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Some things can't be fixed with a pill


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#1 Dr. Mahler

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Posted 03 February 2012 - 06:02 PM

Wouldn't it be nice if all of the symptoms of PD could be fixed with a pill? As beneficial as medication can be for limb symptoms there is not the same benefit for speech and swallowing. The good news is that the literature supports the benefits of exercise to improve speech and swallowing function. Communication is so important for quality of life that I encourage you, regardless of your stage of PD, to start speech and swallowing exercises today. It is best to start before intelligibility is compromised or you have difficulty swallowing your pills. A speech-language pathologist can help identify the exercises that are right for you. If you have any questions about changes in speech or swallowing as a result of PD or treatment, please write to us on this forum. We look forward to hearing from you.

Sincerely,

Dr. Mahler
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

#2 Golden01

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Posted 03 February 2012 - 09:01 PM

I support everything you say! My husband is in the communication business and after he completed LOUD therapy, there was such a difference in the quality of his voice. It was intense and it is hard to keep up with the exercises now that he's finished but the training made such a difference for him. His speech therapist was also the one trained at the clinic in helping to improve organizational skills and learn workarounds for cognitive issues (like slower processing time). She was a gem! Another thing he did was finally "share" at work and including the info about his voice therapy helped others understand the problems that might come from Parkinson's Disease. I encourage anyone with PD to find a speech and language specialist (look for credentials like Dr. Mahler's-CCC-SLP).

#3 jas1125

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Posted 08 February 2012 - 03:38 PM

Dr. Mahler:

How do you feel about the EMST device to help with swallowing issues? My mother is starting therapy after an incident of choking and I've asked her therapist about is also. She will also be getting a barium swallow to better assess her condition, but the EMST training and device looked very interesting.
Thanks





Wouldn't it be nice if all of the symptoms of PD could be fixed with a pill? As beneficial as medication can be for limb symptoms there is not the same benefit for speech and swallowing. The good news is that the literature supports the benefits of exercise to improve speech and swallowing function. Communication is so important for quality of life that I encourage you, regardless of your stage of PD, to start speech and swallowing exercises today. It is best to start before intelligibility is compromised or you have difficulty swallowing your pills. A speech-language pathologist can help identify the exercises that are right for you. If you have any questions about changes in speech or swallowing as a result of PD or treatment, please write to us on this forum. We look forward to hearing from you.

Sincerely,

Dr. Mahler



#4 Dr. Mahler

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Posted 28 March 2012 - 02:08 PM

You are asking a very excellent question about swallowing. There are published data by Troche et al., 2010, that were published in Neurology in an article titled, "Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial". That study found that the patients who received EMST had improved swallowing compared to a group that had a sham treatment. These results indicate that for some people with PD, EMST may be a viable option for improving swallowing. However, swallowing is a very complex act. Even though people with PD share a common diagnosis, the swallowing problems they demonstrate can be varied. Therefore, it is best to have an evaluation with a speech-language pathologist who is an expert in PD who can make recommendations uniquely tailored to the individual. EMST is an intensive exercise program targeted to respiration. Other exercise programs that target the larynx can improve vocal fold closure to protect the airway and exercise of the articulators that control the bolus (food or liquid) may also be appropriate (Robbins et al., 2006). Preliminary data published by ElSharkawi et al., in 2002 in the Journal of Neurology, Neurosurgery and Psychiatry titled, "Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT®): a pilot study", showed that people who received LSVT demonstrated improvements in swallow function. If you suspect any type of swallowing difficulty, it is important to talk to your physician and seek intervention as quickly as possibly since swallowing disorders can potentially lead to serious health consequences.

I hope that answers your question. Please write again if you have any follow-up questions.

Sincerely,

Dr. Mahler:

How do you feel about the EMST device to help with swallowing issues? My mother is starting therapy after an incident of choking and I've asked her therapist about is also. She will also be getting a barium swallow to better assess her condition, but the EMST training and device looked very interesting.
Thanks
[/quote]
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

#5 Dr. Mahler

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Posted 28 March 2012 - 02:09 PM

Thank you for sharing your story about a positive outcome with speech therapy to improve communication effectiveness. I'm sure that your story will help others who read this website.

Dr. Mahler


I support everything you say! My husband is in the communication business and after he completed LOUD therapy, there was such a difference in the quality of his voice. It was intense and it is hard to keep up with the exercises now that he's finished but the training made such a difference for him. His speech therapist was also the one trained at the clinic in helping to improve organizational skills and learn workarounds for cognitive issues (like slower processing time). She was a gem! Another thing he did was finally "share" at work and including the info about his voice therapy helped others understand the problems that might come from Parkinson's Disease. I encourage anyone with PD to find a speech and language specialist (look for credentials like Dr. Mahler's-CCC-SLP).
[/quote]
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island




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