LSVT LOUD Speech Treatment for people with Parkinson’s Disease

Up to 89% of people with Parkinson’s disease (Parkinson’s) develop speech problems.

Speech signs may appear early and have a big effect on quality of life. Common speech issues for people with Parkinson’s include problems with:

• voice: reduced loudness, and monotone, hoarse and breathy voice quality;
• articulation: imprecise consonants and vowels; and
• speech rate: increased, decreased, or variable.

The problems are caused by: reduced amplitude of movement; increased rigidity; and sensory processing abnormalities, including a reduced awareness of soft voice.

Since the 1990s, the Lee Silverman Voice Treatment (LSVT) LOUD has been a gold standard speech treatment for people with Parkinson’s.

LSVT LOUD:

• has a single target – vocal loudness;
• is intense – 16, 1-hour sessions over 4 consecutive weeks, with a high-effort mode of treatment; and
• retrains sensory perception of normal loudness and internal cuing.

To date, three randomised controlled trials have shown, collectively, that LSVT LOUD is:

• effective in producing significant immediate and long term improvements in loudness (up to 2 years);
• more effective than no treatment; and
• more effective than an articulation therapy delivered with the same intensity and dose. 

Apart from volume, LSVT LOUD may have positive knock on effects to other aspects of communication.

Lower quality studies have shown that LSVT LOUD may improve articulation; rate; intonation; speech intelligibility; voice quality; and facial expression.

LSVT LOUD can treat people with:

• mild-moderate Parkinson’s to maintain functional communication and quality of life; and
• advanced Parkinson’s, including those with atypical Parkinson’s and after deep brain stimulation.

Banter has two speech pathologists certified to provide LSVT LOUD treatment. Listen to David’s radio interview about LSVT LOUD here.

For an accessible audio version of the infographic, check out our video below:

Primary source: Ramig, L., Halpern, A., Spielman, J., Fox, C. (2018). Speech Treatment in Parkinson’s Disease: Randomized Control Trial (RCT).  Movement Disorders, 33(11), 1777-1791.

Related articles:

• A voice treatment for Parkinson’s Disease that works: LSVT LOUD (radio interview)
• Parkinson’s Disease: common voice and speech problems and what can be done about them
• LSVT LOUD Fact Sheet
• Can LSVT LOUD help people with Parkinson’s Disease swallow safely?