Hoarse Voice Parkinson’s Disease

Two: Creating Goals For Treatment

Connected Speech Pathologys voice therapists have the training to provide the best therapy methods. All of our voice therapists have a deep understanding of the research of voice therapy techniques. Since each client is unique and will respond to different therapy methods, we will create a treatment program tailor-made for your needs. We will choose the right therapy technique for each individual and adapt therapy when they do or do not respond to a specific plan.

If I Have Speech And Voice Problems How Can I Maintain And Improve My Communication

Some tips to improve communication include:

• Choose a quiet, low-noise space. Turn off televisions, radios and other devices that create noise.
• Speak slowly.
• Make sure your listener can see your face. Look at the person while you are talking. A well-lit room improves face-to-face conversation, increasing the ability to be understood.
• Use short phrases. Say one or two words or syllables per breath.
• Plan periods of vocal rest before planned conversations or phone calls. Know that fatigue significantly affects your ability to speak. Techniques that work in the morning might not work later in the day.
• Keep your throat hydrated. Drink plenty of water. Dont drink caffeinated or alcoholic beverages. Use a humidifier if the air in your home is dry.
• Keep an upright posture, straight chin, slightly lifted neck to improve airflow from lungs to your vocal cords.
• If you are soft spoken and your voice has become low, consider using an amplifier.

If some people have difficulty understanding you, these additional strategies might help:

Speaking And Voice Problems And Stroke

If you see someone with the following symptoms, call 911 right away:

• They suddenly have trouble trying to speak, they slur their words, or mumble.
• They struggle to read, write, or understand others when they could before.
• When you ask them to smile, their face looks uneven or droops on one side.
• They have new weakness or numbness in one or both arms or in one or both legs.

Talk to a doctor about ways to prevent a stroke, including watching your loved oneâs blood pressure, blood sugar, cholesterol, and weight. Try to get them to exercise for at least 30 minutes a day and to eat a healthy diet with lots of fruits and veggies. Help them remember to take all their medicines at the right times every day.

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Voice Articulation And Uency Disorders In Parkinsons Disease

Table I. Clinical aspects of hypokinetic dysarthria and typical features of voice disorders in Parkinsons disease.

Voice and speech parameters

Gamboa et al and Ramig et al fail to detect any statistical difference between patients with PD and healthy controls

ATRI: amplitude tremor intensity index DVB: degree of voice break F0: fundamental frequency Fatr: amplitude tremor frequency Fftr: fundamental frequency tremor frequency FTRI: frequency tremor intensity index jitter: frequency perturbation MPT: maximum phonation time NHR: noise to harmonic ratio PD: individuals with Parkinsons disease shimmer: amplitude perturbation vF0: fundamental frequency variation VTI: voice turbulence index.

What Alternative Communication Devices And Tips Can Help With My Voice And Speech Problems

If you have difficulty speaking, are frustrated and stressed by your inability to communicate or tire from the efforts to speak, consider the following devices and methods to be better understood:

• Amplification: This could be a portable personal amplifier or a telephone amplifier that can be used to increase vocal loudness in soft-spoken people. The amplifier also decreases voice fatigue.
• TTY telephone relay system: This is a telephone equipped with a keyboard so speech can be typed and read by a relay operator to the listener. Either the whole message can be typed or just the words that are not understood.
• Low-technology devices: Paper-based books and boards, alphabet boards and typing devices are examples of low technology assistive methods.
• High-technology electronic speech enhancers, communication devices: Computers with voice synthesizers and speech generating devices are available. Talk to a speech-language pathologist about the available high technology devices best suitable for your needs.

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Gender Affirming Voice And Communication Services

Anyone, regardless of gender identity, may benefit from voice therapy. Voice therapy is beneficial for transgender or non-binary people who feel uncomfortable with their voice. We can tailor voice therapy interventions to your needs. We have experience working with transgender women, transgender men, non-binary people, and a wide range of people along the gender spectrum. We can help transgender and non-binary people adapt their voices and communication patterns to match their gender identity.

