Lee Silverman Voice Treatment for traumatic brain injury dysarthria

Solomon, N., McKee, A. And Garcia-Barry, S. (2001). Intensive voice treatment and respiration treatment for hypokinetic-spastic dysarthria after traumatic brain injury. American Journal of Speech-Language Pathology. (10) 51-64.

What was the problem or question the authors were asking?

A young man who had sustained massive brain trauma was examined to see which method would help him to breath and speak properly again.

What research or background information was described?

The efficacy of the Lee Silverman Voice Treatment (LSVT) was explored and tested in terms of a patient twenty months after the sustainment of a major injury. LSVT is "an intensive 4-week program that focuses on increased vocal effort" (Solomon 2001,-page 51). It has proven to be successful in helping patients with Parkinson's.

c. Therefore, what was the purpose of the present article?

To see whether or not the LSVT would help a young man with traumatic brain injury (tbi) and therefore expand its usage beyond people with Parkinson's disease.

II. Methods:

a. Subjects, Number, Ages, Sex, and Any Other Identifying Characteristics:

One young man, age unknown, 20 months after a tbi

b. Instrumentation or Materials Used:

The breathing and speaking functions were measured using spirometry, respiratory kinematics, intelligibility, and acoustic and auditory perception measures

c. Procedures:

Breathing and speech were initially assessed. Six weeks of treatment were given and documented. These were continued for an additional ten weeks and then tested again. Finally, tests were conducted three months after the treatments stopped to see which gains had remained and which had been lost.

III. Results:

What did the authors find? Did they use statistical analysis: was this significant?

They found that several of the criterions returned to their baseline measurements but that improvement in resting and speech remained present. There were also still improvements in vocal SPL and intelligibility. Statistical analysis was employed because they compared the present patient with his conditions before the test.

IV. Conclusions and Discussion:

a. How did these findings compare with what had already been reported?

No published reports had tested how these procedures worked with people who had tbi.

b. How did the authors explain their findings?

They explained through clear text what it is that they had discovered.

c. What are further research needs?

Further research is needed to determine if results would be the same in all patients with tbi or not.

2 Courage Center, Minneapolis, MN

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

Submitted on February 18, 2000

Accepted on November 20, 2000