Objective: To evaluate the clinical effectiveness of two speech and language therapy (SLT) approaches compared to no SLT (control) for people with Parkinson’s disease (PD). The trial compared Lee Silverman Voice Treatment (LSVT) versus ‘standard’ NHS SLT.
Background: An estimated 60% of people with PD develop speech/voice problemsm negatively affect their quality of life and that of their carers and family. The evidence for the effectiveness of Lee Silverman Voice Treatment or standard NHS therapy is not clearcut.
Method: People with PD and speech/voice problems were randomised to LSVT, ‘standard’ NHS SLT, or no SLT (control) in a 1:1:1 ratio. This was a pragmatic, multicentre, parallel group, superiority trial conducted in the UK in outpatient and home settings. LSVT consisted of 4, 60-minute sessions per week for 4 weeks consisting of maximum effort drills and high effort speech production tasks plus daily home-based practice. ‘Standard’ NHS SLT consisted of local NHS practices determined by a participant’s individual needs, typically once a week for an hour, for 6 weeks. Both interventions were provided by suitably trained and experienced speech and language therapists or assistants. The primary outcome was participant-completed voice handicap index (VHI) total score at three months after randomisation. Analysis was based on the intention to treat principle.
Results: 388 participants were randomised into the trial: 130 participants to LSVT, 129 to ‘standard’ NHS SLT and 129 to no SLT (control). The Voice Handicap Index was improved (lower score better) following LSVT compared with no SLT (control) -8.0 (-13.3, -2.6) p=0.0001, but not for ‘standard’ NHS SLT compared to no SLT (control) 1.7 (-3.8, 7.1) p=0.4. LSVT compared to ‘standard’ NHS SLT was improved -9.6 (-14.9, -4.4) p<0.0001. These results were supported by all sensitivity analyses. No serious adverse events were reported.
Conclusion: People with PD-related speech/voice problems experienced a significantly greater reduction in the impact after 3 months following LSVT compared to no SLT (control). The impact of speech/voice problems did not differ after receiving ‘standard’ NHS SLT compared to no SLT (control) and LSVT was significantly more effective than ‘standard’ NHS SLT. This trial was funded by the NIHR HTA Programme: HTA 10/135/02. ISRCTN12421382. Ethics: 15/WM/0443
To cite this abstract in AMA style:
C. Sackley, C. Rick, S. Patel, R. Woolley, M. Brady, A. Nicoll, S. Dickson, G. Beaton, C. Smith, H. Nankervis, C. Burton, P. Masterson-Algar, N. Ives, S. Jowett, Z. Abdali, L. Sharp, T. Jeffreys, C. Clarke. Lee Silverman voice treatment versus standard NHS speech and language therapy versus control in Parkinson’s disease: the PD COMM randomised controlled trial. [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/lee-silverman-voice-treatment-versus-standard-nhs-speech-and-language-therapy-versus-control-in-parkinsons-disease-the-pd-comm-randomised-controlled-trial/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/lee-silverman-voice-treatment-versus-standard-nhs-speech-and-language-therapy-versus-control-in-parkinsons-disease-the-pd-comm-randomised-controlled-trial/