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
- 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
See A Speech Therapist
Speech and language therapists are trained to diagnose and treat speech, language and swallowing difficulties. If youre living with Parkinsons disease, a speechie can help you:
- Maintain your communication skills
- Help you use non-verbal techniques to aid communication
- Improve your muscle strength and coordination using certain exercises
- Use assistive communication devices and techniques to make communication easier.
What Is The Cause
PD damages the nerves in the brain. It causes problems with movement and communication, including changes in speech. The exact way that PD causes speech and swallowing problems remains unclear.4,5
The nerve cells in the heavily damaged area of the brain produce dopamine. This is a chemical messenger that transmits signals to parts of the brain that help regulate smooth, purposeful movement.4
The muscles in the face, mouth, and throat also need to move to generate speech and help with swallowing. Doctors think that damage to dopamine-producing nerve cells leads to dysfunction in the movement of muscles involved in speech and swallowing, along with those in the trunk and limbs.4
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Choosing The Right Exercise Class For Parkinsons
When trying to find an exercise class to join, it can be hard to know which ones to try because there are many different types of classes that are marketed to people with PD. When you are evaluating a class, it is important to remember the following:
- It is the components of the exercise class that are important . You do not need to specifically do boxing or dance if you can achieve these elements of exercise in other ways.
- The instructor should have expertise in PD. APDA offers a training for fitness professionals which helps them better understand how to create exercise programs best suited for people with PD.
- The ratio of class members to instructors should be low enough to maintain safety.
- The class should be adaptable for people of different abilities and mobility. Many classes will offer seated options or other modifications.
It may take a few tries to find the types of exercise that suits you best so dont give up! Feel free to try different classes in your area to see what types of exercise appeal to you. It can also be motivating to take classes together with a friend or family member. You can hold each other accountable, and also have some fun together. As you find classes you enjoy, you can incorporate those modalities into your exercise schedule. For help in finding classes in your area, you can contact one of our Chapters or Information & Referral Centers. There are also many virtual classes that you can join from home.
As A Result Of Her Research Dr Cynthia Fox Helped Develop An Effective Approach To Speech Therapy Treatments For Parkinsons Disease
Dr. Cynthia Fox is the co-founder and Chief Executive Officer at LSVT Global, which oversees the LSVT LOUD and LSVT BIG programs. The mission of LSVT Global is to continue to develop and advance these programs, as well as to train speech, physical and occupational therapists around the world in these techniques so that they can positively impact the lives of their patients. Dr. Fox began her work with LSVT more than twenty years ago, conducting efficacy research on the voice techniques for PD. She subsequently worked closely on the development of the LSVT BIG program. She has numerous publications in these areas of research and has presented extensively around the world. Dr. Fox continues to serve as faculty for LSVT LOUD and LSVT BIG training and certification courses.
I had the privilege of talking with Dr. Fox about LSVT LOUD and LSVT BIG.
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Dual Task Training For Parkinson
Publisher: Triad Solutions, Inc.
Dual Task Training is combining speech therapy with physical movement and cognitive tasks. It has been shown to be the most comprehensive and fun type of speech therapy. This page has seven short dual task exercise videos plus one video of aquatic dual task training.
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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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.
Best Tips To Improve Voice Quality & Voice Exercises For Parkinsons Disease
Parkinsons disease people face changes in their voice or speech. It is a significant problem, causing difficulties in communication and not able to pronounce words clearly. Today, we have discussed Voice exercises for Parkinsons disease.
Parkinsons disease has affected the speech of the patient in many ways. Speech may be garbled. Speech may become monotone, lacking the ups & downs of voice. The speech problem worsens as the disease advances.
Sometimes the person faces difficulty articulating the right words, causing speech to be slower. In this circumstance, speech therapists can be helpful for people with PD who face speech difficulties.
The best part of the Speech therapist, they can teach several techniques that make stronger the voice. One of the techniques of speech therapists is LSVT.
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Speech Exercises For Parkinsons Make A Difference
One common health issue associated with Parkinsons disease is dysarthria , which is often accompanied by dysphagia .
This is because Parkinsons affects the muscles in the mouth and throat, causing speech impediments. While different individuals with Parkinsons experience difficulty speaking in different ways, most with the condition feel that speaking is more difficult even though their friends may not realize it.
If I Have Parkinsons Disease What Kind Of Speech And Voice Problems May I Experience
If you have Parkinsons disease, some of the voice and speech difficulties seen include:
- Softened voice. Reduced volume to your voice.
- Speaking in an unchanging pitch .
- Having a hoarse or strained quality to your voice.
- Having a breathiness to your voice. Breathiness in the quality of your voice that is easily heard by your listeners. It takes more effort and energy to speak. You run out of gas as you speak.
- Trouble clearly and easily pronouncing letters and words.
- Tremor in your voice.
- Using short rushes of speech.
- Loss of your facial expression.
