Ways To Improve Speech In Parkinsons Disease
5 min read
Parkinsons disease is a neurodegenerative disorder that affects the motor neurons. As it progresses, the person with PD may become harder to understand as their voice becomes softer or hoarse. Their face may become more masked or expressionless, and their voice may sound monotone with less emotion. They may speak faster , mumble, or repeat . Together these symptoms are known as hypokinetic dysarthria.
A speech-language pathologist is a specialist in communication disorders and can help a person with PD to speak more clearly and confidently. Here are 9 ways an SLP can help:
Parkinson’s Voice Project Practice Videos
Four Speak Out! practice videos, each with a different Parkinson’s Voice Project speech language pathologist .
Cost: $34.99/month or $349.99/year, first month free
Online post speech therapy maintenance with a speech language pathologist trained in either LSVT LOUD or Speak OUT!
Includes 15+ voice practice sessions per week as well as facial exercises, articulation practice, and more.
Publisher: LSVT Global, Inc. Cost: $28 for DVD or download $15/year streaming
Speech exercises for people with Parkinson’s Disease and other neurological conditions. Available in English and Cantonese.
Protective Effect Of Exercise In Animal Models Of Parkinsonism
Multiple studies have documented that vigorous exercise in animal models of parkinsonism mitigates the effects of the dopaminergic neurotoxins, 6-hydroxydopamine and 1-methyl,4-phenyl,1,2,3,6-tetrahydropyridine , with evidence for a neuroprotective effect. In these rat/mouse studies, exercise is controlled, using running wheels or treadmills in the case of unilateral 6-OH-DA to create hemiparkinsonism, cast immobilization of the good limb forces use of the affected limb. This literature may be summarized as follows.
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Fitness Tips To Manage Pd Symptoms
- Choose an exercise program that you will actually do! Dont design a great, Parkinsons-specific program and then skip it because its too hard or not fun.
- Follow a varied routine. Perform simple stretches and posture exercises daily, and make sure to include aerobic and strengthening exercises several times per week.
- Keep intensity at a level that feels somewhat hard for you.
- Consider joining an exercise class or group. Classes are good motivation and also provide an opportunity to socialize. Trained instructors give clear guidelines and offer modifications.
- Try exercise videos or home exercise equipment if it is difficult to get out.
- Music can enhance performance by providing rhythm to coordinate movement.
- Be creative with your fitness. Challenge yourself and have fun!
- Consider attending Moving Day, a Walk for Parkinsons, in your area to keep moving and strengthen your PD fitness community.
Sponsored by Kyowa Kirin. Content created independently by the Parkinsons Foundation.
For more insights on this topic, listen to our podcast episode Benefits of Practicing Tai Chi Chuan Exercises.
How Can I Improve My Speech With Parkinson’s Disease
Speech-language pathologists can help people with Parkinson’s disease maintain as many communication skills as possible. They also teach techniques that conserve energy, including non-verbal communication skills. Speech-language pathologists are also available to:
- Recommend appropriate communication technologies that will help with daily activities.
- Treat all types of speech, language, and communication problems.
- Evaluate swallowing function and recommend changes as necessary.
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Chair Exercises For Parkinsons Patients
Exercises for Parkinsons patients are designed to help counter the forward slumped posture and rigidity that develops as the disease progresses. Through physical therapy, patients are able to regain their mobility and live fuller lives.
Chair exercises for Parkinsons patients can be performed in an outpatient therapy center, and even within their own home. Are you or loved one looking to improve your range of motion, balance, and overall posture? Here are three sitting exercises to perform in the comfort of your own home:
Chair Exercise 1 Improve posture in patients living with Parkinsons.
Sit in a stable chair with your back against the base.Lean forward and reach with your hands toward your feet out in front of you.Quickly and with high energy, pull back into your original seating position with your back flat against the chair.Repeat several times.
Chair Exercise 2 Regain rotation of the trunk to counter the effects of Parkinsons disease.
Sit comfortably in a stable chair and place feet shoulder-width apart.Place your hands out in front of you, with both palms touching.Take one arm and stretch out to your side, leaving the other hand at the center. Be sure to extend your arm with your fingertips are engaged, so you can obtain maximum efficiency.Quickly and with high energy, bring your stretched arm back to the center and smack the palms of your hands.Repeat these motions several times on both hands.
Neuroprotective Benefits Of Exercise
Neuroprotection is when your brain works to prevent the death of neurons, or brain cells. For people with PD, exercise is not only vital to maintaining balance, mobility and daily living activities, but it has the potential to have a neuroprotective effect.
The Parkinsons Foundation studied exercise as part of our Parkinsons Outcomes Project study. Our Center of Excellence network believes that exercise is important to good outcomes in PD, and data supports that. Exercising enhances the sense of wellbeing, even across different disease stages and severities.
