lmahlerJoined: 02 Apr 2007Posts: 1
Posted: Fri Nov 09, 2007 12:12 pm Post subject: Voice, speech & swallow changes associated with PD
Speech, voice, and swallowing changes in PD are very common. About 89% of people with PD will experience a decrease in communication ability or swallowing at some point in the disease process. There are motor and sensory causes for these changes. Speech and voice characteristics typically include reduced loudness, hoarse voice quality, monotone, imprecise articulation, and vocal tremor. People with PD often think they are talking loud enough when they actually are speaking very softly or they may not be aware that they have swallowing problems. This misperception is due to sensory deficits in PD that contribute to decreased communication and swallowing problems. Sensory deficits can effect walking, writing, and posture, as well as voice, speech, and swallowing (Ho, Bradshaw, Iansek, & Alfredson 1999; Ho, Iansek & Bradshaw, 2000; Robbins, Logemann, & Kirshner, 1986). Medical management to improve the symptoms of PD includes pharmacological management and more recently neurosurgical procedures such as deep brain stimulation of the globus pallidus or subthalamic nucleus. Although there has been documented improvement in limb and axial symptoms with medical management, the improvement in voice, speech, and swallowing has not been demonstrated as consistently (Kompoliti, Wang, Goetz, Leurgans, & Raman, 2000; Trail, Fox, Ramig, Sapir, Howard & Lai, 2005). Therefore, there is a need for people with PD to receive efficacious behavioral treatment for voice, speech, and swallowing disorders. Motor and sensory deficits need to be addressed in treatment for long-term carryover to functional communication (Fox et al., 2002; Ramig et al., 2002). A study by Ramig et al., (2001) provided evidence for the efficacy of LSVT® and long term maintenance of positive treatment effects on voice and speech disorders in patients with PD for up to two years. Results from a preliminary study of eight people with PD demonstrated a spreading of effects of amplitude training to improving swallow function in addition to voice and speech (El Sharkawi et al., 2002). Talk to your doctor about getting a referral to a speech-language pathologist who has experience working with people who have PD. They can work with you and empower you to communicate effectively and swallow safely._________________Leslie Mahler, PhD, CCC-SLP Assistant Professor University of Rhode Island
Back to top
No comments:
Post a Comment