Major Study Reveals Most Effective Speech Therapy for Parkinson’s Disease

A major clinical trial led by the University of Nottingham has demonstrated that Lee Silverman Voice Treatment (LSVT LOUD®) is superior to standard NHS speech and language therapy for treating Parkinson’s disease patients. Credit: SciTechDaily.com

Research from the University of Nottingham indicates that LSVT LOUD®, a specialized speech treatment, is more effective than traditional NHS therapy for Parkinson’s disease sufferers, improving their speech and overall quality of life.

A major clinical trial has shown the Lee Silverman Voice Treatment (LSVT LOUD®) is more effective than the current speech and language therapy provided by the NHS, when treating patients with Parkinson’s disease (PD).

The NIHR HTA-funded trial results were published on July 10 in the BMJ. They showed that LSVT LOUD® was more effective at reducing the participant’s reported impact of voice problems than no speech and language therapy, as well as the NHS-delivered speech and language therapy.

The trial was led by experts from the Universities of Nottingham and Birmingham, along with colleagues at Sandwell and Dudley Hospital Trust, University College London, King’s College London, the University of Bangor, Canterbury Christ Church University and Glasgow Caledonian University.

It was carried out by NHS Speech and Language Therapy services across the UK and coordinated and analyzed by the team at the Birmingham Clinical Trials Unit (BCTU) at the University of Birmingham.

Participant Experiences and Quality of Life Impact

Professor Catherine Sackley, from the School of Health Sciences and the NIHR Nottingham Biomedical Research Centre, led the study. She says: “The impact of speech and communication problems in people with PD can cause them to feel stigmatized. It can stop them from going out, stop them socializing, and stop them from doing day-to-day tasks such as shopping, which can have a detrimental impact on their quality of life.

“This is the first study of its kind to look at the most effective treatment options. The results clearly show that, delivered in this way, the LSVT LOUD® method is both effective and it can be cost-effective. The NHS method as it is currently delivered is not effective. Now we have this data, we need to look at other factors and whether if different therapies are delivered in different ways, this would further impact the results.”

Building on a pilot study funded by The Dunhill Medical Trust, participants were recruited from 40 NHS sites across the UK and were randomized into three groups. One group received the LSVT LOUD®, one received the current NHS speech and language treatment and the third didn’t receive any therapy.

Comparison of LSVT LOUD® and NHS Treatments

LSVT LOUD® is an effective speech treatment for people with PD and other neurological conditions. The treatment trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Patients are given voice exercises to do this.

The NHS treatment is a personalized program delivered by a therapist and is less intensive. It is delivered over six to eight sessions rather than the LSVT LOUD® which is delivered in 16 sessions over four weeks.

Between September 2016 and March 2020, 388 people with PD and Dysarthria (difficulty speaking) took part in the trial. 130 were allocated to the LSVT LOUD® group, 129 to the NHS therapy group and 129 received none.

LSVT LOUD® consisted of four face-to-face or remote 50-minute sessions, each week delivered over four weeks, with additional home-based practice. The NHS speech and language therapy was determined by the local therapist in response to a participant’s individual needs, an average of one session every other week was delivered over 11 weeks.

Trial Findings and Conclusions

The findings of the trial showed that LSVT LOUD® was more effective at reducing the impact of Dysarthria than no speech and language therapy and the NHS version. The NHS therapy showed no evidence of benefit compared to no speech and language therapy.

Adrian Wrigley, who has Parkinson’s said: “Speech and language therapy research is very important to me personally, as I’ve seen firsthand how the loss or reduction of our main communication tool leads to higher levels of frustration and anxiety not only for those of us with Parkinson’s but our partners and friends. So the development of a treatment that works is very important for the Parkinson’s community.”

For more on this research, see The Voice Treatment Giving Parkinson’s Patients a New Lease on Life.

Reference: “Lee Silverman voice treatment versus NHS speech and language therapy versus control for dysarthria in people with Parkinson’s disease (PD COMM): pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial” by Catherine M Sackley, Caroline Rick, Marian C Brady, Rebecca Woolley, Christopher Burton, Smitaa Patel, Patricia Masterson-Algar, Avril Nicoll, Christina H Smith, Sue Jowett, Natalie Ives, Gillian Beaton, Sylvia Dickson, Ryan Ottridge, Leslie Sharp, Helen Nankervis and Carl E Clarke, 10 July 2024, BMJ.
DOI: 10.1136/bmj-2023-078341

The study was funded by the National Institute for Health Research, Health Technology Assessment program.