Title page for ETD etd-04052010-130458


Type of Document Master's Thesis
Author Michiels, Heidi Huckabee
URN etd-04052010-130458
Title Treatment Effect of Maximum Performance Speech Therapy for Individuals with Parkinson's Disease and Dysarthria
Degree Master of Arts (M.A.)
Department Communication Sciences & Disorders
Advisory Committee
Advisor Name Title
Donovan, Neila Committee Chair
Hoffman, Paul Committee Member
Kim, Yunjung Committee Member
Keywords
  • communicative effectiveness
  • Parkinson’s disease
  • dysarthria treatment
Date of Defense 2010-01-22
Availability unrestricted
Abstract
The Lee Silverman Voice Treatment (LSVT™) has received much attention in the past decade for its use in the treatment of individuals with Parkinson’s disease (Jones, 2005; Ramig, Countryman, O'Brien, Hoehn, & Thompson, 1996; Ramig, Sapir, Countryman et al., 2001; Wohlert, 2004). This intensive program requires therapy four times a week for four weeks in order to improve perceptual characteristics of the voice, such as loudness. However, since LSVT™ was introduced, the rehabilitation industry has experienced systematic reductions in allowable frequency and duration of covered services. The result has been that individuals often cannot qualify for the rigorous LSVT™ protocol (Centers for Medicare and Medicaid Services, 2008).

The present study followed the standard treatment protocol but manipulated the dose of treatment to determine if a reduced dose of treatment would be effective for individuals with PD (IwPD) and dysarthria. Our treatment schedule used frequency, intensity, and duration variables that more closely mirrored the current state of clinical practice (e.g., 45 minutes, 2 times per week for 8 weeks). Two IwPD participated in the study and demonstrated improvements in maximum vocal SPL, but these gains were not maintained at a 6-month follow-up. Treatment outcomes indicated improvement in body structure/function as evidenced by increased vocal SPL by both participants across all three speech tasks. Speech intelligibility scores and communicative effectiveness ratings also improved for one participant. Results, though preliminary, indicated a reduced dosage of the LSVT™ protocol does exhibit treatment efficacy and treatment outcomes comparable to the original, intensive LSVT™ protocol, thus moving this treatment closer to determining the most clinically feasible and client-friendly version of LSVT™.

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