Semin Speech Lang 2006; 27(4): 283-299
DOI: 10.1055/s-2006-955118
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

The Science and Practice of LSVT/LOUD: Neural Plasticity-Principled Approach to Treating Individuals with Parkinson Disease and Other Neurological Disorders

Cynthia M. Fox1 , Lorraine O. Ramig2 , Michelle R. Ciucci3 , Shimon Sapir4 , David H. McFarland5 , Becky G. Farley6
  • 1Research Associate, National Center for Voice and Speech, Denver, CO Research Lecturer, Department of Neurology, University of Arizona, Tucson, Arizona
  • 2Professor, Department of Speech, Language, Hearing Sciences, University of Colorado-Boulder; Senior Scientist, National Center for Voice and Speech, Denver Center for the Performing Arts, Denver, Colorado; Adjunct Professor, Columbia University, New York, New York; University of Colorado-Boulder, Boulder, Colorado
  • 3Lecturer, University of Texas-Austin, and University of Colorado-Boulder, Boulder, Colorado
  • 4Associate Professor, Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel, Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Studies, University of Haifa, Mount Carmel, Haifa, Israel
  • 5École d'orthophonie et d'audiologie et centre de recherche en sciences neurologiques, Faculté de médecine, Université de Montréal and School of Communication Sciences and Disorders and Center for Research on Language, Mind and the Brain, McGill University, University de Montréal, Montréal, Québec, Canada
  • 6Assistant Research Professor, Department of Physiology, University of Arizona, Tucson, Arizona
Further Information

Publication History

Publication Date:
21 November 2006 (online)

Abstract

Our 15 years of research have generated the first short- and long-term efficacy data for speech treatment (Lee Silverman Voice Treatment; LSVT/LOUD) in Parkinson's disease. We have learned that training the single motor control parameter amplitude (vocal loudness) and recalibration of self-perception of vocal loudness are fundamental elements underlying treatment success. This training requires intensive, high-effort exercise combined with a single, functionally relevant target (loudness) taught across simple to complex speech tasks. We have documented that training vocal loudness results in distributed effects of improved articulation, facial expression, and swallowing. Furthermore, positive effects of LSVT/LOUD have been documented in disorders other than Parkinson's disease (stroke, cerebral palsy). The purpose of this article is to elucidate the potential of a single target in treatment to encourage cross-system improvements across seemingly diverse motor systems and to discuss key elements in mode of delivery of treatment that are consistent with principles of neural plasticity.

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Lorraine O RamigPh.D. CCC-SLP 

Department of Speech, Language, Hearing Sciences, University of Colorado, Boulder

Campus Box 409, Boulder, CO 80303

Email: ramig@spot.colorado.edu

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