Ultrasound Treatment Shows Promise For Managing Tremor
Positive results from a clinical trial of focused ultrasound therapy for tremor have been published in The New England Journal of Medicine.
Studies using focused ultrasound for Parkinsons are currently underway and if successful they could provide a non-invasive alternative treatment for people with Parkinsons.
Dr Beckie Port, Senior Research Communications Officer
Researchers at INSIGHTEC, a company with a focus on non-invasive surgical treatments, carried out a trial of their focused ultrasound treatment on 66 people with essential tremor and found significant improvements in hand tremor after 3 months.
Essential tremor is a type of uncontrollable shake or tremble in part of the body.
It is a separate condition to Parkinsons but this form of treatment may prove to be helpful for people with Parkinsons in the future.
Recommended Reading: Parkinsons And Boxing Connection
Speech And Sound Therapy
Parkinsons often affects speech, making it difficult for people to speak loudly, pronounce words clearly, speak fluidly, swallow and show facial expression.Dysarthria and dysphagia can make life difficult for people with Parkinsons. Both can be helped by seeing a speech therapist and by using sound therapy.
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.
Also Check: Does Ldn Help Parkinson’s
The Lee Silverman Voice Treatment
The Lee Silverman Voice Treatment is the first speech treatment for PD proven to significantly improve speech after one month of treatment.
- Exercises taught in the LSVT method are easy to learn and typically have an immediate impact on communication.
- Improvements have been shown to last up to two years following treatment.
- LSVT methods have also been used with some success in treating speech and voice problems in individuals with atypical PD syndromes such as multiple-system atrophy and progressive supranuclear palsy .
LSVT® Guidelines
- Must be administered four days a week for four consecutive weeks.
- On therapy days, perform LSVT exercises one other time during the day. On non-therapy days, perform LSVT exercises two times a day.
- Once you complete the four-week LSVT therapy, perform LSVT exercises daily to maintain your improved voice.
- Schedule six-month LSVT re-evaluations with your specialist to monitor your voice.
- If available in your area, participate in a speech group whose focus is on thinking loud.
- A Digital Sound Level Meter can help you monitor voice volume. Place the meter at arm distance to perform the measurement. Normal conversational volume ranges between 68-74dB.
What Does It Look Like
Gait in Parkinsons refers to changes in a persons ability to take usual, purposeful steps after developing the disease. Their movements may be slow and stiff. Although the specific presentation may vary among people, a persons steps will typically be smaller and shuffling in nature.
People also may have less arm swing, or arm swing may be absent altogether. There will be less rotation and movement of the torso. The feet will land flat on the floor rather than on the heel. Sometimes, the feet may feel stuck to the floor, a condition known as freezing.
When evaluating Parkinsons gait, a doctor will look for a few common symptoms. They may include:
- taking smaller steps than usual
do not yet know the exact cause of Parkinsons. The disease develops when nerve cells in a portion of the brain called the basal ganglia, that controls movement, become damaged or begin to die. The nerve cells in this region control movement.
In some cases, Parkinsons is hereditary, and experts have found links with specific genetic mutations in a few other cases. However, it does not generally seem to run in families. A combination of genetic and environmental factors is most likely responsible for the development of Parkinsons.
Parkinsons gait is the result of bradykinesia, or slow movements, which is one of the main symptoms of the disease. The brain is less able to process what would normally be automatic movements like swinging arms when walking or moving one foot after another.
Read Also: Brain Chip For Parkinson’s Disease
Mental Outlook Makes A Difference
According to Atwood you can always learn to live better with Parkinsons, since how you live with your illness comes from your mental outlook. You can do something about your mental outlook. Dont think that you are a burden.2
When a chronic illness happens, it affects the whole family, and each family member has to cope with the illness in some way. Dont devalue yourself it is a biological happening and not something to be ashamed of. Parkinsons, like ageing, is something that happens to you, not something you do.
Dont Miss: Cannabis Treatment For Parkinsons
Conventional Treatments For Pd Tremors
PD differs from ET in many respects, and is generally accompanied by multiple symptoms that progressively worsen. In PD, the brain cells that produce a neurotransmitter called dopamine are gradually destroyed. In turn, this diminishes muscle control, leading not only to tremors that occur at rest and during voluntary movement, but also to restricted range of motion, postural impairment, loss of balance and coordination, and cognitive deficits in many cases.
Currently, conventional tremor treatments for PD patients include a range of medications . Some patients experience eventual side effects such as dyskinesia, and over time, medications generally become less effective. Surgical procedures have helped many PD patients greatly reduce tremor, but these do not affect other PD-related impairments. Even so, patients for whom hand tremors greatly reduced their ability to function experience improved quality of life when surgical procedures are successful.
Also Check: Can Parkinson’s Cause Seizures
Strategies For Parkinsons Gait
A person with Parkinsons disease can improve the way they walk with targeted effort. Training that challenges motor and cognitive skills may have a positive effect on coordination.