If you have Parkinsons disease, you may not be aware of the problems with your spoken communication. Changes in the quality of your voice may be the first sign of speech problems followed by the inability to have fluid speech and clear and distinct speech sounds. Speech problems that are severe enough to reduce your ability to be easily understood usually do not occur until later in the course of Parkinsons disease.
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How Can Listeners Help People Who Have Difficulty Speaking And Communicating
Here are some ways friends and family of people with Parkinsons disease can ease speaking and communication difficulties:
- Talk to the person with Parkinsons disease face-to-face only, and look at the person as he or she is speaking.
- Ask questions that require a simple “yes” or “no” answer.
- Repeat the part of the sentence that you understood.
- Ask the person to repeat what he or she said, to speak more slowly or spell out the words you did not understand.
Speak Up For Parkinsons
This free app allows the patient/client to video-record themselves saying words or phrases, reading aloud or having a conversation. It has a volume target zone which turns green when the person is loud enough to reach it. The downside of this app is that you really do have to speak very loud to reach the green target zone. However, it is good for encouraging increased vocal effort and the video-recording can be used for client feedback on articulation, intelligibility and facial movement.
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Recommendations For Caregivers And Family
Cognitive therapy may help by modifying the way caretakers communicate with a patient. Recommendations for caregivers, family and physicians include:
- Avoid complex syntax. Do not use embedded clauses such as, My car, which is very old, is in the shop.” Sentences should be kept short when possible and pauses should be incorporated when long sentences are required.
- Avoid taxing word memory. Chunk information into smaller units whenever possible and wait for acknowledgment before proceeding. For example, phone numbers are not typically remembered in a long string of numbers, but rather 123-456-7890.
- Clearly delineate topics. Conversations should be structured so as to thoroughly discuss a single subject in a compartmentalized manner before shifting to a new and unrelated topic.
- Avoid reliance on emotional expressions. Do not rely on facial expressions to display emotions. Individuals with PD may have trouble recognizing emotional expressions such as a smile or a frown.
- Avoid using phrases with non-literal meaning. For instance, saying she hit the sheets instead of she went to bed can be confusing for the patient.
- Minimize distractions and background noise. A speaker should be oriented to face the listener. This will also help with understanding speech that may be impaired.
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.
For more insights on this topic, listen to our podcast episodeImportance of Early Detection of Swallowing Disturbances or download our Speech and Swallowing book.
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Why Speech Is Affected
One key to understanding speech therapy is to understand the muscle functions and other physical aspects that affect our speech. In the case of Parkinsons and many other conditions, the problem is muscular and not related to intellectual disability. By focusing on gaining as much control over the muscles in the throat that control speech and strengthening those muscles as much as possible, the individual with Parkinsons can begin to reclaim their speaking abilities to a surprisingly large extent.
If you have Parkinsons and are having trouble communicating, we encourage you to look into the possibility of speech therapy with a qualified professional.
The Emotional Toll Of Having Speech Problems From Parkinsons Is Also Challenging
You as a listener might be asking them Im sorry, say that again, or I cant hear you.And they as the speaker can become more frustrated because they feel like theyre repeating themselves. They also feel like theyre shouting or speaking loudly, but are still not being heard.
Because the lack of dopamine also impacts our feelings of worth, motivation and reward, its very easy for that frustration to become anger, anxiety, depression or hopelessness. So its really important to be aware of these characteristics, but its also really important to receive treatment early on.
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.
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What Devices Can Help Speech For Those With Parkinsons Disease
Heres a sample of the devices that are available to help people with Parkinsons disease communicate more clearly.
Palatal lift. A dental apparatus that is similar to a retainer. It lifts the soft palate and stops air from escaping out of the nose during speech.
Amplification. A personal amplifier can be used to increase the volume of the voice. The amplifier also decreases voice fatigue.
TTY telephone relay system. 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 can be typed.
Low technology devices. Notebooks and language boards can be used as alternative communication techniques.
High technology electronic speech enhancers, communication devices. Computers with voice synthesizers and dedicated communication devices are available.
If you are interested in purchasing an electronic communication aid discuss this with your speech therapist before contacting sales representatives for these devices.
Speech And Voice Changes In Pd
The underlying pathophysiological bases of voice, speech, and language changes in PD are complex. Voice quality changes, reduced loudness, loss of intonation variation, and imprecise articulation relate in part to rigidity and stiffness in the oral, laryngeal, and respiratory muscles.1215 However, stiffness and rigidity are insufficient to totally account for changes.
A crucial common denominator that appears to link impairment of articulatory movements, voice production, hand gestures accompanying speech, as well as many other non-communication related motor responses, concerns a failure to adequately scale the dynamics of movement to achieve the required range, force, and velocity, even though basic tone, power, and coordination are sufficient to do so.13,14 Further, pwPD exhibit reduced awareness of the extent and consequences of the under scaling. This appears associated with a deficit in central sensory processing.16,17 Thus, the pwPD is able to achieve adequate loudness, articulatory precision and emphasis when specifically asked to do soeven though increases in loudness may not match those that unaffected speakers make when asked to speak loudly.18,19 However, the pwPD may find it difficult to maintain these features during general conversation.
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