Results from major study of speech and language therapy for Parkinson’s published

The PD-COMM trial was carried out across the UK and involved 288 people with Parkinson’s with speech problems.

Participants were randomly assigned to receive either:

• LSVT LOUD, a type of speech therapy developed specifically for Parkinson’s
• NHS speech and language therapy
• no therapy.

Participants completed questionnaires to assess the impact of their speech difficulties on their quality of life at 3, 6 and 9 months.

The results showed that people who received LSVT LOUD did significantly better than the other 2 groups and these benefits appeared to be maintained.

This is an important study but the findings may be less clear-cut than they first appear because NHS speech and language therapy varies widely across the UK and there is no consensus on what 'standard' therapy is. That makes comparing LSVT LOUD with NHS therapy challenging.

Read the full paper in the British Medical Journal.

How do speech difficulties affect people with Parkinson’s?

Speech and communication problems are common for people with Parkinson’s.

To generate speech, you must move muscles in the throat, mouth and chest. Changes in the brain in people with Parkinson’s mean that your movements become smaller and less forceful than before. This can lead to problems with your speech and communication.

Issues may relate to making sure your voice is loud enough, making your pronunciation clear enough and getting the right tone to your voice.

Adrian Wrigley has Parkinson's and said:

"Speech and language therapy research is very important to me personally, as I've seen first-hand how the loss or reduction of our main communication tool leads to higher levels of frustration and anxiety not only for those of us with Parkinson's but our partners and friends. So the development of a treatment that works is very important for the Parkinson's community.

"Having had NHS treatment and been involved with a few speech research programmes, all of which have made me aware of the reduction in speech levels and control, none have vastly improved it. My voice levels still reduce later in the day as I get tired and my medication wears off."

What is Lee Silverman Voice Treatment?

Lee Silverman Voice Treatment is a type of speech therapy developed specifically for people with Parkinson’s.

The programme helps people to recognise that their voice is too quiet and trains them to speak more loudly. It is an intensive treatment programme and requires daily therapy and homework, with 16 sessions over a month, each lasting up to an hour.

There is already evidence to support the benefits of the treatment and it is recommended in clinical guidelines. Unfortunately, however, it isn’t available everywhere. Our latest UK Parkinson’s audit showed that of the 64 speech and language services that participated, 1/3 offered LSVT to eligible patients. Check with your Parkinson’s team to see if it’s available in your area.

Timely access to personalised therapy is key

Rowan Wathes, Associate Director of Policy & Health Strategy at Parkinson's UK, said:

"Speech and language therapy is a vital component of the management of people with Parkinson's and we really welcome research into the subject.

"Therapists not only support people with their voice, but provide expertise on conversation support, language and word finding, saliva management and swallowing.

"Although this new study provides interesting insights into the effectiveness of the very structured and specific LSVT programme, the findings should not be taken that LSVT is the only way to treat voice problems in Parkinson’s.

"NHS speech and language therapy is variable across the UK and there is no consensus on what 'standard' therapy is. The important thing for people with Parkinson's is for them to have timely access to therapy that is personalised to their needs and goals."