Lee Silverman Voice Treatment (LSVT)

An intensive treatment program for individuals with Parkinson’s Disease

Presented by: Laura Dinges

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Characteristics of Parkinson’s Disease

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

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LSVT background

1st effective treatment for voice and speech disorders of people with Parkinson’s 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

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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

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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

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Additional Information on LSVT

Program targets immediate improvement following treatment and also on developing skills for long-term 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

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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

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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

  

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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

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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 Parkinson’s 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.