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If I Have Parkinsons Disease What Kind Of Speech And Voice Problems May I Experience
If you have Parkinsons disease, some of the voice and speech difficulties seen include:
- Softened voice. Reduced volume to your voice.
- Speaking in an unchanging pitch .
- Having a hoarse or strained quality to your voice.
- Having a breathiness to your voice. Breathiness in the quality of your voice that is easily heard by your listeners. It takes more effort and energy to speak. You run out of gas as you speak.
- Trouble clearly and easily pronouncing letters and words.
- Tremor in your voice.
- Using short rushes of speech.
- Loss of your facial expression.
If you have Parkinsons disease, you may not be aware of the problems with your spoken communication. Changes in the quality of your voice may be the first sign of speech problems followed by the inability to have fluid speech and clear and distinct speech sounds. Speech problems that are severe enough to reduce your ability to be easily understood usually do not occur until later in the course of Parkinsons disease.
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Exercise : Side Leg Raise
STARTING POSITION: Lying on your side. The leg closest to the floor is bent, and the top leg is straight. Cradle your head with your arm, or use a pillow for neck support.
Repeat 20 times per leg.Rest and perform a second set before switching to the other side.
Bad Form Alert!
Its very easy to do this exercise incorrectly. When done correctly, you should feel muscles in the back of your hip working. You should NOT feel it in the front of your hip. If you do, youre using your hip flexor or TFL muscles.
- Let your hips fall backward. Keep them stacked by actively leaning forward.
- Let your leg kick in front of you. Raise it straight up as if youre sliding your heel along an invisible wall behind you.
- Let your toes point up. Keep your foot parallel to the floor, or even point the toes slightly down to the floor if possible.
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Dual Task Training For Parkinson
Publisher: Triad Solutions, Inc.
Dual Task Training is combining speech therapy with physical movement and cognitive tasks. It has been shown to be the most comprehensive and fun type of speech therapy. This page has seven short dual task exercise videos plus one video of aquatic dual task training.
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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Recommendations For Caregivers And Family
Cognitive therapy may help by modifying the way caretakers communicate with a patient. Recommendations for caregivers, family and physicians include:
- Avoid complex syntax. Do not use embedded clauses such as, My car, which is very old, is in the shop. Sentences should be kept short when possible and pauses should be incorporated when long sentences are required.
- Avoid taxing word memory. Chunk information into smaller units whenever possible and wait for acknowledgment before proceeding. For example, phone numbers are not typically remembered in a long string of numbers, but rather 123-456-7890.
- Clearly delineate topics. Conversations should be structured so as to thoroughly discuss a single subject in a compartmentalized manner before shifting to a new and unrelated topic.
- Avoid reliance on emotional expressions. Do not rely on facial expressions to display emotions. Individuals with PD may have trouble recognizing emotional expressions such as a smile or a frown.
- Avoid using phrases with non-literal meaning. For instance, saying she hit the sheets instead of she went to bed can be confusing for the patient.
- Minimize distractions and background noise. A speaker should be oriented to face the listener. This will also help with understanding speech that may be impaired.
Lee Silverman Voice Technique
LSVT is a speech treatment that has been proven to significantly improve speech after one month. Results can last up to two years following treatment. The LSVT method is easy to learn and must be repeated four days a week for four consecutive weeks to be effective. After a four-week treatment period, LSVT exercises should be done daily to maintain the improvements achieved.
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Exercise Class For Parkinsons Disease
Back in Motion Physical Therapy is now offering our new Big and Beyond exercise class for patients with Parkinsons disease. After a year of offering the LSVT Big therapy program, our therapists have witness dramatic functional improvements with their patients! With regular daily practice of the key exercises, patients with Parkinsons disease can maintain and improve their balance, strength and ease of movement. For many patients, compliance with continued exercise is a challenge.
To facilitate exercise compliance, we have recently launched our new Big and Beyond exercise class for the graduates of the LSVT BIG therapy program. These are small group classes with the goal of reinforcing large amplitude movement patterns that were introduced and practiced during the patients time in physical therapy. The class focus is to reinforce the Maximal Daily Exercises for improvements in balance, strength and endurance.
The Big and Beyond exercise class is held in our Lorton and Alexandria VA physical therapy practice locations. The cost is $15 per class. Class size is limited to 6 per class. Call for current class schedule.
The Lee Silverman Voice Treatment
The Lee Silverman Voice Treatment LOUD is the first speech treatment for PD proven to significantly improve speech after one month of treatment.
- Must be administered four days a week for four consecutive weeks.
- On therapy days, perform LSVT exercises one other time during the day. On non-therapy days, perform LSVT exercises two times a day.
- Once you complete the four-week LSVT therapy, perform LSVT exercises daily to maintain your improved voice.
- Schedule six-month LSVT re-evaluations with your specialist to monitor your voice.
- If available in your area, participate in a speech group whose focus is on thinking loud.