What works for one individual may not work for another, so some trial and error may be necessary. A few strategies include:
Is Focused Ultrasound Right For You
If your tremor is impacting your quality of life and medicine isnt helping, then focused ultrasound may be an option for you.
This treatment works best for patients who:
- Have tremor symptoms that are worse or advancing faster on one side than the other.
- Take anti-coagulants or have other conditions that make options like deep brain stimulation dangerous. You and your doctor will decide if you should stop blood thinners before focused ultrasound.
- Do not want to have invasive brain surgery or commit to the ongoing adjustments that deep brain stimulation requires.
This treatment does not work for patients who:
- Cannot have an MRI due to implanted metallic devices , body weight greater than 300 pounds, or allergies to MR contrast agent.
- Have a high skull density ratio. About 15 percent of people have skulls too dense for this treatment.
- Have a history of abnormal bleeding, or conditions like advanced kidney disease, unstable cardiac disease, severe high blood pressure, or certain brain problems.
- Are unable to tolerate being still for the three-hour treatment.
You May Like: Best Medicine For Parkinson Tremor
Complementary Therapies For Pd
Complementary therapies are healing practices, performed in addition to standard treatments, with the goal of improving quality of life. My previous blog on art therapy and its use in Parkinsons disease introduced the concept of complementary therapies. Today, I will discuss complementary therapies more generally and also concentrate on music, dance and singing therapies that are used for PD.
As I have mentioned, some of the complementary therapies that are in use for PD include exercise/movement therapies such as boxing, yoga, and Tai chi, mindfulness techniques such as meditation, manual practices such as acupuncture and massage, and creative pursuits such as singing, music therapy, dance therapy, theater and art therapy.
Most of these complementary therapies have been formally studied in PD patients in some manner, although usually only in small groups of people. Dont see your therapy of choice mentioned? Dont worry the above list is not meant to be comprehensive and does not include every complementary therapy which has been studied in PD patients.
Speech Therapy And Pd
Research shows that 89 percent of people with Parkinsons disease experience speech and voice disorders, including soft, monotone, breathy and hoarse voice and uncertain articulation. As a result, people with PD report they are less likely to participate in conversation, or have confidence in social settings than healthy individuals in their age group.
Speech disorders can progressively diminish quality of life for a person with PD. The earlier a person receives a baseline speech evaluation and speech therapy, the more likely he or she will be able to maintain communication skills as the disease progresses. Communication is a key element in quality of life and positive self-concept and confidence for people with PD.
Recommended Reading: Orthostatic Hypotension Parkinson’s Disease Management
Effects Of Music Therapy On The Emotional Sphere
PD is a complex diagnosis commonly associated with motor dysfunction, but it is also known to encompass cognitive, psychiatric, and mood disorders. Music has been successfully used to address motor and non-motor symptoms. Morris administered two surveys to 19 people with PD and 15 people without PD to assess their subjective impressions and appraisals of music. They concluded that people with Parkinsons may perceive less of an automatic connection between music and activity than their healthy peers. In addition, those with PD may receive more pleasure and value from music than they anticipate. Taken together, these results suggest that people with PD may require encouragement to participate, as well as to the ability to choose familiar selections to better access music-based interventions and the benefits they may offer. This may facilitate adherence to therapy, as music is engaging and enjoyable , improves mood, depressive syndromes , and thus improves the quality of life for people with PD .
Introduction To Parkinsons Disease
Parkinsons Disease is a progressive disorder concerning the nervous system. It progresses gradually, often starting with a barely noticeable tremor in just one hand. But while tremors may be the most well known sign of Parkinsons Disease, the disorder also commonly causes a slowing or freezing of movement. Early on, friends and family may notice that your face shows little or no expression and your arms dont swing when you walk. Maybe your speech becomes soft and mumbling. Parkinsons symptoms tend to worsen as the disease progresses. Todays medical community say there is no cure for Parkinsons Disease and offer many different types of medicines that can treat its symptoms. In some cases, your doctor may suggest surgery. This is where we come in at Universal Sound Therapy we have developed a sound therapy session that is aimed helping your body heal itself and overcome the effects of Parkinsons Disease.
Have you tried every way possible to get rid of your Parkinsons Disease and still cant kick it. Has this disease got you stumped? Dont you think its time to try something new, something different like sound therapy? At Universal Sound Therapy, we have even taken away all the risk of buying one of our downloads. With our 90-Day Money Back Guarantee you have nothing to lose. Give our Universal Sound Therapy Healing Session on Parkinsons Disease a try.
