Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT(R)): a pilot study

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Abstract
Objective: To define the effects of Lee Silverman Voice Treatment (LSVT® 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®. 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®, 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®, 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® included a significant increase in vocal intensity during sustained vowel phonation as well as during reading. Conclusions: LSVT® 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.

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