Lee Silverman Voice Treatment (LSVT) An intensive treatment program for individuals with...
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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.