Focus of the Report: This report focuses on Lee Silverman Voice Treatment (LSVT) LOUD for the treatment of patients with speech and voice problems resulting from Parkinson disease (PD).
Technology Description: LSVT LOUD is an intensive voice therapy regimen that requires high patient engagement, effort, and adherence. A total of 16 (1-hour) sessions are conducted over a month with a certified speech language pathologist, with exercises that aim to maximize patient speaking volume, improve respiratory support during speech for steadier speech, and recalibrate the patient’s sense of loudness. Common LSVT exercises include sustained vowel phonation, describing a picture, reading from a standard passage, and holding a conversation or reciting a monologue. Efforts are made to include everyday phrases that the patient uses in order to incorporate real-world application practice.
Controversy: Historically, traditional speech therapy interventions for patients with PD have not yielded efficacious improvements. However, LSVT LOUD appears to have a consistent ability to instigate meaningful speech improvements in patients. Until recently, LSVT LOUD has had limited accessibility due to limited independence in patients with PD, a 16-day in-person commitment, the need for transportation arrangements for the 16 days, and geographical constraints or lack of speech language pathologists in certain localities. Lately, the emergence of telerehabilitation and an at-home software have offered the potential to improve accessibility, although it remains somewhat unknown if these options are capable of achieving the same level of efficacy as traditional LSVT.
Key Questions:
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Is LSVT LOUD effective for improving PD-related hypokinetic dysarthria?
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How does LSVT LOUD compare with other speech therapies for PD-related hypokinetic dysarthria?
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Is LSVT LOUD safe for the treatment of patients with PD?
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Have definitive patient selection criteria been identified for LSVT LOUD?
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