The Effects of the “SPEAK OUT! ®” and “LOUD Crowd®” Voice Programs for Parkinson Disease

Abstract

Individuals with Parkinson's disease (PD) experience difficulties in various motor functions due to decreased amplitude and sensory guidance. Speech production is a motoric behavior, and difficulties with oral communication are often seen in these patients. The communication problems are primarily due to decreased airflow from the lungs, incomplete vocal fold vibration, and an insufficient range of motion and coordination of the speech articulators. Current behavioral management methods for communication difficulties with PD typically address the reduced vocal intensity in "one-on-one" voice therapy sessions. The present study investigated the effects of a set of voice remediation programs for PD that includes individual and group therapy components, namely, the SPEAK OUT!® and LOUD Crowd® programs. Objective measurements of vocal intensity and perceptual measurements of the patients' ratings of the voice were recorded during the pre-and post-voice treatment phases. Statistically significant improvements were identified in both objective and perceptual measurements.

Prosodic Improvement in Persons with Parkinson Disease Receiving SPEAK OUT!® Voice Therapy

“…® has only been evaluated in 2 rather small investigations by the same group [20,21] and 1 larger-scale study [18]. Levitt [20] obtained efficacy data in 6 male participants with PD when they were off medication at baseline and after SPEAK OUT! ® administration (at 4 weeks).…”

“…The patients' perception of vocal functioning changed significantly (from fair at baseline to good at 4 weeks) for physiological dimensions on the V-RQOL but remained statistically similar on the social-emotional dimensions of this scale. Levitt et al [21] conducted a follow-up study with 12 participants (4 females and 8 males), which in addition to sustained vowel prolongation of the corner vowels also included gliding from the lowest to the highest pitch level and vowels extracted from 3 sentences. Results revealed a 14-to 20-dB SPL increase across tasks.…”

A retrospective study of long-term treatment outcomes for reduced vocal intensity in hypokinetic dysarthria

“…Each treatment session is structured with a hierarchy of speech, voice, and cognitive exercises progressing in the following manner: warm-up vocalizations → sustained vowel production → pitch glides → counting → reading → cognitive exercises. In the published literature, outcome data from only six patients receiving this treatment has been reported [ 20 ]. Reports which document clinical outcomes from larger samples, both in retrospective and prospective designs, will better inform clinical practice and evidence-based application of treatment approaches.…”

Articulation Features of Parkinson’s Disease Patients with Subthalamic Nucleus Deep Brain Stimulation

“…There was a significant correlation between VSA and intelligibility in the off-stimulation condition in the both genders in our study. In previous studies, improvement in speech intelligibility was accompanied by enlarged VSA after speech rehabilitation [25], [27], [41]. Moreover, the VSA value became larger when asked to speak clearly in PD patients [42].…”