Aerodynamic Mechanisms Underlying Treatment-Related Changes in Vocal Intensity in Patients With Parkinson Disease The purpose of this study was to document changes in aerodynamic and glottographic aspects of vocal function in patients with Parkinson disease who received two forms of high effort treatment. Previous reports (Ramig, Countryman, Thompson, & Horii, 1995) have documented increased sound pressure level (SPL) following treatment that trained phonation ... Research Article
Research Article  |   August 01, 1996
Aerodynamic Mechanisms Underlying Treatment-Related Changes in Vocal Intensity in Patients With Parkinson Disease
 
Author Affiliations & Notes
  • Lorraine Olson Ramig
    Department of Communication Disorders and Speech Science University of Colorado at Boulder and Wilbur James Gould Voice Research Center Denver Center for the Performing Arts
  • Christopher Dromey
    Department of Communication Disorders and Speech Science University of Colorado at Boulder and Wilbur James Gould Voice Research Center Denver Center for the Performing Arts
  • Contact author: Lorraine Olson Ramig, PhD, Department of Communication Disorders and Speech Science, University of Colorado, Campus Box 409, Boulder, CO 80309. E-mail: ramig@spot.colorado.edu
Article Information
Special Populations / Older Adults & Aging / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   August 01, 1996
Aerodynamic Mechanisms Underlying Treatment-Related Changes in Vocal Intensity in Patients With Parkinson Disease
Journal of Speech, Language, and Hearing Research, August 1996, Vol. 39, 798-807. doi:10.1044/jshr.3904.798
History: Received July 31, 1995 , Accepted February 29, 1996
 
Journal of Speech, Language, and Hearing Research, August 1996, Vol. 39, 798-807. doi:10.1044/jshr.3904.798
History: Received July 31, 1995; Accepted February 29, 1996

The purpose of this study was to document changes in aerodynamic and glottographic aspects of vocal function in patients with Parkinson disease who received two forms of high effort treatment. Previous reports (Ramig, Countryman, Thompson, & Horii, 1995) have documented increased sound pressure level (SPL) following treatment that trained phonation and respiration (Lee Silverman Voice Treatment: LSVT), but not for treatment that trained respiration only (R). In order to examine the mechanisms underlying these differences, measures of maximum flow declination rate (MFDR) and estimated subglottal pressure (Psub) were made before and after treatment. A measure of relative vocal fold adduction (EGGW) was made from the electroglottographic signal during sustained vowel phonation. Sound pressure level data from syllable repetition, sustained vowel phonation, reading, and monologue tasks were also analyzed to allow a more detailed understanding of treatment-related change in several contexts. Consistent with increases in SPL, significant increases in MFDR, estimated Psub, and EGGW were measured posttreatment in patients who received the LSVT. Similar changes were not observed following R treatment. These findings suggest that the combination of increased vocal fold adduction and subglottal pressure is a key in generating posttreatment increases in vocal intensity in idiopathic Parkinson disease (IPD).

Acknowledgments
This research was supported in part by grants NIH-NIDCD #R01 DC01150 and #P60 DC00976. We are grateful for the suggestions of three anonymous reviewers based on an earlier version of this manuscript.
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