Our assessment involves a thorough interview and vocal analysis using state-of-the-art instrumentation. Our treatment program will be based on each clients desires, needs, and goals. Our therapy approach involves exercises, materials, real-life practice suggestions, objective feedback, and a set of tools to help clients reach their personal communication goals. Treatment can address vocal characteristics, such as pitch and intonation, and nonverbal communication patterns, such as gestures and facial expressions.

Do Swallowing Problems In People With Parkinsons Disease Also Affect Speech

Swallowing problems are a common problem in people with Parkinsons disease. They can occur at any stage of the disease, can change throughout the disease course and often get worse as symptoms progress. Let your healthcare provider and/or speech-language pathologist know as you notice you are having swallowing problems. Symptoms of swallowing problems include drooling, choking, coughing, difficulty taking pills, taking a long time to eat, weight loss and dehydration. The most serious complication of a swallowing problem–and the reason why you should see your provider right away– is aspiration. Aspiration is when food or liquid goes into your windpipe , then passes down into your lungs, which can lead to aspiration pneumonia.

Although swallowing problems may not directly affect your speech, swallowing problems and voice and speech problems often occur at the same time.

A note from Cleveland Clinic

Voice and speech difficulties are common problems in people with Parkinsons disease, especially as the disease worsens. These problems affect your ability to communicate in the work setting and with family and friends which affects the quality of your life. Fortunately a speech-language pathologist can develop an effective treatment program to help improve your ability to communicate.

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Paradoxical Vocal Cord Dysfunction

Paradoxical vocal cord dysfunction or VCD is a condition which leads to shortness of breath or stridor . VCD is often mistaken for asthma, but it does not typically respond to asthma medications. Often the person with VCD feels as if their airway is closing or partially closing and is to get air in. In some cases the throat feels squeezed tight on both breathing in and out. During normal breathing, the vocal cords, which sit at the top of the airway, open to allow air to flow freely in and out of the lungs. During a VCD attack, the airway becomes temporarily narrowed due to the vocal cords partially blocking the airway. The shortness of breath is caused by movement of the vocal cords toward each other during the breathing cycle. VCD often occurs in teenage athletes, but can occur at any age. In adults, the symptoms are most often triggered by environmental irritants. There are often feelings of panic and anxiety associated with the attacks due to the sensation of being unable to breathe. Though the sensation of not being able to breathe is very frightening, VCD is typically a functional disorder and may successfully respond to treatment.

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What Type Of Healthcare Professional Helps People With Speech Problems From Parkinsons Disease

If you have speech and voice problems, see a speech-language therapist. Your primary healthcare provider can help you find a therapist in your local area. Some speech-language pathologists have specialized training that focuses on training people with Parkinsons disease to amplify their voice. This is called the Lee Silverman Voice Treatment.

Speech-language therapists are specifically trained to diagnose and treat speech, language and swallowing disorders. If you have Parkinsons disease, a speech-language pathologist can help you:

• Maintain as many communication skills as possible. Teach you techniques to conserve energy, including using nonverbal communication skills.
• Introduce you to assistive devices and techniques to help improve your communication.
• Recommend exercises to help you improve muscle strength and movements needed to improve your speech and communication options.

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If My Voice Is Hoarse When Should I See My Doctor

You should see your doctor if your voice has been hoarse for more than three weeks, especially if you haven’t had a cold or the flu. You should also see a doctor if you are coughing up blood or if you have difficulty swallowing, feel a lump in your neck, experience pain when speaking or swallowing, have difficulty breathing, or lose your voice completely for more than a few days.

What Are The Treatments For Hoarseness

Treatment of hoarse voice varies depending on the condition causing the persons symptoms. Some of the common treatment options for hoarseness include:

• The voice should be rested for a few days, and one should avoid shouting, talking too much, or even whispering as this may lead to more strain on the vocal cords.
• Drinking a lot of hydrating fluids helps in moistening the throat and relieving the symptoms of a hoarse voice.

