The Effect of LSVT LOUD for Mandarin-speaking Individuals With Hypokinetic Dysarthria Due to Parkinson's Disease

Study Overview
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Brief Summary
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A handful of studies have examined the effects of the Lee Silverman Voice Treatment (LSVT) LOUD on hypokinetic dysarthria in English speakers with Parkinson's disease (PD). Although LSVT LOUD has been found to be effective on improving these speaker's vocal intensity and increasing their speech intelligibility as well as speech function with Phase I evidence, no study has investigated whether Mandarin-speaking individuals with dysarthria secondary to PD would benefit from LSVT LOUD. In the proposed study, speech data of Mandarin-speaking individuals with hypokinetic dysarthria before and after speech therapy will be audio recorded and analyzed in order to examine the effects of LSVT LOUD on the speech function in this population. The same speech data will be played to Mandarin listeners in order to investigate the speech intelligibility of this population. It is hypothesized that Mandarin-speaking individuals with hypokinetic dysarthria secondary to PD will demonstrate reduced vocal intensity, reduced speech intelligibility and impaired speech function before they receive LSVT LOUD. They will improve these speech characteristics following speech therapy and will present with short-term maintenance effects.

Conditions
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Hypokinetic Dysathria

Intervention / Treatment
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* Behavioral: Lee Silverman Voice Treatment (SVLT) LOUD


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mandarin-speaking Taiwanese Hypokinetic dysarthria due to Parkinson's disease No other neurodegenerative diseases No cognitive deficits Age range 30 years and above Exclusion Criteria: Not able to follow verbal directions, speech characteristics uncommon to Parkinson's disease

Ages Eligible for Study
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Minimum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LSVT LOUD<br>LSVT LOUD was developed based on concepts of neuroplasticity, motor learning, skill acquisition and motor speech. LSVT LOUD trains laryngeal and respiratory functions through loud and effortful phonatory tasks (Ramig, Sapir, Countryman, Pawlas, O'Brien, Hoehn, & Thomson, 2001). It targets vocal intensity via stimulation of effortful speech productions with multiple repetitions and through encouraging self-calibrations of loud voice by patients. LSVT LOUD cues patients to speak loud (e.g., Fox et al., 2002; Ramig et al., 2001; Sapir et al., 2007). Having a single cue may increase treatment effects, as it reduces cognitive load in adults with PD because some of them develop cognitive deficits when PD progresses (Fox et al., 2002). Treatment is intensive, consisting of 4 individual sessions a week for 4 weeks, with 16 sessions in one month. | Behavioral: Lee Silverman Voice Treatment (SVLT) LOUD<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speech intelligibility | Speech intelligibility will be assessed by native Mandarin listeners' orthographic transcription accuracy and ratings based on a nine-point Likert scale (from 1 - very difficult to understand to 9 - very easy to understand). | Immediate | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speech function | Speech function will be assessed using acoustic methods. E.g., vowel formant frequencies correlated with vowel articulation will be extracted and analyzed using Praat software. | Immdediate |