Parkinson’s disease (PD) is a common degenerative disease of the central nervous system in the elderly, mainly caused by nigrostriatal dopamine deficiency. The main clinical manifestations are resting tremor, muscle rigidity, bradykinesia and abnormal posture, etc. Currently, the incidence is 1% in people over 60 years of age. Speech impairment is also one of the most common problems in patients with Parkinson’s disease, with an incidence of up to 89%. The speech disorder of Parkinson’s patients is mainly caused by abnormal laryngeal function, and its representative symptoms include vocal incoordination, vocal fatigue, difficulty in vocalization, decreased ability to control vocalization, decreased volume, hoarseness, and decreased clarity of language expression. These symptoms can even appear as first symptoms in patients.
is the most powerful treatment for speech disorders in Parkinson’s patients at this stage Lee Silverman speech therapy (Lee Silverman voice treatment, LSVT) technology was proposed and perfected by American speech-language pathologist Lorraine Ramig in the 1980s. Unlike other methods, LSVT focuses on the most common speech problem in people with Parkinson’s disease, the problem of abnormal voice. The exact mechanism of speech impairment in patients with Parkinson’s disease is still unclear, but the vocal movement in patients with Parkinson’s disease has the following characteristics: reduced range of motion of muscles involved in vocalization, sensory disturbance of one’s own vocalization, and inability to measure the muscle movement of one’s own vocalization strength. The main goals of LSVT training are to improve long-term verbal communication, focusing on increasing sound intensity, promoting perception of vocal motor disturbances, and realigning the sensorimotor system for vocalization.
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Core Points of LSVT Training
< p>1.Increase the amplitude of vocal movement;
2.Improve the ability to sense oneself when vocalizing;
3. Patients need to do their best to complete the training;
4. High-intensity training (about 4 times a week, 4 consecutive times) A total of 16 training sessions per week as a cycle);
5. Quantification of vocal movement.
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The specific implementation of the LSVT method is as follows:
· There are three tasks in the first half of each training session:
< span>1.Train the patient to pronounce vowels for as long as possible, such as instructing the patient to inhale deeply, for as long as possible
2.Train the patient to maximize vocalization frequency range, such as instructing the patient to produce the highest possible pitch first and then the lowest possible pitch;
3.< /strong>Sentence training, instruct the patient to choose 10 phrases or sentences used in daily life for vocal training.
· The second half of each training is stepped sound intensity training,
1.The first week is sound intensity training for words and phrases;< /span>
2.The second week is the sound intensity training of sentences;
3.The third week is sound intensity training when reading;
4.< /span>The fourth week is sound intensity training during conversation.
LSVT aims at three characteristics of Parkinson’s patients, namely: reduced range of muscle movement involved in vocal mechanism, sensory disturbance of own vocalization, It is impossible to adjust the appropriate muscle exercise intensity during vocalization, and there are different degrees of adjustment. It is also necessary to continue the treatment plan and instruct the patient to strengthen self-exercise during non-treatment time.