Facial and vocal expression in idiopathic Parkinson's disease:

Effects of intensive voice therapy (LSVT)

By J.L. Spielman, L. O. Ramig, and J.C. Borod


Voice disorders and facial immobility associated with Parkinson’s disease (PD) have been historically difficult to treat (Katsikitis & Pilowsky, 1996; Schulz & Grant, 2000). However, recent advances in voice therapy have demonstrated significant and lasting improvements in voice and speech following intensive voice therapy (Lee Silverman Voice Treatment, LSVT®, Ramig et al., 1995), as well as increased facial expressivity (Spielman, Ramig, & Borod, 2001). The purpose of the present study was to examine in detail the effects of the LSVT® on both vocal and facial expression in PD.  In this study, 44 individuals with PD were randomly assigned to either an LSVT® or respiratory (RT) control treatment group and received one month of intensive therapy. Video and audio samples of all subjects were taken before and after treatment and then played back randomly in pairs to trained raters, who judged each pair of audio and video clips on measures of facial and vocal mobility, engagement and positive emotion. Overall, members of the LSVT® group received higher ratings on all six variables than members of the RT group. These results indicate the positive effects of intensive voice therapy on both vocal and facial expressivity in PD and support the need for further investigation.