There is an extensive body of scientific evidence supporting the efficacy of the Lee Silverman Voice Treatment (LSVT) in individuals with progressive Dysarthria, specifically Parkinson’s disease. These studies have shown increased speech intelligibility, accuracy for various auditory speech features (Ramig, Bonitati, Lemke, & Horii, 1994; Sapir et al., 2003), and communication outcomes measures following the LSVT program (Countryman, Ramig, Pawlas, & Thompson, 1997).
Studies have revealed that increased loudness, the focus of LSVT, results in global improvements across the speech mechanism in individuals with Parkinson’s. These improvements include motor movements of the speech structures (Schulman, 1989), increased breath support (Dromey & Ramig, 1998), increased closure of the vocal folds (Scherer, 1991), slower speaking rate (Ramig et al., 1995), and increased motivation (Ho, Bradshaw, Iansek, & Alfredson, 1999).
The prescriptive nature of the LSVT also follows a number of principles of both motor learning and neural plasticity, which is a key factor contributing to its effectiveness in improving speech and communication in patients with Progressive dysarthria and Parkinson’s Disease. Motor learning is the change in an individual’s ability to perform a skilled task, as a result of practicing those tasks (Magill, 2004). Neural plasticity refers to the central nervous system’s capacity to change and adapt in response to a brain injury (Ludlow et al., 2008).
There has been great emphasis on the potential application and usefulness of applying principles of motor learning and neural plasticity in delivering Dysarthria treatment (Duffy, 2005; Ludlow et al., 2008). The high frequency and use of repetitive drills in LSVT provides the most advantageous exposure for learning and neural plasticity changes to occur (Schmidt & Wrisberg, 2004). The simple focus of ‘loud’ in the treatment as well as the repetitive nature of the tasks leads to positive feedback received by speakers regarding intelligibility and therefore facilitates an increase in experience-dependent plasticity (Fox et al., 2006).
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This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.
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References
Countryman, S., Ramig, L. O., Pawlas, A. A., & Thompson, L. (1997). Speech rehabilitation and short-term changes in satisfaction of employment in Parkinson disease: A preliminary multiple case study. NCVS Status and Progress Report, 11, 21-35.
Dromey, C, & Ramig, L. O. (1998). Intentional changes in sound pressure level and rate: Their impact on measures of respiration, phonation, and articulation. Journal of Speech, Language, and Hearing Research, 41, 1003-1018.
Duffy, J. R. (2005). Motor speech disorders: Substrates, differential diagnosis, and management (2nd ed.). St. Louis: Elsevier, Mosby.
Fox, C. M., Ramig, L. O., Ciucci, M. R., Sapir, S., McFarland, D. H., & Farley, B. G., (2006). The science and practice of LSVT/LOUD: Neural plasticity-principled approach to treating individuals with Parkinson disease and other neurological disorders. Seminars in Speech and Language, 27(4), 283-299.
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Ramig, L. O., Bonitati, C., Meacl, Lemke, J. H., & Horii, Y. (1994). Voice treatment for patients with Parkinson disease: Development of an approach and preliminary efficacy data. Journal of Medical Speech Language Pathology, 2(3), 191-209.
Sapir, S., Spielman, J., Ramig, L. O., Hinds, S. L., Countryman, S., Fox, C, & Story, B. (2003). Effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on ataxic dysarthria: A case study. American Journal of Speech-Language Pathology, 12, 387-399.
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Schmidt, R. A., & Wrisberg, C. A. (2004). Motor learning and performance: A problem-based learning approach. Champaign, IL: Human Kinetics.
Schulman, R. (1989). Articulatory dynamics of loud and normal speech. Journal of the Acoustical Society of America, 85, 295–312.
