The Effect of Lee Silverman Voice Therapy-LOUD (LVST-LOUD) Therapy Method on Voice and Speech Skills and Examination of Therapy Experiences in Turkish-Speaking Individuals With Parkinson's Disease
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 24
- 试验地点
- 1
- 主要终点
- Qualitative Therapy Experience
研究概览
简要总结
Parkinson's disease often causes speech and voice impairments, such as reduced vocal loudness and decreased speech intelligibility, which significantly impact the quality of life for patients and their families. The Lee Silverman Voice Therapy-LOUD (LSVT-LOUD) is a specialized, evidence-based speech therapy protocol designed to improve vocal function.
This study investigates the effectiveness of the LSVT-LOUD protocol in Turkish-speaking individuals with Parkinson's disease. The research evaluates objective changes in vocal loudness and speech quality, as well as the subjective therapy experiences of participants. By analyzing both clinical outcomes and patient feedback, this study aims to contribute to the clinical application and adaptation of LSVT-LOUD for the Turkish-speaking population
详细描述
This study implements the standardized Lee Silverman Voice Treatment (LSVT-LOUD) protocol, an intensive intervention focused on the recalibration of vocal effort through motor learning principles. The intervention requires participants to attend individual therapy sessions conducted four times per week over a four-week period, with each session lasting 60 minutes.
The protocol emphasizes high-effort phonation and is structured into the following components:
Daily Tasks: Sustained vowel phonation (maximum duration and stability), pitch range exercises (high-to-low and low-to-high glides), and maximum functional loudness drills using high-effort speech.
Hierarchy Tasks: Systematic progression from word-level to sentence-level and, finally, conversational speech tasks, incorporating high-effort vocal production into increasingly complex linguistic structures.
Carry-over Exercises: Daily practice assignments designed to facilitate the generalization of high-effort speech into activities of daily living and social interactions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 40 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis: Patients with a confirmed diagnosis of Idiopathic Parkinson's Disease (Hoehn and Yahr stages I-III).
- •Age: Individuals aged 40-80 years.
- •Language: Native Turkish speakers.
- •Cognitive Status: Sufficient cognitive function to participate in therapy (e.g., Mini-Mental State Examination (MMSE) score ≥ 24).
- •Communication: Presence of voice or speech impairment (e.g., hypophonia, reduced intelligibility) as confirmed by a speech-language pathologist.
- •Stability: Stable medication regimen for at least 1 month prior to the study initiation.
排除标准
- •Neurological Comorbidities: Presence of other significant neurological disorders (e.g., stroke, traumatic brain injury, multiple sclerosis) or active voice disorders (e.g., vocal cord nodules, laryngeal cancer).
- •Hearing Impairment: Uncorrected hearing loss that would interfere with speech assessment or therapy.
- •Cognitive Impairment: Diagnosis of dementia or severe cognitive impairment that prevents participation in the intensive LSVT-LOUD protocol.
- •Recent Surgery: History of laryngeal surgery or deep brain stimulation (DBS) within the last 6 months.
- •Therapy History: Previous experience with LSVT-LOUD or intensive speech therapy within the past year.
结局指标
主要结局
Qualitative Therapy Experience
时间窗: Post-therapy (4 weeks)
Semi-structured interview form conducted with participants and their primary caregivers to explore subjective therapy experiences, including motivation, challenges, perceived benefits, and communication improvements. Analysis performed using thematic analysis methods.
Vocal Intensity (Loudness)
时间窗: Baseline (pre-therapy), post-therapy (4 weeks), 1-month follow-up, and 3-month follow-up.
Measured through acoustic analysis of sustained phonation and standardized speech tasks to evaluate changes in vocal intensity. - Decibels (dB)
Acoustic Voice Stability (Jitter and Shimmer)
时间窗: Baseline (pre-therapy), post-therapy (4 weeks), 1-month follow-up, and 3-month follow-up.
Evaluation of vocal stability by measuring cycle-to-cycle variability in fundamental frequency (Jitter) and amplitude (Shimmer) during sustained vowel phonation. - Unit of Measure: Percentage (%)
Fundamental Frequency (F0)
时间窗: Baseline (pre-therapy), post-therapy (4 weeks), 1-month follow-up, and 3-month follow-up.
Mean fundamental frequency of the voice during sustained phonation. - Hertz (Hz)
次要结局
- Voice Handicap Index (VHI)(Post-therapy (4 weeks))
- Parkinson's Disease Questionnaire (PDQ-39)(post-therapy (4 weeks))