Objectives: To assess the clinical effectiveness of two speech and language therapy approaches versus no speech and language therapy for dysarthria in people with Parkinson's disease.
Design: Pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial.
Setting: The speech and language therapy interventions were delivered in outpatient or home settings between 26 September 2016 and 16 March 2020.
Participants: 388 people with Parkinson's disease and dysarthria.
Interventions: Participants were randomly assigned to one of three groups (1:1:1): 130 to Lee Silverman voice treatment (LSVT LOUD), 129 to NHS speech and language therapy, and 129 to no speech and language therapy. LSVT LOUD consisted of four, face-to-face or remote, 50 min sessions each week delivered over four weeks. Home based practice activities were set for up to 5-10 mins daily on treatment days and 15 mins twice daily on non-treatment days. Dosage for the NHS speech and language therapy was determined by the local therapist in response to the participants' needs (estimated from prior research that NHS speech and language therapy participants would receive an average of one session per week over six to eight weeks). Local practices for NHS speech and language therapy were accepted, except for those within the LSVT LOUD protocol. Analyses were based on the intention to treat principle.
Main Outcome Measures: The primary outcome was total score at three months of self-reported voice handicap index.
Results: People who received LSVT LOUD reported lower voice handicap index scores at three months after randomisation than those who did not receive speech and language therapy (-8.0 points (99% confidence interval -13.3 to -2.6); P<0.001). No evidence suggests a difference in voice handicap index scores between NHS speech and language therapy and no speech and language therapy (1.7 points (-3.8 to 7.1); P=0.43). Patients in the LSVT LOUD group also reported lower voice handicap index scores than did those randomised to NHS speech and language therapy (-9.6 points (-14.9 to -4.4); P<0.001). 93 adverse events (predominately vocal strain) were reported in the LSVT LOUD group, 46 in the NHS speech and language therapy group, and none in the no speech and language therapy group. No serious adverse events were recorded.
Conclusions: LSVT LOUD was more effective at reducing the participant reported impact of voice problems than was no speech and language therapy and NHS speech and language therapy. NHS speech and language therapy showed no evidence of benefit compared with no speech and language therapy.
Trial Registration: ISRCTN registry ISRCTN12421382.
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http://dx.doi.org/10.1136/bmj-2023-078341 | DOI Listing |
Int J Lang Commun Disord
December 2024
Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland.
Background: Key Word Signing (KWS) is one system that can be used to support the communication needs of children with Down syndrome (DS) who attend mainstream school. The success of KWS in schools is mediated by staff experiences and perceptions of KWS. The current study is one of the first to explore KWS use in mainstream schools.
View Article and Find Full Text PDFInt J Speech Lang Pathol
December 2024
Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, Hatfield, South Africa.
Purpose: The study aimed to explore speech-language pathologists' practices regarding image selection and use in the treatment of people living with aphasia. Images are widely utilised with people living with aphasia, however, supporting their communication optimally remains challenging.
Method: Ninety-two speech-language pathologists from South Africa, Australia, USA, and the UK completed a custom-designed online survey.
Neurophysiol Clin
December 2024
Department of Speech-Language Pathology, Federal University of Paraiba - UFPB, João Pessoa, PB, 58051-900, Brazil.
J Voice
December 2024
Department of Speech Therapy, School of Rehabilitation Sciences, Hamadan University of Medical Science, Hamadan, Iran.
Objectives: This study aimed to translate and evaluate the psychometric properties of the Children's Voice Handicap Index-10 for Parents (CVHI-10-P) in Persian for assessing voice-related quality of life in Persian-speaking children.
Methods: The CVHI-10-P was translated into Persian and assessed for face and content validity by a panel of speech-language pathologists. The questionnaire was administered to 141 children aged 6-11 years, including 35 with voice disorders and 106 without.
J Voice
December 2024
Centro de Estudos da Voz (CEV), São Paulo, São Paulo, Brazil.
Objective: To map the procedures and characterize the results of multidimensional voice assessment of individuals with sleep-related breathing disorders.
Method: This scoping review searched the MEDLINE, LILACS, Scopus, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, ProQuest, and MedRxiv databases, manually searched citations, grey literature, and consulted with experts. It included studies whose participants had sleep-related breathing disorders and underwent voice assessment.
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