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Wednesday, April 18, 2018

Ask the Expert: For Parkinson’s patients, speech therapy can improve quality of life

Allison Fancher  April 18, 2018

Allison Fancher, M.A., CCC-SLP, is a speech-language pathologist with IU Health Ball Memorial Rehabilitation Services. For more information, visit https://iuhealth.org/find-medical-services/physical-therapy-rehabilitation or call 765.751.2555.



Parkinson’s disease impacts more than 10 million people worldwide. In addition to the common motor symptoms of Parkinson’s such as tremor, slow movements and balance problems, a person may also develop changes in speech and/or swallowing. 

How can speech therapy help people with Parkinson’s disease?

Speech-language pathologists specialize in treatment of speech, language, cognitive and swallowing disorders. Common complaints from individuals with Parkinson’s disease include:
  • Weak, quiet voice
  • Decreased speech intelligibility (clarity)
  • Swallowing difficulties
  • Impaired cognition/memory

What treatments are available for speech disorders?

Individuals with Parkinson’s disease may suffer from dysarthria, a condition in which the muscles used for speech are weak or difficult to control. This can result in speech that sounds slurred or muffled, impacting ability to be understood by others. Speech-language pathologists can create a treatment plan for the management of dysarthria.  This treatment plan may include exercise, compensatory strategy training and/or caregiver training. Each treatment plan is individualized to ensure effectiveness for the individual with Parkinson’s disease.

What treatments are available for voice disorders?

A common complaint from individuals with Parkinson’s disease is that friends and family struggle to understand speech due to low vocal volume. The Lee Silverman Voice Therapy program (LSVT LOUD) is available for individuals with Parkinson’s or other neurological conditions who struggle to be understood. LSVT LOUD is an evidence-based treatment protocol designed for individuals with PD.
The program consists of four weeks of intensive, high-effort intervention focused on vocal loudness. LSVT LOUD improves vocal loudness by stimulating the muscles of the voice box (larynx) and speech mechanism through a systematic hierarchy of exercises.  People who complete LSVT LOUD note improvements in vocal loudness, articulation and speech intelligibility (clarity), intonation and facial expression. 

What treatments are available for people who have difficulty swallowing?

People with Parkinson’s may experience dysphagia, or difficulty swallowing. This can present in many ways, including a sensation of food “sticking” in the throat, cough with food and liquid intake, or difficulty chewing solid foods. 
A speech-language pathologist can evaluate the safety of the swallow, as well as deliver recommendations for treatment. Effective intervention for dysphagia may include exercise, compensatory strategy training, and/or dietary modifications.  Instrumental assessments such as videofluoroscopic swallow study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES) can also be utilized as needed to assess swallow function.

How can speech therapy help with cognition and memory?

Persons with Parkinson’s may experience difficulties with cognitive abilities such as difficulty with multitasking, problems with processing information, and decreased recall.  Speech-language pathologists provide education to individuals and family members for use of internal and external compensatory strategies that can improve the individual’s ability to recall information and safely complete activities of daily living. Cognitive exercises can also be prescribed as appropriate to increase cognitive demand; some studies suggest this may slow cognitive decline.
If you are experiencing speech, swallowing, and/or cognitive impairments as a result of Parkinson’s disease, you may ask your doctor for a referral for outpatient speech therapy.  A speech-language pathologist can evaluate your current level of functioning and create a treatment plan that is individualized and focused on your personal goals.

How can I learn more?

IU Health Ball Memorial Rehabilitation Services will host a free Parkinson’s seminar on Thursday, May 17 from 6:30 to 7:30 p.m. at 3300 W. Community Drive. Dr. John Wulff, neurologist with Neurology of Eastern Indiana, will discuss recent advances in treatments for patients with Parkinson’s disease. The seminar will also feature physical and speech therapists from IU Health Ball Memorial Rehabilitation Services who are specially certified in Parkinson’s rehabilitation treatments.

https://www.thestarpress.com/story/life/wellness/2018/04/18/ask-expert-parkinsons-patients-speech-therapy-can-improve-quality-life/523925002/

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