Feasibility and Acceptability of Lee Silverman Voice Treatment in Progressive Ataxias
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ORIGINAL ARTICLE
Feasibility and Acceptability of Lee Silverman Voice Treatment in Progressive Ataxias Anja Lowit 1
&
Aisling Egan 1 & Marios Hadjivassiliou 2
# The Author(s) 2020
Abstract Communication difficulties have considerable impact on people with progressive ataxia, yet there are currently no evidencebased treatments. LSVT LOUD® focuses on the production of healthy vocal loudness whilst also improving breath support, vocal quality, loudness and articulation in participating patients. This study aimed to investigate whether Lee Silverman Voice Treatment (LSVT LOUD®) can improve communication effectiveness in these patients. We performed a rater-blinded, singlearm study investigating LSVT LOUD® treatment in a population of patients with progressive ataxia including Friedreich’s ataxia (n = 18), spinocerebellar ataxia type 6 (n = 1), idiopathic cerebellar ataxia (n = 1), and spastic paraplegia 7 (n = 1). Twenty-one patients were recruited to the study, with 19 completing treatment. Sessions were administered via Skype in the LSVT-X format, meaning two sessions per week over a period of 8 weeks. Assessments included two baseline and two post-treatment measures and focused on outcome measures covering aspects ranging from physiological function to impact and participation. Results indicate improvements in patient-perceived outcomes for 14 of the 19 participants, in both speech and psychosocial domains. Speech data furthermore demonstrate significant improvements in prolonged vowel duration, and voice quality measures. Intelligibility and naturalness evaluations showed no change post-treatment. Patients reported high acceptability of the treatment itself, as well as administration by Skype. This is the largest treatment study for people with progressive ataxia published to date. It provides an indication that LSVT LOUD® can have a positive impact on communication in this patient group and could form the basis for larger-scale trials. Keywords Progressive ataxia . Ataxic dysarthria . Voice quality . Speech therapy . Communication participation . Psychosocial wellbeing
Introduction Ataxic dysarthria is a motor-speech disorder associated with cerebellar dysfunction which is prevalent in progressive ataxias. The characteristics of ataxic dysarthria include imprecise articulation, distorted vowels, voice changes, reduced speech rate, flat prosody and poor respiratory support [1]. These changes lead to reduced speech intelligibility and
* Anja Lowit [email protected] 1
Speech and Language Therapy, School of Psychological Sciences and Health, Strathclyde University, 40 George St, Glasgow G1 1QE, UK
2
Sheffield Teaching Hospitals NHS Trust, University of Sheffield, Sheffield S10 2TG, UK
communication breakdown. In a recent survey by Ataxia UK [2], people with progressive ataxia identified speech and communication problems as one of the top three most troublesome symptoms of their disease with significant negative impact on their lives. Whilst our understanding of the nature of the communication problems ex
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