- A Digital Sound Level Meter can help you monitor voice volume. Place the meter at arm distance to perform the measurement. Normal conversational volume ranges between 68-74dB.
How Hard Should I Exercise If I Have Parkinsons Disease
A rating of perceived exertion is a good way to measure intensity. On a scale from 0 to 10, 0 would be how you feel while sitting or lying down, while 10 would be the maximum effort you can give. Building up to an effort between 5 to 8 means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.
How Do I Know If I Have A Speech Or Voice Problem
- My voice makes it difficult for people to hear me.
- People have difficulty understanding me in a noisy room.
- My voice issues limit my personal and social life.
- I feel left out of conversations because of my voice.
- I cannot participate in telephone calls because of my voice.
- My voice problem causes me to lose income.
- I have to strain to project my voice.
- My voice clarity is unpredictable.
- My voice problem upsets me.
- My voice makes me feel handicapped.
- People ask, “What’s wrong with your voice?”
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Ad Brain Atrophy Is Significantly Less Among Those With Cardiorespiratory Fitness
Brain MRI volumetric measurements have revealed progressive brain atrophy in AD, especially affecting the temporal lobe. However, this is attenuated with maintained physical fitness, documented by peak VO2 values during exercise testing. Thus, in patients with AD, peak VO2 correlated with whole brain, white matter, and temporal lobe volumes.42,43 Parenthetically, in a transgenic mouse model of AD, 5 months of exercise significantly reduced brain -amyloid concentrations.44
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Can Music Help People Who Have Parkinsons Disease
After the four-week program, participants start group treatment and join whats called the LOUD Crowd to maintain their skills. LOUD Crowd meets once per week, and offers a community support component as well as skills maintenance.
The program, which started at Northeastern in the fall of 2021, now boasts four graduates and four additional LOUD Crowd participants who completed the individual therapy elsewhere, Martin said. The program just received its third round of funding from the Texas-based Parkinson Voice Project to continue for the upcoming year, and three more people are already enrolled for the summer.
For students such as Bender and Fahey, who receive intensive training in the therapeutic protocol, following participants through the program can be a rewarding experience.
Rob was the first client I ever worked with, Fahey said. Seeing his progressand working with him to achieve that progresshas been really exciting.
Fahey, Bender, and Martin just hope more people join the free program, which is also part of a research study to investigate the many ways it can benefit people with Parkinsons.
As of 2017, Parkinsons affected1 million people in the U.S., a figure that is estimated to grow to 1.6 million by 2037, according to a study published in the National Library of Medicine.
The earlier you intervene with a therapeutic program, the more likely you are to have a good outcome, Martin said.
Shes witnessed those outcomes firsthand.
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There Are Two Popular Programs Offering Speech Therapy For Parkinsons Disease
The two most prevalent programs to help those with speech problems because of Parkinsons disease are LSVT Loud, The Lee Silverman voice treatment LOUD, and also Speak Out! Both of these are incredibly well researched.
All of our Better Speech pathologists are able to be certified in these programs and techniques so that we can offer it to our clients in whole or in part.
LSVT Loud speech therapy program for Parkinsons focuses more on actual articulation
- This program is a bit more structured
- Usually covered in four sessions at 60 minutes each week
- Homework assignments for practice
- Teaches clients to be loud and to communicate with projection.
Speak Out! speech therapy program for Parkinsons focuses on the intent of communication.
- This program has a little bit more flexibility
- Usually covered in three sessions of 45 minutes each week
- Homework assignments for practice
- Focuses on the intent or reason for the communication
Both of these programs include homework assignments to practice outside, which is really fantastic when but then you get to also take those techniques, those tools, those things that you learn and implement them in your everyday life. That way you can then be more functional in your communication, and start to enjoy communicating with those around you.
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Choosing The Right Exercise Class For Parkinsons
When trying to find an exercise class to join, it can be hard to know which ones to try because there are many different types of classes that are marketed to people with PD. When you are evaluating a class, it is important to remember the following:
- It is the components of the exercise class that are important . You do not need to specifically do boxing or dance if you can achieve these elements of exercise in other ways.
- The instructor should have expertise in PD. APDA offers a training for fitness professionals which helps them better understand how to create exercise programs best suited for people with PD.
- The ratio of class members to instructors should be low enough to maintain safety.
- The class should be adaptable for people of different abilities and mobility. Many classes will offer seated options or other modifications.
It may take a few tries to find the types of exercise that suits you best so dont give up! Feel free to try different classes in your area to see what types of exercise appeal to you. It can also be motivating to take classes together with a friend or family member. You can hold each other accountable, and also have some fun together. As you find classes you enjoy, you can incorporate those modalities into your exercise schedule. For help in finding classes in your area, you can contact one of our Chapters or Information & Referral Centers. There are also many virtual classes that you can join from home.
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