• Alcohol and caffeinated drinks consumption should be avoided as it may lead to the dryness of the throat and worsening of hoarseness.
• A De-humidifier can be used to decrease the moisture content of the air. This helps in the opening of the airways and easy breathing.
• Taking a hot shower will help in opening the airways.
• Quitting smoking will prevent any dryness or irritation to the throat.
• The throat can be moistened by chewing gum or sucking on the lozenges. This helps in the stimulation of the saliva and soothing the throat.
• Allergens should be eliminated from your environment as they can either trigger or worsen hoarseness.
• If there are nodules or polyps on the vocal folds, surgery may be recommended.

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What Is The Treatment For Hoarseness

The treatment for hoarseness depends on the underlying cause, for example:

• Acute laryngitis caused by an upper respiratory tract infection will usually improve on its own as the infection clears the body. Conservative treatment with coughsuppressants and humidified air can be helpful.
• Voice rest is also recommendedin order to avoid further irritation or injury to the vocal cords.
• Antibiotics are not indicated for most cases of acute laryngitis.
• Smoking cessation is suggested for those individuals that smoke.
• Individuals with hoarseness caused by vocal overuse or misuse should adhere to voice rest, as serious injury (such as vocal cord hemorrhage can occur to the vocal cords if the voice is strenuously used during episodes of acute laryngitis.
• Medications for gastroesophageal reflux or allergies can treat hoarseness if either of these is found to be the underlying cause.
• In some instances, surgery may be necessary for benign nodules or polyps, trauma to the larynx/vocal cords and for cancer of the larynx.

Speech And Communication Problems

Speech and communication problems are common for people with Parkinsons.

They can include problems with your voice, body language, making conversations and small handwriting. But with the right help and support there are lots of ways you can improve any symptoms.

Changes in the brain in people with Parkinsons mean that your movements become smaller and less forceful than before. This can lead to problems with your speech and communication.

Issues may relate to making sure your voice is loud enough, making your pronunciation clear enough and getting the right tone to your voice.

Problems creating movements that are powerful enough can also affect chewing and safe swallowing. Because of this you may find mealtimes more difficult, with an increased risk of food going down the wrong way.

Find out more: see our information on eating, swallowing and saliva control.

Other communication issues in people with Parkinsons are linked to the way you think. Brain changes mean you may not be able to process thoughts as quickly as you need to.

This includes difficulty finding the right words you need or understanding what other people mean straight away. It also includes problems getting your thoughts together quickly enough to respond to someone in the flow of a conversation. In particular, this can happen when you have to do several different things at once .

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Articles On Physical Problems With Dementia And Alzheimer’s

• Fever

Voice and speaking problems are common in people who have Alzheimerâs disease. Voice problems are different from speaking problems in some important ways. Voice problems are often mild and can be treated at home, but sudden speech problems are more likely to need urgent medical care.

Voice problems are caused by changes in a personâs vocal cords or throat muscles. This might make it hard for someone to talk because their voice is weak, hoarse, scratchy, or raspy. This is called dysphonia. Causes of voice problems include:

Speaking problems are caused by changes in a personâs brain that make it hard for them to understand what is said, figure out what to say, and put the right words together. Someone with these issues may find it hard to remember words. They may also be hard to understand, slur their words, repeat the same sound , or say one word when they mean another. Sometimes theyâre unable to speak at all. They have several causes:

What Are The Causes Of Hoarseness

The causes of hoarseness include:

• Non-cancerous vocal cord nodules: These are benign or non-cancerous growths that form on the vocal cords
• Polyps on the vocal folds
• Vocal cord paralysis: It is a condition in which one or both of the vocal cords are not able to move
• Gastroesophageal reflux disease : It is a chronic digestive disorder in which the contents of the stomach go back up into the food pipe leading to acidity and heartburn

• Lowering of voice
• Sleeping problem due to coughing

If you are at risk of a throat infection, you should contact your doctor without any delay.

