A El Sharkawi1, L Ramig2,4, J A Logemann1, B R Pauloski1, A W Rademaker1, C H Smith1, A Pawlas4, S Baum3 and C Werner2
1 Northwestern University, Evanston, Illinois, USA
2 University of Colorado, Boulder, CO, USA
3 University of Colorado Health Sciences Center
4 Wilbur James Gould Voice Research Center, Denver Center for the Performing Arts, Denver, CO, USA
Dr J A Logemann, Northwestern University, Department of Communication Sciences and Disorders, 2299 North Campus Drive, 3–358 Evanston, Illinois 60208, USA;
Objective: To define the effects of Lee Silverman Voice Treatment(LSVT® on swallowing and voice in eight patients with idiopathicParkinson’s disease.
Methods: Each patient received a modified barium swallow (MBS)in addition to voice recording before and after 1 month of LSVT®.Swallowing motility disorders were defined and temporal measuresof the swallow were completed from the MBS. Voice evaluationincluded measures of vocal intensity, fundamental frequency,and the patient’s perception of speech change.
Results: before LSVT®, the most prevalent swallowing motilitydisorders were oral phase problems including reduced tonguecontrol and strength. Reduced tongue base retraction resultingin residue in the vallecula was the most common disorder inthe pharyngeal stage of the swallow. Oral transit time (OTT)and pharyngeal transit time (PTT) were prolonged. After LSVT®,there was an overall 51% reduction in the number of swallowingmotility disorders. Some temporal measures of swallowing werealso significantly reduced as was the approximate amount oforal residue after 3 ml and 5 ml liquid swallows. Voice changesafter LSVT® included a significant increase in vocal intensityduring sustained vowel phonation as well as during reading.
Conclusions: LSVT® seemingly improved neuromuscular controlof the entire upper aerodigestive tract, improving oral tongueand tongue base function during the oral and pharyngeal phasesof swallowing as well as improving vocal intensity.