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Tuesday, March 3, 2015

Helping Parkinson's patients be heard

ROBIN TRIMARCHI/rtrimarchi@ledger-enquirer.comSpeech-language pathologist Gary Waters at Columbus Speech & Hearing Center demonstrates the LVST LOUD computer program that assists patients with Parkinson's disease who have difficulty talking with enough volume to be heard. 
The four-week program helps patients to speak more loudly and hold enough volume to carry
 on a conversation.
ROBIN TRIMARCHI — rtrimarchi@ledger-enquirer.com 

lgierer@ledger-enquirer.comMarch 2, 2015 

Gary Waters pulled out a yellow measuring tape. He put one end to his mouth and the other to a laptop computer with microphone attached.
The distance was exactly 50 centimeters.
First, Waters spoke in what was little more than a whisper, seconds later, loud enough to be heard in the room next door.
All the time, the loudness and pitch of his speech was monitored on the computer screen with colored sections and moving graph lines.
Waters is director of speech-language pathology at Columbus Speech & Hearing Center on Double Churches Road in Columbus. He was demonstrating an element of the LSVT LOUD program, a speech treatment for people with Parkinson's disease and other neurological conditions.
Parkinson's disease is a progressive disorder of the nervous system that affects movement.
"Parkinson's debilitates throat muscles, so people are speaking quietly but don't even know it," Waters explained. "If they talk louder, a normal range, they think they are shouting."
He said it is not a hearing problem or a cognitive problem.
About 89 percent of people with Parkinson's disease will have problems with speech that begin early in the process and will progressively diminish their quality of life. These conditions are usually not helped by medicine or surgery.
Common speech problems include soft voice, mumbled speech, monotone speech and hoarse voice.
"It is hard for family members who have to constantly tell someone to speak louder," Waters said.
People can't hear them on the telephone.
The goals of the program are to improve vocal loudness and to improve speech intelligibility.
"When the person begins to speak louder, their articulation is better," Waters said.
LSVT LOUD was developed in 1987 by LSVT Global Inc. and has been scientifically studied for nearly 20 years with funding support from the National Institute for Deafness and Other Communication Disorders. The program is in use in 50 countries.
"It is a four-week program with the person coming to a one-hour session four days a week for a total of 16 sessions," Waters said.
It is a way they learn to increase loudness in a healthy way without straining the voice.
According to LSVT literature, the program improves voice and speech by treating the underlying physical pathology associated with the disordered voice. Vocal loudness is accomplished by stimulating the muscles of the larynx and speech mechanism through a series of exercises.
The treatment not only stimulates the motor system but also incorporates sensory awareness training to help people with Parkinson's disease recognize when their voice is too soft, convincing them the louder voice is within normal limits and making them comfortable speaking more loudly.
"We have them practice at home with phrases they use a lot. It can be 'I love you' or something about the dog," Waters said.
When an individual is at a session, they sit exactly 50 centimeters away from the computer.
"Some want to move forward or lean back but then we don't get a proper reading," Waters said.
He said during a session he is constantly telling them "louder, louder, louder."
A support group for those with Parkinson's Disease meets at the center and also at Midtown Medical Center.
He said that in addition to the sessions, a computer program for home use is also available. Waters said most of the clients are referred to the center by a neurologist.
"Once someone learns to control their own voice, their quality of life improves," Waters said.

http://health.einnews.com/article/252738250/XrcVtxpU-2lEE-AK

ead more here: http://www.ledger-enquirer.com/2015/03/02/3593519_helping-parkinsons-patients-be.html?rh=1#storylink=cpy

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