How Can I Maintain And Enhance My Speech
What Causes Parkinson’s Disease
Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.
What Alternative Communication Devices And Tips Can Help With My Voice And Speech Problems
If you have difficulty speaking, are frustrated and stressed by your inability to communicate or tire from the efforts to speak, consider the following devices and methods to be better understood:
- Amplification: This could be a portable personal amplifier or a telephone amplifier that can be used to increase vocal loudness in soft-spoken people. The amplifier also decreases voice fatigue.
- TTY telephone relay system: This is a telephone equipped with a keyboard so speech can be typed and read by a relay operator to the listener. Either the whole message can be typed or just the words that are not understood.
- Low-technology devices: Paper-based books and boards, alphabet boards and typing devices are examples of low technology assistive methods.
- High-technology electronic speech enhancers, communication devices: Computers with voice synthesizers and speech generating devices are available. Talk to a speech-language pathologist about the available high technology devices best suitable for your needs.
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Ii Characteristics Of Dysarthria In Parkinsons Disease
Speech rate characteristics as well as dysfluency in PD also deserve comment. Speech rates vary widely in persons with PD. Instrumental measures suggest that some speakers with PD have a normal rate, other individuals have a speech rate that is slower than normal and other persons have a speech rate that is faster than normal. In fact, hypokinetic dysarthria, which is the type of dysarthria most often associated with PD, is the only dysarthria for which rate may be faster than normal. Perceptual impressions of rate in PD must be confirmed with instrumental measures, as listeners perception of the rate of Parkinsonian speech grows abnormally rapidly. That is, for a sentence produced at the same physical rate by a speaker with PD and a neurologically normal speaker, the sentence produced by the speaker with PD will be perceived by listeners to be faster. Imprecise articulation and monopitch or reduced variation in voice fundamental frequency in the acoustic speech signal of PD have been proposed as potential explanations. Dysfluency occurs in approximately 15 to 45% of persons with PD, typically at the beginning of utterances or after a pause. The dysfluency is typically mild in severity and is characterized by rapid, blurred phoneme repetitions.
What Devices Can Help Speech For Those With Parkinson’s Disease
Here’s a sample of the devices that are available to help people with Parkinson’s disease communicate more clearly.
Palatal lift. A dental apparatus that is similar to a retainer. It lifts the soft palate and stops air from escaping out of the nose during speech.
Amplification. A personal amplifier can be used to increase the volume of the voice. The amplifier also decreases voice fatigue.
TTY telephone relay system. A telephone equipped with a keyboard so speech can be typed and read by a relay operator to the listener. Either the whole message can be typed or just the words that are not understood can be typed.
Low technology devices. Notebooks and language boards can be used as alternative communication techniques.
High technology electronic speech enhancers, communication devices. Computers with voice synthesizers and dedicated communication devices are available.
If you are interested in purchasing an electronic communication aid discuss this with your speech therapist before contacting sales representatives for these devices.
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What Is The Best Treatment For Parkinson Disease
Levodopa, the most effective Parkinsons disease medication, is a natural chemical that passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa , which protects levodopa from early conversion to dopamine outside your brain. This prevents or lessens side effects such as nausea.
B Feeding Modifications And Drooling
Adaptive utensils may be helpful for promoting and extending independent eating. Later-stage PD may be accompanied by dementia, which complicates management of feeding and swallowing, as patients may be unable to follow directions for some compensatory strategies. Patients also may be unable to feed themselves, necessitating a trained feeder. Feeders should be trained to monitor the safety of each swallow as well speed and duration of meal. Because patients with PD may take longer to swallow, a longer mealtime should be allowed. Relatedly, for patients with reduced pharyngeal wall contraction and posterior tongue base retraction or who demonstrate impulsive feeding behavior, taking too much food too rapidly can result in increased risk of aspiration owing to collection of food in the pharynx. Smaller bites at a slower rate should be encouraged. Enteral feeding by means of a percutaneous endoscopic gastrostomy may improve quality of life by providing nutritional support., For patients who are able, PEG does not preclude some nutrition by mouth for pleasure or nutrition.
