Saleem Shakeela, Miles Anna, Allen Jacqueline
Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand.
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Int J Speech Lang Pathol. 2025 Feb 3:1-15. doi: 10.1080/17549507.2025.2455635.
This study compared the effects of Lee Silverman Voice Treatment and Expiratory Muscle Strength Training on swallow, cough, and voice function in individuals with Parkinson's disease.
Fifty-eight individuals with mild-moderate Parkinson's disease (male = 45, = 69 years, = 8) were enrolled in a two-treatment clinical trial and completed four consecutive weeks of either Lee Silverman Voice Therapy or Expiratory Muscle Strength Training. All participants completed standard protocol videofluoroscopic swallow study, spirometry-cough tests, acoustic-voice assessment, and self-rated questionnaires pre- and post-therapy. Data were analysed by masked clinicians using specialised software. Mixed-model repeated measures and t-tests were performed.
Lee Silverman Voice Treatment resulted in greater effects in acoustic aerodynamic voice measures (loudness, pitch-range, and aerodynamic-efficiency; < .05) compared to the Expiratory Muscle Strength Training group. There were significant effects on pharyngoesophageal segment maximum opening ( =.01) following Lee Silverman Voice Treatment. Expiratory Muscle Strength Training resulted in significantly greater change in maximum hyoid displacement (Hmax; = .04) and decreased Hmax duration ( .01) compared to Lee Silverman Voice Therapy group. No cough measures and self-reported questionnaires significantly differed between groups with both groups improving post-treatment.
Both Lee Silverman Voice Therapy and Expiratory Muscle Strength Training improved specific swallow efficiency and airway defence capacity despite differences in task and therapeutic dose. Only Lee Silverman Voice Thearpy improved vocal intensity. Both treatments are feasible options for individuals with mild-moderate Parkinson's disease.
本研究比较了李·西尔弗曼嗓音治疗（Lee Silverman Voice Treatment，LSVT）和呼气肌力量训练对帕金森病患者吞咽、咳嗽及嗓音功能的影响。
58例轻中度帕金森病患者（男性45例，年龄=69岁，标准差=8）参与了一项双治疗临床试验，连续四周接受李·西尔弗曼嗓音疗法或呼气肌力量训练。所有参与者在治疗前后均完成了标准方案的电视荧光吞咽造影研究、肺活量咳嗽测试、声学嗓音评估及自评问卷。数据由盲法临床医生使用专业软件进行分析。采用混合模型重复测量和t检验。
与呼气肌力量训练组相比，李·西尔弗曼嗓音治疗在声学空气动力学嗓音指标（响度、音高范围和空气动力学效率；P<0.05）上产生了更大的效果。李·西尔弗曼嗓音治疗后，咽食管段最大开口度有显著变化（P=0.01）。与李·西尔弗曼嗓音治疗组相比，呼气肌力量训练导致最大舌骨位移（Hmax；P=0.04）有显著更大的变化，且Hmax持续时间缩短（P<0.01）。两组咳嗽指标和自评问卷无显著差异，两组治疗后均有改善。
尽管任务和治疗剂量存在差异，但李·西尔弗曼嗓音疗法和呼气肌力量训练均提高了特定的吞咽效率和气道防御能力。只有李·西尔弗曼嗓音疗法提高了嗓音强度。两种治疗方法都是轻中度帕金森病患者可行的选择。
