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Lee Silverman Voice Treatment (LSVT)






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Lee Silverman Voice Treatment (LSVT). An intensive treatment program for individuals with Parkinson’s Disease Presented by: Laura Dinges. Characteristics of Parkinson’s Disease. Affects both speech and voice Exhibits common form of hypokinetic dysarthria Decreased loudness Monotone
Lee Silverman Voice Treatment (LSVT)

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Slide 1

Lee Silverman Voice Treatment (LSVT)

An intensive treatment program for individuals with Parkinson’s Disease

Presented by: Laura Dinges

Slide 2

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

Slide 3

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

Slide 4

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

Slide 5

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

Slide 6

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

Slide 7

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

Slide 8

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

Slide 9

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

Slide 10

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.


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