MT & Speaking Voice in Parkinson’s Disease
Speaking voice is an area of concern for many individuals with Parkinson’s Disease since being able to communicate makes a real difference in our daily quality of life. People with PD often experience softer voices and find it harder to talk to others, potentially leading to self-isolation and to lose of desire to attempt communicating with people around them. In this AMTA-Pro podcast, our MT-BC colleague Sarah Swann Solberg discusses some of these issues and overviews her research about the impact of music therapy interventions on improving the speaking voice of individuals with PD. Susan recommends continued research because of the potential significance on the quality of lives of over 10 million people worldwide currently diagnosed with Parkinson’s Disease.
[display_podcast]
Music Therapy and the Speaking Voice in Parkinson’s Disease
AMTA-Pro Podcast ~ July, 2020
Sarah Swann Solberg, MMT, MT-BC
— + —
According to the National Institute of Health (2010), nearly 500,000 people in the United States have PD with 70%-100% of people diagnosed with PD experience voice changes (ASHA, 2018). Speaking voice is an area of concern for many individuals with Parkinson’s Disease since being able to communicate makes a real difference in our daily quality of life. People with PD often experience softer voices and find it harder to talk to others, potentially leading to self-isolation and to lose of desire to attempt communicating with people around them.
The purpose of this research was to explore the impact of individual Neurologic Music Therapy (NMT) sessions on speaking voice and quality of life in individuals with Parkinson’s disease (PD). Individuals with PD have significantly decreased laryngeal functioning (Smith et al., 1995). Neurologic music therapy techniques have demonstrated the unique ability of music-based interventions to improve maximum phonation time, voice quality, and articulatory control in people with PD (Azekawa, & LaGasse, 2018). Improved communication in people with PD has been shown to improve daily quality of life and increase effective communication (Elefant, Baker, de Lotan, Lagesen, and Skeie, 2012). The dependent measures for this study were acoustic, perceptual, and quality of life metrics related to speaking voice. Data collection of acoustic measures and self-report measures were recorded before and after the 6-week NMT intervention protocol. In this podcast, Susan overviews the results of her research about music therapy interventions on improving the speaking voice of individuals with PD, and she recommends continued research because of the potential significance on the quality of lives of over 10 million people worldwide currently diagnosed with Parkinson’s Disease.
This research aligns with the following goals of the Music Therapy Research 2025 initiative:
o Define and describe the intervention using accepted standards of specification in published research and as part of research planning. When planning a research study, the music therapy intervention needs to be identified and specified by intervention and not just by the term “music therapy.”
o Conduct music therapy studies that focus on specific interventions for specific diagnoses/conditions. Numerous past published studies have commingled populations and conditions, especially in group music therapy settings.
o Partner with the health sciences field to conduct research, encourage team science, and secure lines of funding.
Bibliography
Ang, K., Maddocks, M., Xu, H., & Higginson, I. J. (2017). The effectiveness of singing or
playing a wind instrument in improving respiratory function in patients with long-term neurological conditions: A systematic review. Journal of Music Therapy, 54, 108–131: doi:10.1093/jmt/thx001
Azekawa, M., & Lagasse, A. (2018). Singing exercises for speech and vocal abilities in individual with hypokinetic dysarthria: A feasibility study. Music Therapy Perspectives, 36, 49-49. doi:10.1093/mtp/miw042
Bowen, L. K., Hands, G. L., Pradhan, S., & Stepp, C. E. (2013). Effects on Parkinson’s disease on fundamental frequency variability in running speech. Journal of Medical Speech-Language Pathology, 21, 235–244.
De Angelis, E. C., Mourão, L. F., Ferraz, H. B., Behlau, M. S., Pontes, P. A. L., Andrade, L. A. F. (1997). Effect of voice rehabilitation on oral communication of Parkinson’s disease patients. Acta Neurologica Scandinavica, 96, 199–205. doi:10.1111/j.1600-0404.1997.tb00269.