Read Also: Pump For Parkinson’s Disease
Gait And Lower Limb Movement Therapy
This section is opened with a review article from Hackney et al., which provides a comprehensive introduction to the core theme of this research topic. The focus is on neural substrates used for internally and externally guided movement in healthy participants and PD patients. The compendium of articles presented in this review provides an overview of the possible functional basis for the efficacy of pace-based rehabilitation interventions and also identifies future directions that merit additional investigation. The next article by Ashoori et al. continues along this theme and takes an in-depth look at the subject of rhythmic auditory stimulation . The authors not only discuss the underlying mechanisms for its therapeutic power but also deliver a synopsis of the benefits stemming from RAS-based interventions and other technological innovations that enable the creation of online cues that are adapted to the needs of each patient. This article is supplemented by the work of Maculewicz et al. and presents a roundup of the technological solutions currently available that make use of instrumented footwear and that can also be used for RAS. We would like to redirect readers, who are interested in finding out more about the progress of health informatics in PD management, to the recently published article of Espay et al. .
Sensory Flicker As A Treatment
Dr. Singer and her colleagues in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University are developing a novel approach to treating the disease that involves light and sound pulsing at 40 Hz.
The idea is that the flickering sensory stimuli will entrain nerves deep within the brain to fire at the same frequency, which may, over time, restore their lost connectivity.
In murine models of Alzheimers, the researchers found that sensory entrainment at gamma frequencies leads to immune changes that clear beta-amyloid, a toxic protein associated with the disease.
However, the effects of this type of sensory flicker on the brains of people with Alzheimers are unknown.
The question also remained whether humans would tolerate the treatment and stick with the necessary daily regimen of sensory stimulation.
To test its safety and tolerability, Dr. Singers lab enrolled 10 participants with MCI associated with early Alzheimers.
They selected people with mild disease to ensure that they would be able to describe how well they tolerated the treatment.
In addition, they excluded anyone with a history of migraine, tinnitus, or seizures from the study because flickering sensory stimuli can exacerbate these conditions.
The researchers randomly assigned the volunteers to either 8 weeks of 1 hour of flicker treatment per day or 4 weeks without treatment followed by 4 weeks of treatment.
You May Like: World Parkinson’s Disease Day
Clinical Trials For Complementary Therapies In Pd
Just like they do for medications, clinical trials are also done for complementary therapies. Trials that test complementary therapies in PD can be conducted in a variety of ways, some more rigorous than others. Typically, patients are assessed for different outcome measures depending on the treatment. For example, a study of massage investigated the change in pain level as an outcome measure, whereas studies of acupuncture looked at changes in sleep and depression as outcome measures. The different types of treatments have not been compared to each other, so there is little way of knowing if one edges out the others in terms of effectiveness on any given measure.
In general, however, these modalities are low-risk and typically demonstrate improvement in either a motor or a non-motor symptom. Additional research with larger and more rigorous trials is needed, but it is exciting to realize that there are many possible therapeutic avenues to explore. It is also important to note that complementary therapies are typically not covered by insurance, so they may be out of financial reach for many people with PD. Increased research demonstrating the efficacy of these modalities is the first step in convincing insurance providers that these services are worth covering.
Tips and Takeaways
Tips For Coping With Speech Difficulties
- Exercise your voice by reading out loud or singing every day.
- Drink enough water, avoiding shouting and rest your voice when it is tired.
- Train your voice like an actorsit and stand with good posture, do exercises for articulation, breathing and projecting the voice.
- Get feedback from friends and family members about how others perceive your speech develop a cue or code word you can use in public to make you focus on speaking clearly.
- If you have soft speech, use tools such as a voice amplifier , placed on your shirt, and on the telephone . Ask an occupational therapist about other tools.
- Make eye contact with the person to whom you are speaking.
- Reduce background noise.
- Socialize in small groups or one-on-one.
- If you experience a facial masking, use feeling words to communicate your emotions . Use practice physical gestures to help convey emotions.
- Determine which times of day your speech is best. Plan social engagements around those times.
Even in the early stages of PD, many report that their voices are too soft, causing others to ask them to repeat themselves. Other people with PD may have a gruff or hoarse quality to their voice. Try these strategies:
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Dont Miss: Does Michael Bolton Have Parkinsons
Don’t Miss: Classic Signs Of Parkinson’s Disease
Sound Vibration Reduces Tremors
The bulk of acoustic-based intervention studies on PD report improvements in bradykinesia and speech functions using RAS. However, tremors are often the first symptoms in PD to be noticed. These can affect the hands, mouth, and limbs , impacting activities of daily living . Very limited studies to date have explored how acoustic-based interventions help reduce or control tremors.
To our best knowledge, tremor reduction is evidenced in studies applying Vibroacoustic therapy . VAT delivers passive low-frequency sound vibrations in contrast to RAS, the latter, an active form of acoustic therapy. In clinical settings, VAT supports the idea that patients should not only listen to music in isolation but sense vibrations as well . The VAT involves transducers embedded into chairs or mattresses, which send vibrations to and through the body. According to Punkanen and Ala-Ruona , the best combination for VAT is a combination of music, sound waves and therapeutic interaction, which allows therapists to address a patients mental and cognitive states, alongside motor function.