Early-onset Parkinson disease / Posted 1 year ago

A multi-centre randomised controlled trial to compare the clinical and cost effectiveness of Lee Silverman Voice Treatment versus standard NHS speech and language therapy versus control in Parkinson’s disease (PD COMM)

Parkinson’s disease (PD) is a common movement disorder, affecting approximately 120,000 people in the UK. Over two thirds of people with PD report having speech related problems which has a great impact on their lives, leading to increased physical and mental demands during conversation, reduced independence and social withdrawal.
Speech and language therapy (SLT) is advocated for people with PD but current provision is low, with a recent Parkinson’s UK survey reporting that just 37% of the patients included had received SLT. This may be attributed, in part, to the limited scientific evidence of a benefit of SLT for people with PD. Currently 2 different types of SLT are available in the UK: standard NHS SLT, typically consisting of 1 hour per week for 6 – 8 weeks and Lee Silverman Voice Training (LSVT), a more intensive therapy comprising of 4 sessions per week for 4 weeks. From the literature it is unclear if one or both of these treatments is effective or acceptable to people with PD, and if there is a benefit whether it continues once the treatments have stopped.
We propose a study in which LSVT, traditional NHS SLT and a no intervention control will be compared in people with PD. People with PD will be randomly assigned to one of the 3 groups and their communication effectiveness and quality of life will be compared before and after treatment (baseline and 3 months), and 6 and 12 months later to see if any benefit remains.

  • Inclusion Criteria :
    • People who have idiopathic PD defined by the UK PDS Brain Bank Criteria. These criteria are in standard use throughout the NHS in the UK and supported by the NICE guidelines
    • Person with PD or carer report problems with their speech or voice when asked
  • Exclusion Criteria :
    • Dementia as usually defined clinically by the person with PD’s physician
    • Evidence of laryngeal pathology including vocal nodules or a history of vocal strain or previous laryngeal surgery within their medical records or from discussions with client, as LSVT is not appropriate for this group
    • Received SLT for PD speech or voice related problems in the past 2 years NB: Individual involvement in the trial is 12 months, but participants randomised to the control group can be referred for SLT at the end of trial (e.g. after 12 months) or, if it becomes medically necessary during the trial (e.g. within 12 months of randomisation).
  • Study start date : 11/10/2016
  • Study end date : 30/11/2020
  • Wales-Based Study Contact : please speak to your clinician
Contact details
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