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How Is Hoarseness Treated

Treatment depends on the condition causing the hoarseness. The conditions and their treatments include:

• Using your voice too much. Rest your voice . Drink water.
• A cold or sinus infection. Let the common cold run its course, or take over-the-counter cold medicines.
• Laryngitis. Talk to your healthcare provider. You may be prescribed antibiotics or corticosteroids.
• Gastroesophageal reflux . There are a variety of treatment options for GERD, including antacids and proton pump inhibitors.
• Vocal fold hemorrhage. Voice rest.
• Neurological diseases and disorders. There are a variety of treatment options for each neurological disease and disorder.
• Vocal nodules, cysts and polyps. Dietary changes and voice therapy with a speech-language pathologist. Surgery is sometimes recommended.
• Vocal fold paralysis. A simple procedure performed by an ENT may push a paralyzed vocal fold back towards the center, or a more complicated surgery may be necessary.
• Laryngeal cancer. Treatment options include radiation therapy, chemotherapy, immunotherapy and surgery.
• Recurrent respiratory papillomatosis . Like nodules, papillomas are benign growths. Procedures are done to remove the growths and make sure your airways are clear.
• Muscle tension dysphonia. Treatment options observation or voice therapy with a speech-language pathologist.

Speech And Voice Disorders In Parkinsons

There are several reasons people with PD have reduced loudness and a monotone, breathy voice. One reason is directly related to the disordered motor system that accompanies PD, including rigidity, slowness of movement and tremor. For example, the poor muscle activation that leads to bradykinesia and hypokinesia in the limbs can translate to the muscles involved in speech. These problems with muscle activation can result in reduced movements of the respiratory system , larynx and articulation .

Another cause of speech and voice impairment in PD is a change in sensory processing that is related to speech. It is believed that people with PD may not be aware that their speech is getting softer and more difficult to understand. When people in this situation are asked to bring their voice to normal loudness, they often feel as though they are shouting, even though they are perceived by listeners to be speaking normally

Another cause of this condition is that people with PD may have a problem with cueing themselves to produce speech with adequate loudness. Individuals with PD can respond to an external cue , but their ability to cue themselves internally to use a louder voice is impaired. These problems can be frustrating both for the person and for the family.

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Few Techniques To Keep Speech & Voice Strong For Parkinsons People

Exercise No: 1

• Sit or stand tall & then you inhale through your nose, feel your ribs and belly expand as you fill your lungs with air.
• Continue to take several deep breaths from your diaphragm. The diaphragm is a large main muscle located at the base of the lungs and plays a vital role in the breathing process. Abdominal muscles help move your diaphragm.
• Exhale gradually through your mouth as you are blowing out a candle.

Exercise No: 2

• Take a deep breath and then push from your diaphragm as you say, AH for minimum of 15 seconds. You just feel that your voice fills the room. Now You push from your diaphragm & say each sound for at least 15 seconds.
• Next step, first take a deep breath and then slide up and down your pitch range by first saying OH and then EE. Continue to alternate between these two sounds for 30 seconds.

Exercise No: 3

Exercise No: 4

• Say Hi /Hello in a soft voice
• Now say Hi /Hello in your COMFORTABLE LOUD voice.
• Now take in a deep breath and say hi/hello in your LOUDEST VOICE.

Exercise No: 5

• To improve your voice for speaking, you will need to exercise it on a regular schedule. Warm your voice before using it extensively, but also practice vocal exercises twice per day for the best results. Try setting aside 15 minutes to do vocal exercises when you wake up. Then do them again before you go to bed, such as while you are making dinner or taking a bath.

Exercise No: 6

Say the following longer sentences in a loud and clear voice

Exercise No: 7