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[Dysphagia] Voice ex for dysphagia
See below. While the mechanisms attributing to the dysfunction may be
different for these two patient types (CVA/PD),
One can make a case for applying the same principles if the presentation
is similar
Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT(r)):
a pilot study
A El Sharkawi1, L Ramig2,4, J A Logemann1, B R Pauloski1, A W
Rademaker1, C H Smith1, A Pawlas4, S Baum3 and C Werner2
1 Northwestern University, Evanston, Illinois, USA
2 University of Colorado, Boulder, CO, USA
3 University of Colorado Health Sciences Center
4 Wilbur James Gould Voice Research Center, Denver Center for the
Performing Arts, Denver, CO, USA
Objective: To define the effects of Lee Silverman Voice Treatment
(LSVT(r) on swallowing and voice in eight patients with idiopathic
Parkinson's disease.
Methods: Each patient received a modified barium swallow (MBS) in
addition to voice recording before and after 1 month of LSVT(r).
Swallowing motility disorders were defined and temporal measures of the
swallow were completed from the MBS. Voice evaluation included measures
of vocal intensity, fundamental frequency, and the patient's perception
of speech change.
Results: before LSVT(r), the most prevalent swallowing motility
disorders were oral phase problems including reduced tongue control and
strength. Reduced tongue base retraction resulting in residue in the
vallecula was the most common disorder in the pharyngeal stage of the
swallow. Oral transit time (OTT) and pharyngeal transit time (PTT) were
prolonged. After LSVT(r), there was an overall 51% reduction in the
number of swallowing motility disorders. Some temporal measures of
swallowing were also significantly reduced as was the approximate amount
of oral residue after 3 ml and 5 ml liquid swallows. Voice changes after
LSVT(r) included a significant increase in vocal intensity during
sustained vowel phonation as well as during reading.
Conclusions: LSVT(r) seemingly improved neuromuscular control of the
entire upper aerodigestive tract, improving oral tongue and tongue base
function during the oral and pharyngeal phases of swallowing as well as
improving vocal intensity.
Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System
Phone 302-733-1015
Fax 302-733-1061
edolinger at christianacare.org
-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On
Behalf Of sorriso at adelphia.net
Sent: Tuesday, March 06, 2007 9:19 AM
To: dysphagia listserv; ASHA Div 13 list
Subject: [Dysphagia] Voice ex for dysphagia
I have a patient (CVA, hx CVA) with whom I am doing vocal function/Lee
Silverman-like exercises for swallow. His brother/POA asked the OT the
rationale for this and she wasn't able to explain. The patient has a
family meeting in two days and I would like to provide something written
for them to review after I talk with them. In a quick search, I've
found nothing appropriate for nonprofessionals. Do you have any
suggestions for sources on the internet?
Thanks for your assistance,
Linda A. Zanchi, MA CCC-SLP
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