Research at the University of Nottingham suggests that LSVT LOUD®, a specialist speech treatment, is more effective than traditional NHS treatment for people with Parkinson’s, improving their speech and overall quality of life.

A large clinical trial has shown that Lee Silverman’s Voice Therapy (LSVT LOUD®) is more effective in treating people with Parkinson’s disease (PD) than current speech and language therapy provided by the NHS.

The results of the NIHR HTA-funded research were published on 10 July. BMJ They showed that LSVT LOUD® was more effective in reducing the effects of self-reported voice problems than no speech and language therapy and NHS-provided speech and language therapy.

The trial was led by experts from the Universities of Nottingham and Birmingham, along with colleagues from Sandwell and Dudley Hospital Trust, University College London, King’s College London, Bangor University, University of Canterbury, Christ Church and Glasgow Caledonian University. It was carried out by the NHS Speech and Language Therapy Services in the UK and coordinated and analysed by the Birmingham Clinical Research Unit (BCTU) team at the University of Birmingham.

Participants’ experience and impact on quality of life

The study was led by Professor Catherine Sackley, from the Faculty of Health Sciences and the NIHR Nottingham Biomedical Research Centre. She said: “The speech and communication problems of people with dyslexia can make them feel stigmatised. This can stop them going out, prevent them from communicating and doing everyday things like shopping, which can have a negative impact on their quality of life.

“This is the first study of its kind to look at the most effective treatment options. The results clearly show that the LSVT LOUD® method can be effective and cost-effective in this way. The currently used NHS method is ineffective. Now that we have this data, we need to look at other factors and determine whether different treatments are being used in different ways to influence outcomes.”

Based on a pilot study funded by The Dunhill Medical Trust, participants were recruited from 40 NHS centres across the UK and randomised into three groups. One group received LSVT LOUD®, one group received ongoing NHS speech and language therapy and the third group received no therapy.

Comparison of LSVT LOUD® and NHS treatment

LSVT LOUD® is an effective speech therapy for people with Parkinson’s disease and other neurological conditions. The treatment helps people with Parkinson’s syndrome to use their voice at a more normal volume when speaking at home, at work or in public. To do this, patients are given voice exercises. NHS treatment is a personalised programme run by a therapist and is less intensive. It is carried out over six to eight sessions, as opposed to LSVT LOUD® which is carried out over 16 sessions over four weeks.

Between September 2016 and March 2020, 388 people with Parkinson’s syndrome and dysarthria (difficulty speaking) participated in the study. 130 were assigned to the LSVT LOUD® group, 129 to the NHS therapy group, and 129 to neither.

LSVT LOUD® consisted of four 50-minute face-to-face or remote sessions delivered once a week for four weeks, with additional practice at home. NHS speech and language therapy was determined by the local therapist in response to the participant’s individual needs, with an average of one session every two weeks for 11 weeks.

Summary and results of the study

The results of the study showed that LSVT LOUD® was more effective in reducing the impact of dysarthria than no speech and language therapy and the NHS version. NHS therapy showed no evidence of benefit compared with no speech and language therapy.

Adrian Wrigley, who has Parkinson’s disease, said: “Speech and language therapy research is very important to me personally because I have seen first-hand how the loss or reduction of our primary means of communication leads to increased levels of frustration and anxiety, not just for patients but also for our partners and friends. So developing effective treatments is very important for the Parkinson’s community.”