Singing Helps Early-stage Parkinson’s Patients Retain Speech, Respiratory Control, Studies Show

Singing may help people with Parkinson’s disease — especially in its earlier stages — because it strengthens muscles involved in swallowing and respiratory control, suggests two studies from researchers at Iowa State University.

One study, “Therapeutic singing as an early intervention for swallowing in persons with Parkinson’s disease,” was published in the journal Complementary Therapies in Medicine. The other, “Effects of singing on voice, respiratory control and quality of life in persons with Parkinson’s disease,” appeared in Disability and Rehabilitation.

Parkinson’s research and current treatments largely focus on symptoms relating to motor skills, and less on those like voice impairment, even though weakness in vocal muscles affects respiration, swallowing abilities and quality of life. Voice impairments in Parkinson’s —  present in 60 to 80 percent of patients, are characterized by reduced vocal intensity and pitch, and breathy voice.

Previous research has suggested that singing can ease voice impairment and improve respiratory control in people with other diseases or conditions, leading researchers to examine if it could also aid those with Parkinson’s, especially in the disease’s early stages.

Elizabeth Stegemöller’s singing class for Parkinson’s patients in Ames, Iowa. Photo credit: Iowa State University

Lead author Elizabeth Stegemöller conducted two separate pilot studies to determine whether a group of 25 Parkinson’s patients would benefit from light therapy, singing for 60 minutes once a week, or more intensive therapy that involved singing for 60 minutes twice a week. Board-certified music therapies conducted the sessions, which included vocal and articulation exercises as well as group singing. After eight weeks, researchers measured vocal, respiratory and quality-of-life parameters.

Results showed that both groups had significant improvement in respiratory pressure, including both breathing in and breathing out. Phonation time, a measure of how long a person can sustain  a vowel sound, also significantly improved. Patients also reported significant improvement in measures of both voice-related and whole health-related quality of life.

“We’re not trying to make people better singers,” Stegemöller said in a press release. “We’re trying to work the muscles involved with swallowing and respiratory control, to make them work better and therefore protect against some of the complications of swallowing.”

Stegemöller, an assistant professor of kinesiology at Iowa State in Ames, runs singing classes there for Parkinson’s patients. She also collaborates with Iowa State Extension and Outreach to pilot an eight-week training session in several counties across northern Iowa, with the goal of creating a DVD to train extension specialists to conduct such classes on their own.

“We do a lot of vocal exercises in classes that focus on those [vocal and respiratory] muscles,” Stegemöller said. “We also talk about proper breath support, posture and how we use the muscles involved with the vocal cords, which requires them to intricately coordinate good, strong muscle activity.”

The goal now is to expand the initiative, she said, adding that “if the DVD is an effective training tool, we’d like to have as many classes as possible across the state.”