Wednesday, September 21, 2022

Speech Therapy For Parkinson’s Disease Exercises

Voice Choral Singing Therapy

Parkinson’s Home Speech Therapy Workout

Voice Choral Singing Therapy uses music therapy to help patients increase their respiratory volume and reduce vocal fatigue. Research studying VCST has shown it can improve vocal intensity and intelligibility however, it does not provide significant improvements in functional measures of vocal quality.2

Medicare And The Therapy Cap Removal

Historically, Medicare has limited the amount of physical, occupational and speech therapy a beneficiary could receive each year. In some years, Congress created an exceptions process that allowed individuals to access therapy above the cap if the services were deemed medically necessary, but this process needed to be renewed by lawmakers every few years, creating uncertainty and the potential for coverage denials.

Q: I Read With Interest A Recent Study In Which You Compared Lsvt Outcomes In People Speaking Different Languages Can You Summarize Your Results What Ramifications Does This Have For Reaching Communities Which Traditionally Did Not Have Easy Access To Lsvt

A: There are more than 50,000 LSVT LOUD and LSVT BIG Certified Clinicians representing 78 countries in the world. This has opened the opportunity for research in many different countries and languages. This is particularly interesting related to LSVT LOUD and the impact of language on treatment outcomes. We were curious to examine outcomes from published research studies across these different languages to understand if there is a differential effect of LSVT LOUD. Our hypothesis was that there would not be, given LSVT LOUD is geared towards the underlying neurological deficits in PD .

While all the studies looked at different aspects of speech, voice or communication, the outcomes were comparable to what has been published for English speakers across these measures. For example, Spanish speakers improved speech intelligibility, Cantonese speakers improved loudness and intonation, but not lexical tone, Quebecois French speakers increased vowel space area as did German speakers. Persian speakers improved self-perception of voice and Japanese speakers had short and long-term improvements in vocal loudness. As such, it appears that the benefits from this treatment may be universal regardless of language background. Prospective language comparison studies are needed to further clarify these findings.

We hosted a webinar on this topic that people might find interesting.

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Lee Silverman Voice Technique

LSVT is a speech treatment that has been proven to significantly improve speech after one month. Results can last up to two years following treatment. The LSVT method is easy to learn and must be repeated four days a week for four consecutive weeks to be effective. After a four-week treatment period, LSVT exercises should be done daily to maintain the improvements achieved.

Q: Can You Tell Us About The Virtual Speech Therapist Under Development

A form of physical and speech therapy that

A: The virtual speech therapist is an extension of our current LSVT Companion® technology. The LSVT Companion is an FDA-cleared medical device that assists in the delivery of LSVT LOUD sessions. The virtual therapist adds a more humanistic avatar to the existing platform to further engage clients during vocal practice.

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Zoom Voice Group For Pwp

Cost: $60 / 6 weeks

Class: voice exercise

  • Monday: 11am

Duration: 60 minutes

Classes run in 6 week sessions with a break in between. Class size is limited. Registrants must commit to all 6 weeks. You can register for the class with the instructor, speech language therapist, Jocelyn Lagier, on her website, by phone , or by using this form and mail her a check for tuition.

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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Speech Therapy Helps Parkinson’s Patients

Treatment Teaches Patients to Speak Loud and Low

Two studies in the Feb. 11 issue of Neurology show that a classic speech therapy technique can actually reprogram the brain to help Parkinson’s patients speak more effectively, and a new modification of this technique can further improve their speaking abilities.

Researchers say about 89% of people with Parkinson’s disease have speech and voice symptoms, but only 3% to 4% of them receive speech treatment. Most people with Parkinson’s have soft voices because the disease makes it harder to force the necessary amount of air through the larynx or voice box to produce a normal speaking volume, and the vocal cords are often weakened and don’t vibrate adequately to produce sound.

Although drugs and surgery may improve other symptoms of Parkinson’s, these treatments usually do little to improve speech problems.

In the first study, researchers found evidence that a voice treatment frequently used to improve speech in Parkinson’s patients produced tangible changes in the brain in areas associated with motor skills.

Researchers from the University of Texas Health Science Center at San Antonio compared PET brain scans in Parkinson’s patients before and after a month of intensive voice and loudness training using the Lee Silverman method, which teaches patients to “speak loud, think shout.” They found a shift in brain activity that suggested a change from more effortful speech to a more automatic form of speech production.

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Parkinson’s Voice Project Practice Videos

Parkinson’s Disease Exercises: LSVT LOUD Vocal Therapy

Four Speak Out! practice videos, each with a different Parkinson’s Voice Project speech language pathologist .

Cost: $34.99/month or $349.99/year, first month free

Online post speech therapy maintenance with a speech language pathologist trained in either LSVT LOUD or Speak OUT!

Includes 15+ voice practice sessions per week as well as facial exercises, articulation practice, and more.

Publisher: LSVT Global, Inc. Cost: $28 for DVD or download $15/year streaming

Speech exercises for people with Parkinson’s Disease and other neurological conditions. Available in English and Cantonese.

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The Lee Silverman Voice Treatment

The Lee Silverman Voice Treatment LOUD 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.

    Notice To International Customers

    On July 1, 2021, new taxation rules come into effect as part of the European Unions Value-Added Tax eCommerce package. eCommerce merchants must now register, and tax physical goods exported to the EU prior to shipment or the tax is passed on to the customer.

    While we value our international customers, the new regulations are burdensome for a small company like ours. As a result, we are suspending physical product sales to Europe and Great Britain.

    Our downloadable Voice Aerobics® DVD and Breathwork videos are still available for purchase.

    Please view those products to learn more or contact us directly with questions.

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    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.

