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Saturday, November 4, 2017

Speech treatment for Parkinson’s comes to area

November 4, 2017  Alyx Arnett

Newly-implemented program through St. Vincent only one offered in area

Richard Szep exercises his voice alongside Courtney Wisher, M.S., CCC-SLP, during a speech therapy session.


When Richard Szep was diagnosed with Parkinson’s disease in 2006, he already had begun to notice one of the symptoms some patients experience: reduced voice loudness.
His once-loud voice now was meek, monotone, and people were having trouble hearing him, which was frustrating to the former Delco engineer. But this year, 11 years into his diagnosis, he found some relief.
Szep was the second patient to partake in St. Vincent Kokomo’s recently-implemented LSVT Loud therapy program, an evidence-based speech therapy treatment for individuals with Parkinson’s disease. Upon completion, the results left him smiling and his wife able to hear him from the other room at home.
“It helped me hear myself, and the fact of the matter is when we speak we speak quite low. It’s not that we want to; it’s just what happens,” said Szep, 77.
Four days a week for four weeks, Szep sat down with Courtney Wisher, M.S., CCC-SLP, at St. Vincent’s rehab facility and went through the intensive program that required him to do voice exercises into a microphone. The microphone was connected to a program that tracked his volume and how many seconds he could hold saying “ah.”
He went through various other exercises, including one called “functional phrases” that required Szep to give Wisher 10 sentences he said on a daily basis. One of them was, “Where are my glasses?” By practicing those phrases in a loud voice, Wisher said it would internally cue him to use his “loud voice” at home or in a social environment.
“The program is all about the patient self-calibrating their loudness and changing the way they perceive their loudness. To you and me, it’s like, ‘You’re not talking loud enough.’ But to a patient with Parkinson’s, it’s like, ‘I am talking loud.’ They’re not, so it’s re-cueing their internal monitor,” said Wisher.
The program is focused on a single goal: to speak loudly.
The program also required Szep to complete homework by practicing the exercises at home. Szep’s wife, Susan, said when she’d hear Szep saying “ah” in the other room, she would shout it back at him.
“He said it made it more fun to know someone was hearing him,” said Susan.
At the end of the program, data showed great improvement from Szep. When he started, his baseline measurement for loudness was 63.5 dB SPL (decibel sound pressure level), and he tracked 4.4 seconds for a sustained “ah.” At the end of the program, his dB SPL was 83.4, and he finished with 8.6 seconds for a sustained “ah.”
“A two-decibel loudness increase is huge, and he doubled his time,” said Wisher. “He did amazing.”
In addition to helping with loudness, the program also is said to be an effective treatment for problems such as diminished facial expression and impaired swallowing. With the program being new to the area, Wisher said she’s looking forward to helping other Parkinson’s patients improve their quality of life.
However, Wisher noted the program isn’t for all Parkinson’s patients. Studies indicate the therapy is most effective for those in the mid to moderate stages of Parkinson’s. She encouraged patients who are interested to come in for an initial voice evaluation.
Susan said there’s a noticeable difference in Szep’s audibility following the program. Szep also attends the Rock Steady boxing program at the YMCA, and Susan said it was heartwarming to be able to hear him over all of the other boxers last week in his session.
“I could hear him about all the others. It was really great,” she said. “I just love the way this program is coming to help physically, mentally, in so many different ways.”
For more information on LSVT Loud, call Wisher at 765-236-8500. For information on the local Parkinson’s support group, call Susan, who facilitates the group, at 765-438-3508.
http://kokomoperspective.com/kp/lifestyles/speech-treatment-for-parkinson-s-comes-to-area/article_93a8f704-be61-11e7-9ac3-6339ef659968.html

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