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The Role Of A Parkinsons Physical Therapist
As you can see, there are a number of reasons why your Parkinsons symptoms may be getting worse after exercise and it may be hard to pinpoint exactly whats happening on your own. This is where seeing a Parkinsons trained physical therapist is incredibly beneficial. They can help you problem-solve your situation, personalize an exercise program and adapt it over time.
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What Is Parkinsons Disease
Parkinsons Disease is a neurodegenerative disorder, which leads to progressive deterioration of motor function.;PD is diagnosed by a neurologist and typically appears after the age of 60, though early onset Parkinsons can also occur prior. The progression of the disease and the extent of impairment is extremely individual.
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Speech And Voice Disorders In Parkinsons
There are several reasons people with PD have reduced loudness and a monotone, breathy voice. One reason is directly related to the disordered motor system that accompanies PD, including rigidity, slowness of movement and tremor. For example, the poor muscle activation that leads to bradykinesia and hypokinesia in the limbs can translate to the muscles involved in speech. These problems with muscle activation can result in reduced movements of the respiratory system , larynx and articulation .
Another cause of speech and voice impairment in PD is a change in sensory processing that is related to speech. It is believed that people with PD may not be aware that their speech is getting softer and more difficult to understand. When people in this situation are asked to bring their voice to normal loudness, they often feel as though they are shouting, even though they are perceived by listeners to be speaking normally
Another cause of this condition is that people with PD may have a problem with cueing themselves to produce speech with adequate loudness. Individuals with PD can respond to an external cue , but their ability to cue themselves internally to use a louder voice is impaired. These problems can be frustrating both for the person and for the family.
Treating Speech And Language Problems In Parkinsons Disease
Potential treatments for speech and language problems of PD include medication, behavioral therapies, and surgery. The most recent assessments of these therapies suggest, however, that surgery is not effective for speech problems, although it may improve some of the severe motor problems of PD. In addition, there are no medication;therapies that are effective when used alone.
Treating the basic motor problems of PD optimally appears to be a prerequisite for improving speech problems. That is, if the PD motor problems are untreated, the speech problems do not respond well to behavioral treatments. PD medication is, therefore, necessary but not sufficient. In short, the optimal treatment strategy for speech and language problems of PD appears to be a combination of PD medication plus some form of behavioral speech therapy.
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What You Can Do
As of 2021, there is no definite cure for Parkinsons disease. There is also no definite known cause. Its likely due to a combination of an individuals susceptibility and environmental factors. Most cases of Parkinsons disease happen without a genetic link.
According to research published in 2012, only report having a family member with the disease. Many toxins are suspected and have been studied, but no single substance can be reliably linked to Parkinsons.
However, research is ongoing. Its estimated that
What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
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How Parkinsons Affects Speech And Communications
Some people living with Parkinsons will not experience speech and communication difficulties. However, a large number of people do develop problems with speech and non-verbal communication. The stage when these problems might emerge is different for everyone. The symptoms will vary from person to person but may include:
- Reduced volume of speech
- Reduced body language, including hand gestures
How Does Parkinson’s Cause Vision Issues
Parkinsons is characterized by a loss of dopamine producing cells in the substantia nigra portion of the brain. The reduction of dopamine can affect the visual cortex. So Parkinsons can impair mobility of the eyes just like the limbs. There are several kinds of visual disturbances that may be experienced by people with Parkinsons. Many who experience changes in vision or eye mechanics seek out a consultation from a neuro-opthalmologist, someone who specializes in visual problems associated with neurological disease.2
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Peripheral Triggering Factors May Precede Parkinsons Disease
NEW ORLEANSA triggering peripheral cause can be identified at least three years before the onset of sporadic Parkinsons disease in about 91% of cases, according to research presented at the 2013 Annual Meeting of the American Neurological Association. Triggering factors include a habitual sleep posture, trauma and persistent pain, and/or peculiar and persistent motor habits.
If such factors are detected early, remission is possible before irreversible destruction of the substantia nigra, reported Gobinathan Devathasan, MD, a neurologist at the Mount Elizabeth Medical Centre in Singapore.
The findings are based on 140 patients with early Parkinsons disease who were responsive to levodopa. Patients were questioned regarding their sleeping posture and position. Habitual sleepers were defined as having greater than 70% of their sleep time in either the right, left, supine, or prone position; others were grouped as nonhabitual or turning sleepers. The investigators also inquired about trauma and persistent pain, as well as peculiar and persistent motor habits and intense sport activities.
