive voice and respiration (LSVT) treatment, focusing on increased vocal fold adduction and respiration, is more e ffective than respiration (R) treatment alone for improving vocal inte nsity and decreasing the impact of Parkinson disease on communication.