Spielman Jennifer, Ramig Lorraine O, Mahler Leslie, Halpern Angela, Gavin William J
National Center for Voice and Speech, 1101 13th Street, Denver, CO 80204, USA.
Am J Speech Lang Pathol. 2007 May;16(2):95-107. doi: 10.1044/1058-0360(2007/014).
The present study examined vocal SPL, voice handicap, and speech characteristics in Parkinson's disease (PD) following an extended version of the Lee Silverman Voice Treatment (LSVT), to help determine whether current treatment dosages can be altered without compromising clinical outcomes.
Twelve participants with idiopathic PD received the extended treatment version (LSVT-X), similar to LSVT except that it was administered twice a week in 1-hr sessions over 8 weeks and required substantially more home practice. Recordings were made in a sound-treated booth immediately before and after treatment, and again 6 months later. Vocal SPL was measured for 4 different tasks and compared with data from a previous study, in which participants with PD received traditional LSVT 4 times a week for 4 weeks. Listener ratings were conducted with audio samples from both studies, using sentence pairs from a standard passage. LSVT-X participants completed the Voice Handicap Index (VHI) before each set of recordings.
Participants receiving LSVT-X significantly increased vocal SPL by 8 dB after treatment and maintained increased vocal SPL by 7.2 dB at 6 months. VHI scores improved for 25% of the LSVT-X participants following treatment, and listener ratings indicated audible improvement in speech.
LSVT-X successfully increased vocal SPL (which was consistent with improvements following traditional LSVT), decreased perceived voice handicap, and improved functional speech in individuals with PD. Further large-scale research is required to truly establish LSVT-X efficacy.
本研究对帕金森病(PD)患者在接受扩展版李·西尔弗曼嗓音治疗(LSVT)后的嗓音声压级(SPL)、嗓音障碍及言语特征进行了研究,以帮助确定在不影响临床疗效的情况下,当前的治疗剂量是否可以改变。
12名特发性帕金森病患者接受了扩展治疗版(LSVT-X),与LSVT相似,不同之处在于它每周进行两次,每次1小时,为期8周,并且需要更多的家庭练习。在治疗前和治疗后立即在隔音室进行录音,6个月后再次录音。对4种不同任务的嗓音声压级进行测量,并与之前一项研究的数据进行比较,在该研究中,帕金森病患者每周接受4次传统LSVT治疗,为期4周。使用来自标准段落的句子对,对两项研究的音频样本进行听众评分。LSVT-X参与者在每组录音前完成嗓音障碍指数(VHI)评估。
接受LSVT-X治疗的参与者在治疗后嗓音声压级显著提高了8dB,6个月时仍保持提高了7.2dB。25%接受LSVT-X治疗的参与者在治疗后VHI评分有所改善,听众评分表明言语有明显改善。
LSVT-X成功提高了帕金森病患者的嗓音声压级(这与传统LSVT治疗后的改善情况一致),降低了嗓音障碍感,并改善了功能性言语。需要进一步的大规模研究来真正确定LSVT-X的疗效。