Intensive Voice Treatment and Respiration Treatment for Hypokinetic-Spastic Dysarthria After Traumatic Brain Injury The short-term efficacy of the Lee Silverman Voice Treatment (LSVT) and the short- and long-term efficacy of LSVT exercises combined with respiration treatment and physical therapy (Combination Treatment) were examined for a young man diagnosed with mixed hypokinetic-spastic dysarthria 20 months after sustaining a traumatic brain injury (TBI). The efficacy ... Research Article
Research Article  |   February 01, 2001
Intensive Voice Treatment and Respiration Treatment for Hypokinetic-Spastic Dysarthria After Traumatic Brain Injury
 
Author Affiliations & Notes
  • Nancy Pearl Solomon
    University of Minnesota, Minneapolis
  • Amy S. McKee
    University of Minnesota, Minneapolis
  • Sandra Garcia-Barry
    Courage Center, Minneapolis, MN
  • * Currently affiliated with Courage Center, Minneapolis, MN
    Currently affiliated with Courage Center, Minneapolis, MN×
  • Contact author: Nancy Pearl Solomon, PhD, 115 Shevlin Hall, 164 Pillsbury Drive SE, University of Minnesota, Minneapolis, MN 55455.
    Contact author: Nancy Pearl Solomon, PhD, 115 Shevlin Hall, 164 Pillsbury Drive SE, University of Minnesota, Minneapolis, MN 55455.×
Article Information
Research Articles
Research Article   |   February 01, 2001
Intensive Voice Treatment and Respiration Treatment for Hypokinetic-Spastic Dysarthria After Traumatic Brain Injury
American Journal of Speech-Language Pathology, February 2001, Vol. 10, 51-64. doi:10.1044/1058-0360(2001/008)
History: Received February 18, 2000 , Accepted November 20, 2000
 
American Journal of Speech-Language Pathology, February 2001, Vol. 10, 51-64. doi:10.1044/1058-0360(2001/008)
History: Received February 18, 2000; Accepted November 20, 2000
Web of Science® Times Cited: 14

The short-term efficacy of the Lee Silverman Voice Treatment (LSVT) and the short- and long-term efficacy of LSVT exercises combined with respiration treatment and physical therapy (Combination Treatment) were examined for a young man diagnosed with mixed hypokinetic-spastic dysarthria 20 months after sustaining a traumatic brain injury (TBI). The efficacy of the LSVT, an intensive 4-week program that focuses on increased vocal effort, is well documented for idiopathic Parkinson’s disease. This is the first known published account of the use of LSVT with TBI. Breathing and speech function were assessed by spirometry, respiratory kinematics, intelligibility, and other selected acoustic and auditory-perceptual measures. Improvements generally were minor and inconsistent after LSVT, although sound pressure level (SPL) and loudness increased notably. After an additional 6 weeks of intensive Combination Treatment, gains were documented for resting and speech breathing. Moreover, SPL increased further and sentence intelligibility improved substantially. The gains were maintained to varying degrees after 10 weekly sessions of Combination Treatment. Although several measures returned to baseline 3 months after treatment ceased, some improvements in resting and speech breathing remained. Most important clinically, improvements in vocal SPL and sentence intelligibility persisted.

Acknowledgments
A portion of this project was based on a thesis completed by A.S.M. under the direction of N.P.S. in partial fulfillment of the Master of Arts Degree in Communication Disorders at the University of Minnesota. Funding was provided in part by the Bryng Bryngelson and Clark Starr Research Funds of the Department of Communication Disorders at the University of Minnesota. Preliminary versions of this research were presented at the 1998 Conference on Motor Speech in Tucson, AZ, and the 1998 Convention of the American Speech-Language-Hearing Association in San Antonio, TX.
Roberta Wehrs from the Struthers Parkinson’s Center and Barbara Hentges from the Courage Center are gratefully acknowledged for their expert clinical intervention. Gratitude is extended to Drs. Leslie Glaze and James Carey for their helpful input, and to Dr. Edward Carney for graphical and statistical assistance. Finally, we thank “JN” for providing us this opportunity, data, and inspiration.
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