High-intensity Group Vocal Exercise to Improve Laryngeal Function in Patients With Parkinson Disease
| Status: | Completed |
|---|---|
| Conditions: | Parkinsons Disease |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | Any - 100 |
| Updated: | 8/29/2018 |
| Start Date: | August 22, 2017 |
| End Date: | December 13, 2017 |
The overall goal of this T2 translational research project is to pilot an interdisciplinary
high-intensity group singing program to improve speech and swallowing in patients with
Parkinson's Disease (PD) and to explore the impact of this program on quality of life (QOL).
This research has three specific aims: 1) Determine the effects of a high-intensity group
vocal training program on vocal function and laryngeal structure; 2) Determine the
transference of vocal training to laryngeal aspects of swallowing; 3) Determine the effect of
patient-reported changes in Quality of Life (QOL) as the result of participation in a group
vocal training program.
Twenty patients with Parkinson Disease will be recruited from the Fresco Institute for
Parkinson's & Movement Disorders to participate in a 12-week vocal training program. The
program will train participants using maximum vocal function exercises targeting vocal
deficits specific to PD. Choral singing therapy sessions will be conducted once weekly with
daily home practice exercises based on principles that have been successful in other
intensive PD vocal exercise programs.
high-intensity group singing program to improve speech and swallowing in patients with
Parkinson's Disease (PD) and to explore the impact of this program on quality of life (QOL).
This research has three specific aims: 1) Determine the effects of a high-intensity group
vocal training program on vocal function and laryngeal structure; 2) Determine the
transference of vocal training to laryngeal aspects of swallowing; 3) Determine the effect of
patient-reported changes in Quality of Life (QOL) as the result of participation in a group
vocal training program.
Twenty patients with Parkinson Disease will be recruited from the Fresco Institute for
Parkinson's & Movement Disorders to participate in a 12-week vocal training program. The
program will train participants using maximum vocal function exercises targeting vocal
deficits specific to PD. Choral singing therapy sessions will be conducted once weekly with
daily home practice exercises based on principles that have been successful in other
intensive PD vocal exercise programs.
Deterioration of speech and swallowing is a hallmark of Parkinson Disease (PD). There is
emerging evidence that choral singing benefits people with PD across a range of modalities.
Despite the increasing popularity of "Parkinson's choirs", rigorous study of these benefits
is lacking. There is a large body of evidence that intense vocal training improves speech and
communication for people with PD. However, the intense training places high demands on
clinical and patient resources and, due to its individualized approach, lacks the potential
psycho-social benefits of a group intervention.
It is hypothesized singing training program will increase vocal loudness, range of
articulation, and prosodic variation during speech. Additionally, given existing evidence for
neuroplastic transference of voice-related interventions to swallowing function, laryngeal
components of swallowing function will also improve post-intervention. Finally, investigators
expect to see improvements in patient-reported QOL measures corresponding with improved
speech and laryngeal function and/or as the result of group interaction.
All participants will complete a standardized battery of assessment pre- and post- treatment
including acoustic and aerodynamic assessment of voice, dynamic magnetic resonance imaging of
speech and swallowing, and videofluoroscopic evaluation of swallowing. The outcome of this
work will be a rigorous understanding of how choral singing therapy can positively impact the
voice, swallowing function, and quality of life for patients with PD.
emerging evidence that choral singing benefits people with PD across a range of modalities.
Despite the increasing popularity of "Parkinson's choirs", rigorous study of these benefits
is lacking. There is a large body of evidence that intense vocal training improves speech and
communication for people with PD. However, the intense training places high demands on
clinical and patient resources and, due to its individualized approach, lacks the potential
psycho-social benefits of a group intervention.
It is hypothesized singing training program will increase vocal loudness, range of
articulation, and prosodic variation during speech. Additionally, given existing evidence for
neuroplastic transference of voice-related interventions to swallowing function, laryngeal
components of swallowing function will also improve post-intervention. Finally, investigators
expect to see improvements in patient-reported QOL measures corresponding with improved
speech and laryngeal function and/or as the result of group interaction.
All participants will complete a standardized battery of assessment pre- and post- treatment
including acoustic and aerodynamic assessment of voice, dynamic magnetic resonance imaging of
speech and swallowing, and videofluoroscopic evaluation of swallowing. The outcome of this
work will be a rigorous understanding of how choral singing therapy can positively impact the
voice, swallowing function, and quality of life for patients with PD.
Inclusion Criteria:
- Confirmed diagnosis of Stage One, Two or Three on the Hoehn and Yahr Staging of
Parkinson's Disease
- Current swallowing severity of normal, mild, or moderate without aspiration
- Stable regimen of anti-PD medication for >30 days
Exclusion Criteria:
- Prior voice and/or swallowing therapy related to PD
- History of head and neck cancer
- History of oropharyngeal or laryngeal surgery
- Current or former smoker (quit < 5 years)
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