    The Cause Of Parkinsons Disease Is Related To The Lack Of Dopamine Being Created In The Brain

    Parkinson

    This can happen when the brain cells stop producing a very specific chemical or neurotransmitter known as dopamine. Dopamine is really important because its responsible for our coordination of our movement. An additional challenge is that its also responsible for our feelings of feeling motivated and rewarded.

    This is different than causes of dementia, or problems after stroke, but Parkinsons can also have an impact on cognition, along with the physical problems.

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    Improving Speech & Movement Through Lee Silverman Voice Treatment Programs For Parkinsons Disease

    People with Parkinsons disease often find that they have difficulty with their speech and their ability to be properly understood in conversation. Their voice may not be as loud, or their articulation as clear as it once was. They may speak in a monotone voice which does not convey the emotion that listeners expect to hear. When these communication issues are not addressed, problems can progress and significantly impact quality of life. People with PD may even limit their conversation with others, for fear of not being properly understood.

    The Lee Silverman Voice Treatment was first developed as a speech therapy modality to help people with PD combat these issues. It aims to recalibrate the perception of loudness that a person with PD has of their voice, prompting participants to speak at a more normal volume.

    More recently, the LSVT BIG® program was developed, applying similar principles to the size of movements that people with PD make. As PD progresses, movements tend to become smaller and smaller. LSVT BIG aims to recalibrate a persons perception of the size of their movements so that participants begin to move in larger, more intentional ways.

    What Emergency Type Devices Should A Person With Parkinsons Disease With Speech And Voice Problems Have At Hand

    To preparing for emergencies:

    • Use an intercom system or baby monitor to alert others that there is an emergency.
    • Use bells or buzzers if you are not able to speak. Use “codes” that signify urgency. For example, a tinkling bell might mean, “I’d like company,” while an air horn might mean there’s an emergency.
    • Carry a cell phone that is equipped with pre-programmed numbers. Preprogram all of your telephones so they can automatically dial the necessary emergency number.
    • Sign up for a “Life Call” button service if you spend time alone. Pressing a button on a device usually worn on the wrist or around neck signals a service company that alerts loved ones and/or your local emergency service.

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    Ways To Improve Speech In Parkinsons Disease

    5 min read

    Parkinsons disease is a neurodegenerative disorder that affects the motor neurons. As it progresses, the person with PD may become harder to understand as their voice becomes softer or hoarse. Their face may become more masked or expressionless, and their voice may sound monotone with less emotion. They may speak faster , mumble, or repeat . Together these symptoms are known as hypokinetic dysarthria.

    A speech-language pathologist is a specialist in communication disorders and can help a person with PD to speak more clearly and confidently. Here are 9 ways an SLP can help:

    There Are Two Popular Programs Offering Speech Therapy For Parkinsons Disease

    Parkinson’s Disease Exercises: LSVT BIG Movements

    The two most prevalent programs to help those with speech problems because of Parkinsons disease are LSVT Loud, The Lee Silverman voice treatment LOUD, and also Speak Out! Both of these are incredibly well researched.

    All of our Better Speech pathologists are able to be certified in these programs and techniques so that we can offer it to our clients in whole or in part.

    LSVT Loud speech therapy program for Parkinsons focuses more on actual articulation

    • This program is a bit more structured
    • Usually covered in four sessions at 60 minutes each week
    • Homework assignments for practice
    • Teaches clients to be loud and to communicate with projection.

    Speak Out! speech therapy program for Parkinsons focuses on the intent of communication.

    • This program has a little bit more flexibility
    • Usually covered in three sessions of 45 minutes each week
    • Homework assignments for practice
    • Focuses on the intent or reason for the communication

    Both of these programs include homework assignments to practice outside, which is really fantastic when but then you get to also take those techniques, those tools, those things that you learn and implement them in your everyday life. That way you can then be more functional in your communication, and start to enjoy communicating with those around you.

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    What Devices Can Help Speech For Those With Parkinson’s Disease

    Here’s a sample of the devices that are available to help people with Parkinson’s 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.

    Watching My Dad Lose Vocal Power Is Painful

    Speech changes, including dysarthria or difficulty speaking, are common in Parkinsons, affecting about 89% of those with the condition. Often, patients have hypokinetic dysarthria, characterized by a reduced voice intensity, problems articulating words, a hoarse voice, and a monotonous pitch.

    While these speech changes can affect a persons social and professional life, only 3% to 4% of those with such alterations take part in speech therapy to improve their ability to communicate, the researchers reported.

    Additionally, the success of such therapies requires intensive training and participants willingness to practice regularly at home, for which the essential motivation can be challenging.

    A pair of researchers in Portugal proposed a game-based way of practicing voice exercises for Parkinsons patients with hypokinetic dysarthria, designed to make and keep them motivated.

    Our proposal is to combine therapy, technology, feedback, and fun to motivate patients to practice the voice exercises regularly and at home, and to give them the appropriate feedback that allows them to understand their performance, the researchers wrote.

    Accessed as an app on a computer or mobile device and controlled by the users voice, the game involves three exercises commonly used in speech therapy and selected at the advice of speech therapists. Each has a particular focus on helping a person increase their vocal intensity, or ability to speak more loudly.

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    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:

    What If I Have An Emergency How Will I Communicate

    Pin by Neurological Surgery on Parkinson
    • Use an intercom system or baby monitor to alert others that there is an emergency.
    • Use bells or buzzers if you are not able to speak. Use “codes” that signify urgency. For example, a tinkling bell may mean, “I’d like company” while an air-horn means there’s an emergency.
    • Carry a portable phone that is equipped with pre-programmed numbers.
    • Pre-program all of your telephones so they can automatically dial the necessary emergency number.
    • Consider a “life call” button if you spend time alone.

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