Category: Parkinson's Disease (Other)
Objective: To demonstrate the ability to improve vocal volume and improve perceived disability and quality of life in PD patients at the unstructured conversational level during a 2-week in-patient multimodal intensive neurorehabilitation and care (i-MINC) stay.
Background: SPEAK OUT!® is a 12-week vocal intensity training program with maintenance via group treatment to improve vocal volume and intelligibility consisting of 40-minute sessions, 3 times weekly with home practice twice daily required. This was modified for use during a 2-week acute rehabilitative stay. Expiratory muscle strength training (EMST) has been shown to significantly improve vocal volume in people with PD over a 5-week period.
Method: 275 moderately advanced PD patients who were able to complete Voice Handicap Index (VHI) scale and participate in the protocol were included in this study.
Modified SPEAK OUT!® performed once daily during 60-minute therapy session.
EMST performed daily per protocol recommended by manufacturer during therapy session.
Vocal volume was monitored during all tasks and during unstructured conversation utilizing a sound level meter.
Both VHI and Vocal volume were evaluated on admission and at discharge from the i-MINC program, and scores were analyzed using a t-test.
Results: The mean admission vocal volume was 51.98dB and increased to 58.36dB at discharge.
The mean VHI scores upon admission were 49.16 and decreased to 41.99.
Both changes were extremely statistically significant (<0.001) for improvement utilizing the protocols during i-MINC.
Conclusion: This study highlights the effectiveness of utilizing EMST along with a modified SPEAK OUT!® protocol. The parallel improvement in Vocal Volume and VHI scores suggest that the protocols in place during i-MINC are effective in improving patient’s volume of voice as well as perception of disability and quality of life in a shortened time period. Future studies may focus on efficacy of modification of current PD protocols to adapt for use during i-MINC.
Table 1
References: To be submitted
To cite this abstract in AMA style:
P. Fischetti, J. Yu, M. Mccrossin, L. Rubin. Improving Vocal Volume and Quality of Life for People with Parkinson’s Disease (PD) utilizing EMST and SPEAK OUT!® in the In-Patient Multimodal Intensive Neurorehabilitation And Care Setting. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/improving-vocal-volume-and-quality-of-life-for-people-with-parkinsons-disease-pd-utilizing-emst-and-speak-out-in-the-in-patient-multimodal-intensive-neurorehabilitation-and-care-setting/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/improving-vocal-volume-and-quality-of-life-for-people-with-parkinsons-disease-pd-utilizing-emst-and-speak-out-in-the-in-patient-multimodal-intensive-neurorehabilitation-and-care-setting/