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 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.

Note:

Currently affiliated with Courage Center, Minneapolis, MN

Key Words: LSVT, TBI, dysarthria, breathing, voice, physical therapy, treatment efficacy

Submitted on February 18, 2000
Accepted on November 20, 2000