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The maintenance of communication in Parkinson's disease (PD) requires a long term management plan, due to the progressive nature of the associated communication deficits. While intensive behavioural treatment has been demonstrated to improve speech intelligibility in PD, the effects can decrease over time. People with PD also experience changes in their ability to participate in conversation and everyday communication. Methods to maintain communication after a primary speech treatment are of interest to clinicians and people with PD.
A group therapy program (Loud and Proud) was developed according to current theories of neurorehabilitation, and the principles of the Lee Silverman Voice Treatment (LSVT LOUD®). The program was designed to target vocal loudness (a critical component of the LSVT LOUD®) and known areas of difficulty experienced by people with PD, including participating in group conversations, speaking in the presence of cognitive competition, and speaking over background noise.
This study provided initial findings related to evaluation of the Loud and Proud group therapy program and intervention outcomes for people with PD who had previously completed LSVT LOUD®. This research provides some evidence to suggest that group therapy following LSVT LOUD® may effect a change in specific speech parameters and aspects of communicative function in people with PD. However, further research is required in order to establish the efficacy of this intervention in relation to a revised protocol, optimal dosage, and alternative modes of service delivery.
The overall aim of this research was to investigate the outcomes of group therapy (Loud and Proud) as a maintenance strategy for speech and language following the Lee Silverman Voice Treatment (LSVT LOUD®).
Research is now underway to investigate the efficacy of a revised, student-led version of Loud and Proud.
Initial data showed that people with Parkinson's disease had louder voices, spoke more, and were more involved in setting topics in conversations after the group program. The sample size was small (N = 12) and further data is being collected, from a student-led version of Loud and Proud.