Dromey, C., Ramig, L. O., & Johnson, A. B. (1995). Phonatory and articulatory changes associated with increased vocal intensity in Parkinson disease: A case study. Journal of Speech, Language, and Hearing Research, 38, 751–764. doi:10.1044/jshr.3804.751
Elefant, C., Baker, F. A., Lotan, M., Lagesen, S. M., & Skeie, G. O. (2012). The effect of group music therapy on mood, speech, and singing in individuals with Parkinson’s disease – A feasibility study. Journal of Music Therapy, 49, 278–302: doi:10.1093/jmt/49.3.278
Fang, T., Hwang, W-J, & Chen, L-M. (2014). Speech disorders of voice quality, maximum sound prolongation, and s/z ratio in patients with Parkinson’s disease. Intergrams, 15, 1-22. doi: benz.nchu.edu.tw/~intergrams/intergrams/151/151-fang.pdf
Haneishi, E. (2001). Effects of a music therapy voice protocol on speech intelligibility, vocal acoustic measures, and mood of individuals with Parkinson’s disease. Journal of Music Therapy, 38, 2 73–290. doi:10.1093/jmt/38.4.273
Hoehn, M. M., & Yahr, M. D. (1967). Parkinsonism: Onset, progression, and mortality. Neurology, 17, 427–442. doi:10.1212/WNL.17.5.427
Hogikyan, N. D., & Sethuraman, G. (1999). Validation of an instrument to measure Voice-Related Quality of Life (V-RQOL). Journal of Voice, 13, 557–569. doi:10.1016/S0892-1997(99)80010-1
Ikui, Y., Nakamura, H., Sano, D., Hyakusoku, H., Kishida, H., Kudo, Y.,…Tanaka, F. (2014). An aerodynamic study of phonations in patients with Parkinson’s disease (PD). Journal of Voice, 29, 273–280. doi:10.1016/j.jvoice.2014.08.012
LSVT Global. (2018). What is LSVT Loud?. Retrieved from https://www.lsvtglobal.com/LSVTLoud
Matheron, D., Stathopoulos, E. T., Huber, J. E., & Sussman, J. E. (2017). Laryngeal aerodynamics in healthy older adults and adults with Parkinson’s disease. Journal of Speech, Language, and Hearing Research, 60, 507–524. doi:10.1044/2016_JSLHR-S-14-0314
Sackley, C. M., Smith, C. H., Rick, C. E., Brady, M. C., Ives, N., Patel, S., …. Clarke, C. E. (2018). Lee Silverman voice treatment versus standard speech and language therapy versus control in Parkinson’s disease: A pilot randomized controlled trial. Pilot and Feasibility Studies, 4, 1–10. doi:10.1186/s40814-017-0222-z
Shih, L. C., Piel, J., Warren, A., Kraics, L., Silver, A., Vanderhorst, V., … Tarsy, D. (2012). Singing in groups for Parkinson’s disease (SING-PD): A pilot study of group singing therapy for PD-related voice/speech disorders. Parkinsonism and Related Disorders, 18, 548–552. doi:10.1016/j.parkreldis.2012.02.009
Simberg, S., Rae, J., Kallvik, E., Salo, B., & Martikainen, K. (2012). Effects of speech therapy on voice and speech in Parkinson’s after a 15-day rehabilitation course: A pilot study. Internation Journal of Therapy and Rehabilitation, 19, 273–286. doi:10.12968/ijtr.2012.19.5.273
Smith, M. E., Ramig, L. O., Dromey, C., Perez, K. S., & Samandari, R. (1995). Intensive voice
treatment in Parkinson disease: Laryngostroboscopic findings. Journal of Voice, 9,
453–459. doi:0.1016/S0892-1997(05)80210-3
Thaut, M. H., & Hoemberg, V. (2015). Handbook of Neurologic Music Therapy. Oxford, UK:
Oxford University Press.
Yinger, O. S., & Lapointe, L. L. (2012). The effects of participation in group music therapy
voice protocol (G-MTVP) on the speech of individuals with Parkinson’s disease. Music
Therapy Perspectives, 30, 25–31. doi:10.1093/mtp/30.1.25
Zraick, R., Kempster, G. B., Connor, N. P., Klaben, B. K., Bursac, Z., & Glaze, L. E., (2011).
Establishing validity of the Consensus-Auditory-Perceptual Evaluation of Voice (CAPE-V). American Journal of Speech-Language Pathology, 20, 14–22. doi:10.1044/1058-0360(2010/09-0105
About the AMTA-Pro Podcast Speaker
Sarah Swann Solberg, MMT, MT-BC is a board-certified music therapist who received her bachelor’s degree in music from the Sunderman Conservatory at Gettysburg College and completed both the Master of Music in Vocal Performance and Master of Music Therapy degrees at Appalachian State University. She completed her internship in music therapy at Park Nicollet Medical Center in Minneapolis, Minnesota. Sarah has a particular interest in treating voice disorders that result from Parkinson’s disease and stroke and completed a thesis entitled “Neurologic Music Therapy to Improve Speaking Voice in Individuals with Parkinson’s Disease: A Multiple Case Study.” She is music therapist for Medi-Home Hospice in Watauga and Ashe Counties, NC.