Neurologists have been tardive to accept a peripheral initial cause because the most common factorhabitual nonturninghas not been identified as yet, stated Dr. Devathasan. Moreover, the gating theory sounds weak, and there was no alternative convincing mechanism.
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What Is Nonverbal Communication
Nonverbal communication, also called augmentative and alternative communication , is a method of communicating without spoken words.
When communication needs cannot be met through speech, the following techniques can help:
- Make the best use out of what speaking ability is left.
- Use expressions and gestures to communicate.
Non-verbal communication can help people with speech difficulties actually speak better by:
- Reducing the frustration and stress of being unable to communicate.
- Alleviating the pressure to speak.
- Allowing the person to be more relaxed and come across in a more understandable manner.
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Support Groups And Networking
There are many different types of support groups. But they can broadly be defined as a group of people who have something in common – in this context Parkinsons – who meet to discuss and exchange ideas and information, or voice concerns. The group may also include partners, family and/or carers.
Each group will be individual with varying activities, meeting places, opportunities and capabilities. Sometimes there is a trained leader, such as a counsellor or social worker, although many Parkinsons groups are run by people with the condition as well as experienced volunteers. Groups often meet once a month, but many meet more regularly.
Most members find participating in a group supportive and a good way to interact with others in a similar position. Many Parkinsons organisations have support groups. To find out about how groups operate in your own country contact your national Parkinsons association.
How Do I Know If I Have A Swallowing Problem
- I have recently lost weight without trying.
- I tend to avoid drinking liquids.
- I get the sensation of food being stuck in my throat.
- I tend to drool.
- I notice food collecting around my gum line.
- I tend to cough or choke before, during or after eating or drinking.
- I often have heartburn or a sore throat.
- I have trouble keeping food or liquid in my mouth.
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Other Symptoms Of Parkinsons
The primary motor symptoms of PD are tremor, rigidity, postural instability , and bradykinesia .
PD also causes many secondary motor symptoms, including micrographia , changes in gait , stooped posture, dystonia , cramping, difficulty swallowing, sexual dysfunction, impaired fine motor dexterity, and akathisia .
In addition to these motor symptoms, PD can cause non-motor symptoms such as depression, difficulty swallowing or chewing, urinary problems, constipation, skin problems, sleep problems, pain, and cognitive problems, such as memory problems or slow thinking.1,7
A Swallowing And Medication
As previously mentioned, levadopa treatment tends to have the most predictable effects on limb symptoms in PD. Nonetheless, certain aspects of eating and swallowing may be enhanced by medication. It therefore is recommended that patients time their meals and medication in such a way that they receive maximum medication effect during meals so as to facilitate upper extremity control and possibly oral and pharyngeal function. Similarly, some patients may show improvement in swallowing when medication is changed. Thus, in patients who have changed medication, the clinician may opt to wait several weeks to begin swallow therapy especially in the form of active range of motion exercises to determine whether the medication benefits the patients swallow. Some patients experience xerostomia as a side effect of pharmacologic treatment for PD. Depending on the existence of other swallowing and eating difficulties, taking frequent sips of water, throat lozenges or lemon drops, as well as synthetic saliva may prove helpful.
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Support Groups And Parkinsons
A support group is not a substitute for the support of family and friends but can provide an opportunity to:
- make new friends and enjoy the social opportunities support groups offer
- extend your support team which can make it easier to get the help you need, when you need it
- provide support for your carer and close family
- minimise feelings of isolation and having to cope with Parkinsons alone
- learn about clinical trials and opportunities to participate in them .
If youre unsure, it may be useful to attend one or two meetings before you commit to joining a group. Talk to members to find out more about what the group offers and any aspects that are of particular interest to you. Remember that almost everyone is apprehensive about going first time, but if after several meetings you dont feel comfortable then see if there is another local group as no two groups are the same.;
The Parkinsons association;in your country may be able to provide contact details for local groups. Your care team may also have suggestions or you could look in your local library, local newspaper, or on the Internet.
If there isnt a group in your area then you might want to consider setting one up. Your national Parkinsons association;may be able to provide helpful information on starting a new group.