Lee Silverman Voice Treatment (LSVT)

Lee Silverman Voice Treatment (LSVT)

Lee Silverman Voice Treatment (LSVT) An intensive treatment program for individuals with Parkinsons Disease Presented by: Laura Dinges Characteristics of Parkinsons Disease

Affects both speech and voice Exhibits common form of hypokinetic dysarthria Decreased loudness Monotone Vocal tremor Hoarseness Rapid rate of speech 2 LSVT background

1st effective treatment for voice and speech disorders of people with Parkinsons Disease (PD) Developed in 1987 by Dr. Lorraine Ramig and Carolyn Mead, both speech-language pathologists Named after one of the 1st patients to receive treatment 3 LSVT background (cont.) Began as a treatment program for PD, now includes other neurological disorders Intensive behavioral treatment is 4 days a week for 4 weeks (16 sessions)

Patients also asked to practice at home 4 LSVT techniques Techniques intended to help patients with PD increase intelligibility and vocal loudness Program emphasizes loud speech 5 basic concepts of program:

Think loud; Think shout Speech effort has to be high Must be intensive treatment Must be able to recalibrate loudness level Quantifiable improvements over time 5 Additional Information on LSVT Program targets immediate improvement following treatment and also on developing skills for longterm maintenance.

Must be trained and certified s-lp to administer treatment 400+individuals with PD have been successfully treated in efficacy research studies Approx. 90% of patients with PD improve from treatment 6 PET brain images and LSVT Study from Neurology journal by Liotti and colleagues (2003) Looked at brain activity before and after voice treatment with LSVT using PET images

5 patients with mild to moderate PD and speech disorders; 5 healthy subjects PET images produced in 5 patients with PD during phonation and reading exercises before and after a cycle of LSVT 7 PET brain images and LSVT (cont.) 5 healthy subjects-images generated during same activities Before treatment: In patients with PD, motor and pre-motor cortex activated (voluntary effort)

In healthy subjects, automatic circuits activated, especially basal ganglia After treatment, patients images appeared more similar to healthy individuals images 8 Summary 1.5 million people are diagnosed with PD in the US Individuals with PD often exhibit certain speech and voice characteristics LSVT-1st effective treatment Techniques: increase loudness and improve

intelligibility Many people with PD have been successfully treated with this program 9 References Cleveland Hearing & Speech Center (2003). Fact sheet: Parkinson Disease and the Lee Silverman Voice Treatment. Received on March 27, 2003, from http://www.chsc .org/Online_Press_Room/LSVT Fact Sheet.pdf Lee Silverman Voice Treatment Organization (n.d.). Lee Silverman Voice Treatment facts. Retrieved on March 27, 2003, from http://www.lsvt.org/main_site.htm Liotti, M., Ramig, L.O., Vogel, D., New, P., Cook, C.I., Ingham, R.J., Ingham, J.C., & Fox, P.T. (2003). Hypophonia in Parkinsons disease: neural correlates of voice treatment

revealed by PET. Neurology,60(3), 432-440. Stemple, J., Klaben, B.G., & Glaze, L.E., (2000). Clinical Voice Pathology: Theory and Management. (3rd edition). Singular Publishing. 10

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