Long-term effects of Lee Silverman Voice Treatment on daily voice use in Parkinson’s disease as measured with a portable voice accumulator

Abstract

This study examines the effects of an intensive voice treatment focusing on increasing voice intensity, LSVT LOUD Lee Silverman Voice Treatment, on voice use in daily life in a participant with Parkinson's disease, using a portable voice accumulator, the VoxLog. A secondary aim was to compare voice use between the participant and a matched healthy control. Participants were an individual with Parkinson's disease and his healthy monozygotic twin. Voice use was registered with the VoxLog during 9 weeks for the individual with Parkinson's disease and 2 weeks for the control. This included baseline registrations for both participants, 4 weeks during LSVT LOUD for the individual with Parkinson's disease and 1 week after treatment for both participants. For the participant with Parkinson's disease, follow-up registrations at 3, 6, and 12 months post-treatment were made. The individual with Parkinson's disease increased voice intensity during registrations in daily life with 4.1 dB post-treatment and 1.4 dB at 1-year follow-up compared to before treatment. When monitored during laboratory recordings an increase of 5.6 dB was seen post-treatment and 3.8 dB at 1-year follow-up. Changes in voice intensity were interpreted as a treatment effect as no significant correlations between changes in voice intensity and background noise were found for the individual with Parkinson's disease. The increase in voice intensity in a laboratory setting was comparable to findings previously reported following LSVT LOUD. The increase registered using ambulatory monitoring in daily life was lower but still reflecting a clinically relevant change.

HiCommunication as a novel speech and communication treatment for Parkinson's disease: A feasibility study

“…It has shown that voice sound levels of PwPD and matched healthy controls from recordings in a controlled environment (such as a recording studio) are not representative of speech registered outside the clinical environment also in low background noise (Gustafsson et al, 2019a). In another recent study, comparisons of registrations between a pair of twins with similar living conditions where one twin was healthy and the other had PD and underwent LSVT-LOUD ® also showed differences in voice sound level registered in daily life compared to data from registrations from a controlled registration in a studio setting (Körner Gustafsson et al, 2019b).…”

Using Portable Voice Accumulators to Study Transfer of Speech Outcomes Following Intervention – A Feasibility Study

“…Notably, voice sound level increased following the increase in environmental noise ranges for all participants which is in line with the known impact of environmental noise on voice use. 43 Results from earlier studies 23,28 show that participants with PD regulate their voice sound level in response to noise ranges to a lesser degree than their matched healthy controls. For four of the individuals in this pilot study the level of environmental noise was lower during the registration period post intervention.…”

“…21 Real-time monitoring of speech and voice function with wearable devices, commonly referred to as portable voice accumulators (PVAs), can be one approach to evaluate intervention programs, taking ecological validity and clinical relevance into account. [22][23][24] PVAs can be used to register voice use objectively over a longer period in daily life settings. Using PVAs to study voice use in daily life was first attempted in 1974 by Holbrook and colleagues 25 and the method has been used in research since then, although clinical availability is still very limited.…”

Terapia vocal com abordagem respiratória em idosos: revisão integrativa da literatura

“…No entanto, ainda falta muito a se conhecer sobre o RET no Brasil, pois parece não ser um programa utilizado e difundido no país, além da dificuldade de se encontrar artigos sobre esse programa. O LSVT® é considerado um método de excelência no tratamento da voz para pacientes com DP 34 e possui como principal objetivo aumentar o impulso respiratório e promover ajuste dos músculos laríngeos ao estimular e treinar o aumento do volume da voz 34,35 .…”