‘ParkinSong’ and Other Song Therapy Programs May Help Preserve Speech, Study Says

‘ParkinSong’ and Other Song Therapy Programs May Help Preserve Speech, Study Says

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.

7 comments

  1. Anna1060 says:

    Dispiriting to read that people’s loudness ability reverted after training ceased. Any way round this? Why not just vow to sing with gusto while washing dishes? That more than matches the 2-hour weekly drill.

    • Dr Jeanette Tamplin says:

      Hi Anna, just to clarify, our singing participants did not revert back after the intervention. In fact they kept singing for the full 12 month intervention period and beyond. (we will publish this 12 month data soon). This is the beauty of group singing programs – the enjoyment and motivation that singing brings.
      But singing with gusto while you wash the dishes is also an excellent idea!

  2. Eda M. Gebell says:

    I have been singing in my community chorale for many years. I was diagnosed with Parkinson’s in 2009. Our music director has a background in opera and is a vocal coach. She has sung professionally all over Europe. It is the breathing techniques and warm up excersizes that keep my voice strong. It is not about loud, it is about controlling your breathing and using the muscles in our inside.
    I sing about 4 hours a week

  3. D. Duane MaGee says:

    I’m very pleased to hear about this! I have advocated using singing techniques, in dealing with voice problems, for people who have Parkinson’s. As one who majored in speech, and later, voice, in College, I learned a lot about phonetics, breathing techniques, and voice and vocal production. Singing is an art, and also singing correctly, with proper technique, has been very helpful to me, because, as a person diagnosed with Parkinson’s Disease, I have times when I have problems with my voice. So, I utilize the training I have had, and it helps, especially breathing correctly, to have more sound, and even voice production. Thanks for sharing this information

  4. Brewer Jill says:

    Thanks for researching this important subject. Interesting and exciting article. Is there a way to access the specific vocal exercises utilized? I’m a voice teacher working with a student with Parkinson’s.

  5. Jeff Welt says:

    I facilitate a PD support. The ParkSong program sounds like a great idea for those with PD. Our group is located in Portland, Maine. It would be very helpful to know what resources are available for establishing a local group.

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