Intensive singing interventions have the potential to increase vocal loudness, respiratory muscle strength, and voice-related quality of life in people with Parkinson’s disease, a study suggests.
The study, “ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson’s Disease,” was published in Neurorehabilitation and Neural Repair.
Communication impairment is common among Parkinson’s patients. The neurodegenerative disorder not only affects the muscles needed for movement, but also the ones necessary to control communication capacity, including speech and facial expressions.
Around 90% of those living with Parkinson’s have voice and speech changes, but few seek medical advice. Patients’ voice can become difficult to hear due to throat muscle rigidity (stiffness).
There are known similarities between anatomical and neural requirements for both singing and speaking. Evidence suggests that singing may have the potential to ease some of the speech-motor changes associated with several neurological disorders.
Researchers from the University of Melbourne in Australia examined the impact of a singing-based therapeutic intervention, called ParkinSong, on voice, speech, respiratory function, and voice-related quality-of-life in people with Parkinson’s.
A total 75 patients, 46 men and 29 women with a mean age of 74.3 years, were included in the controlled trial (ACTRN12617000528358). Participants were randomly assigned to four groups, in which they engaged in singing-based intervention with different frequency. The ParkinSong weekly group comprised 20 individuals and the monthly group 27, while the control weekly counted 15 participants and the control monthly group had 13.
According to the investigators, this is the first controlled trial studying the efficacy of a singing-based therapeutic training program in Parkinson’s disease.
ParkinSong training consisted of 30 minutes of high-intensity music-based vocal exercises incorporating respiratory control, vocal loudness, pitch control, and speech clarification strategy activities. After that, participants underwent 60 minutes of singing popular and traditional songs and rounds, with a focus on loud voice projection and increased respiratory support. Patients then had 30 minutes of social interaction and conversation practice over morning or afternoon tea, where they were asked to use the strategies for generating loud voice that had been practiced during the training session. The intervention was delivered either once a week or once a month, for three months.
“Weekly control participants attended weekly painting, dancing, or tai chi sessions, and monthly control participants attended monthly peer support groups,” the researchers said.
The team found that patients in the ParkinSong sessions had significantly better vocal intensity, respiratory muscle strength (as measured by maximum expiratory pressure), and voice-related quality of life, compared with those in the control groups. Voice-related quality of life was scored by applying the Voice Activity and Participation Profile (VAPP) questionnaire, a reliable measure for assessing patients’ voice problems and degree of severity.
Comparison of weekly and monthly ParkinSong interventions revealed there was a higher vocal intensity in the weekly group, suggesting that the intensive approach positively affected speech characteristics.
After completion of the three months of therapeutic intervention, loudness decreased in both control groups, and there were no differences between the groups on the longest time patients could say a vowel, or on inspiratory muscle strength.
“Singing groups offer an engaging way to enhance voice and communication for people living with [mild to moderately severe] Parkinson’s disease as well as providing opportunities for socialization,” the researchers concluded.