Stefanie Countryman

Changes in vocal loudness following intensive voice treatment (LSVT®) in individuals with Parkinson's disease: A comparison with untreated patients and normal age-matched controls

This study assessed the impact of the Lee Silverman Voice Treatment (LSVT®) on vocal loudness [sound pressure level (SPL)] in a group of dysarthric individuals with idiopathic Parkinsons disease (IPD). Pre‐ to post‐treatment changes in SPL in the treated group were compared with changes in voice SPL during the same time in two control groups: individuals with IPD not treated with the LSVT® and in non‐disordered individuals, age‐matched to the patients. All subjects produced the same voice and speech tasks—sustaining vowel phonation, reading the “Rainbow Passage,” producing a short monologue, and describing a picture. These tasks were recorded at three different occasions: just prior to treatment, just after treatment, and 6 months following treatment. The individuals treated with LSVT® increased voice SPL from baseline to post‐treatment by an average of 8 dB and from baseline to 6 months follow‐up by an average of 6 dB. These changes were statistically significant and perceptibly audible. No significant changes in SPL were observed in the control groups during the time corresponding to the treatment and follow‐up. Differences in SPL between the treated and untreated patients at post‐treatment and follow‐up were statistically significant for all voice and speech tasks. These findings, along with others, provide additional support for the efficacy of the LSVT®. Mov. Disord. 16:79–83, 2001.

Intensive speech treatment for patients with Parkinson's disease Short- and long-term comparison of two techniques

The purpose of this study was to evaluate the long-term (12 months) effects of two forms of speech treatment on the speech and voice deficits that occur in Parkinsons disease. Thirty-five patients with idiopathic Parkinsons disease were assigned to one of two speech treatment groups: voice and respiration (The Lee Silverman Voice Treatment [LSVT]) or placebo (respiration) treatment. Vocal intensity data from before, immediately after, and at 6 and 12 months after speech treatment revealed statistically significant differences between the treatment groups. Only subjects in the LSVT group improved or maintained vocal intensity above pretreatment levels by 12 months after treatment. The placebo group had statistically significant deterioration of vocal intensity levels from before to 12 months after treatment during conversational monologue. The LSVT group did not deteriorate to levels below pretreatment in vocal intensity over the 12-month period. This study is the first to document the short- and long-term effects of intensive speech treatment (LSVT), which focuses on the voice, for patients with Parkinsons disease compared with a placebo speech treatment group. NEUROLOGY 1996;47: 1496-1504

Speech Loudness and Quality 12 Months after Intensive Voice Treatment (LSVT®) for Parkinson’s Disease: A Comparison with an Alternative Speech Treatment

Thirty-five individuals with idiopathic Parkinson’s disease were enrolled in speech treatment. Twenty-two were enrolled in a high-effort phonatory-respiratory treatment program (Lee Silverman Voice Treatment, LSVT®) and 13 were enrolled in a high-effort respiratory treatment program (RET). Perceptual judgments of speech loudness and quality were made independently by 6 listeners on recordings of the ‘Rainbow Passage’. These recordings had been obtained just before treatment (pre) and at 12 months’ follow-up (FU12). The speech samples in the LSVT group, but not in the RET group, were significantly more likely to be perceived ‘louder’ and ‘better quality’ at FU12 than at pre (p < 0.0001). These findings, along with others, suggest that the long-term effects of the LSVT are perceptible, clinically significant and treatment-specific.

Supraglottal Hyperadduction in an Individual With Parkinson DiseaseA Clinical Treatment Note

Recent treatment for voice problems associated with idiopathic Parkinson disease has primarily focused on increasing reduced vocal loudness and improving true vocal fold hypoadduction, common voice...

The effect of intensive voice therapy on speech and voice deficits in atypical Parkinson’s disease

Acoustic data were collected twice pre‐treatment, once post‐treatment, and 6 months post‐treatment on three atypical Parkinson’s disease patients following intensive voice therapy. Using a custom‐built software program, the following variables were measured: maximum duration of sustained vowel phonation and sound pressure level from sustained vowel phonation, a standard passage, and spontaneous speech. Using the C‐Speech application [Milenkovic, J. Speech Hear. Res. 30, 529–538 (1987)], fundamental frequency variability was measured from a standard passage and spontaneous speech. Single‐word intelligibility was calculated using naive listeners’ perceptions. The patients achieved statistically significant improvement on all variables post‐treatment but did not maintain improvement as a group during reading and spontaneous speech by the 6‐month data collection session. These results suggest the effectiveness of intensive voice treatment in atypical Parkinson’s disease as well as provide insight into the und...