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Speech, voice and Swallowing Exercise


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#1 Dr. Mahler

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Posted 17 June 2010 - 05:06 PM

It is summer when many of us are getting outside more and thinking about exercise. Did you know that exercise is important for speech, voice and swallowing as well as for walking and endurance?

Speech problems are very common in people with Parkinson disease! It has been reported that as many as as 89% of people with PD have trouble with their speech or voice. The most common difficulties include reduced vocal loudness, monotone, mumbled articulation and a hoarse or breathy sounding voice. Changes in swallowing are frequently found in PD also. When speech difficulties are present they interfere with quality of life because listeners may not be able to understand you or ignore the interesting things you have to say. It has been reported that as many as 95% of people with PD have dysphagia (Bird, Woodward, Gibson, Phyland, & Fonda, 1994; Logemann, Blonsky & Boshes, 1975; Potulska, Friedman, Krolicki & Spychala, 2003). When dysphagia is present it has a negative impact on quality of life by interfering with the ability to take medications, maintain hydration and nutrition, and may result in aspiration pneumonia. Muscle strengthening exercises may increase tongue strength and range of motion in the elderly and may also help people with PD (Logemann, 1998; Robbins, et al., 2005). Better muscle strength and endurance has the potential to improve speech and swallowing function. Intensive voice treatment may also improve speech and swallowing (El Sharkawi et al., 2002; Ramig et al., 1995, 2001).

Exercise can be very beneficial for people with PD. Don't forget about exercise for muscles of speech, voice and swallowing. Get started sooner rather than later to maintain a good quality of life. To learn more consult a speech-language pathologist in your area who knows Parkinson disease well.

Dr. Mahler, PhD, CCC-SLP
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

#2 yjt_1957

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Posted 20 May 2011 - 11:14 PM

Dear Dr.,
Here, not easy to find a speech-language pathologist, is singing loudly getting help?

I found singing not only having voice out via throat, but also via "stomach". So,I
think the stomach may be as the complement aid to the throat weak muscle.(Of course, the
throat(mouth) muscle need to exercise, but still a little weak. ) Am I right??

Since it is not easy for me to find a speech-language pathologist here, would you pls tell
me which resources may I get the related information,such as booklet or paper from Web
sites.

Best Regards.

#3 Dr. Mahler

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Posted 01 June 2011 - 09:08 AM

Dear Friend with PD,

Thank you for writing back. Yes, I know that it can be challenging to find a speech-language pathologist (SLP) that is easily accessible. However, it is worth figuring out how to address this challenge. If the speech changes that accompany PD were just a laryngeal event affecting the muscles of speaking, then singing would help. The reality is that the speech changes cause by PD are much more complicated than that. The cause of PD is a loss of dopamine cells in the basal ganglia. The basal ganglia have many connections throughout the central nervous system that affect not only how muscles move, but also an individual's perception of their speech (and movement) as well as cognitive changes that make learning new things more difficult. It is typical for a person with PD to think they are speaking at normal loudness when, in reality, they are speaking so softly it is difficult to hear them. Treatment of the speech disorder in PD should address all of these things and be done according to principles of neural plasticity to make treatment changes generalize to functional communication and last.

Technology has made access to treatment easier. I suggest you try to find the closest SLP, who is experienced in working with people with PD, and complete an evaluation and then maybe 2-4 treatment sessions in one week in person. Then you could do therapy by telehealth (on a computer using Skype technology) or using software. LSVT LOUD is a behavioral treatment with Level I efficacy data demonstrating that it works to improve the speech of people with PD (Ramig, et al., 2001, Journal of Neurology, Neurosurgery & Psychiatry). This therapy has telehealth and software options designed for people who have difficulty accessing treatment directly.

I hope that you will be able to problem-solve your situation to get the treatment that can improve your speech and help improve your quality of life.

Sincerely,

Dr. Mahler
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

#4 yjt_1957

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Posted 03 June 2011 - 09:17 PM

Dear Dr. Mahler,

Thanks for your clear & useful info.

Best Regards.

#5 Dr. Mahler

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Posted 08 June 2011 - 07:47 AM

Dear Dr. Mahler,

Thanks for your clear & useful info.

Best Regards.


You are very welcome. Please write again if future questions come up that we can help with online.

Sincerely,

Dr. Mahler
Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island




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