Comparison of Simultaneous to Sequential Physical & Vocal Treatment in Parkinsons Disease

Research Objectives: To compare the efficacy of simultaneous voice and physical fitness treatment to sequential voice treatment and physical fitness treatment.
To report changes in pre- to post- outcomes on measures of voice perturbation and noise, vocal intensity, and maximum phonation time from both conditions of treatment; simultaneous voice and physical fitness and sequential physical fitness and voice treatment.

Design: This is a pilot, small group pre-treatment to post-treatment measures comparison study.

Setting: Participants were recruited from the community who met the inclusion criteria and then attended treatment sessions on a university campus.

Participants: Participants were recruited from the community and included in the study based on inclusion and exclusion criteria. Twenty-one qualified participants were alternately assigned into a treatment condition. There were three treatment conditions: simultaneous treatment group with seven participants, sequential physical first treatment group with seven participants, and sequential voice first treatment group with seven participants.

Interventions: Voice treatment included exercises consistent with SPEAK OUT! treatment: warm-up, sustained phonation 'ah', counting aloud, glissandos, cognitive tasks answered aloud, recitation and/or singing, and joke telling. The physical fitness exercises included functional fitness and balance tasks similar to those in the Senior Fitness Test (SFT) and basic balance tasks in different stances.

Main Outcome Measures: The focus of this poster is to present the outcomes related to voice. Outcome measures included: conversational dB (loudness), sustained phonation in dB, Sustained phonation in duration, and harmonics-to-noise ratio.

Results: The focus of this poster is to present the outcomes related to voice. Improvement on voice measures were measure specific. Both groups evidenced an increase in harmonics-to-noise ratio. In the Sequential groups, an increase was evidenced in Conversational dB (dB = loudness) and decreases were evidenced in sustained phonation in both dB and duration. In the Simultaneous group, increases were evidenced in Sustained phonation in both dB and duration and a decrease was evidenced in Conversational dB.

Conclusions: Based on observational data, it appears that the effect of participating in treatment sequentially, one therapy service followed by another, may increase conversational loudness but may be harmful in building sustained phonation in both loudness and duration when compared to the benefits of participating in two therapies simultaneously.

Author(s) Disclosures: This research was supported by a grant through the University of Central Oklahoma.
The author receives a salary from the University of Central Oklahoma and support for this research was conducted on salaried time.
Travel to present this research may be funded by the University of Central Oklahoma.