Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease:: a pilot randomised controlled trial (PD COMM pilot)

Catherine M. Sackley; Christina H. Smith; Caroline Rick; Marian C. Brady; Natalie Ives; Smitaa Patel; Rebecca Woolley; Francis Dowling; Ramilla Patel; Helen Roberts; Sue Jowett; Keith Wheatley; Debbie Kelly; Gina Sands; Carl E Clarke; PD COMM Pilot Collaborative Group

doi:10.1186/s40814-017-0222-z

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: a pilot randomised controlled trial (PD COMM pilot)

Catherine M. Sackley, Christina H. Smith, Caroline Rick, Marian C. Brady, Natalie Ives, Smitaa Patel, Rebecca Woolley, Francis Dowling, Ramilla Patel, Helen Roberts, Sue Jowett, Keith Wheatley, Debbie Kelly, Gina Sands, Carl E Clarke, PD COMM Pilot Collaborative Group

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Abstract

Background: Speech-related problems are common in Parkinson’s disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVTLSVT LOUD®).

Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised, controlled trial (RCT) ofcomparing LSVTLSVT LOUD®, SLT andversus no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible. LSVTLSVT LOUD® is a standardised regime (16 sessions over 4 weeks). SLT comprised individualised content per local practice (typically weekly sessions for 6-8 weeks). Outcomes included recruitment and retention, treatment adherence and data completeness. Outcome data assessedcollected at baseline, 3, 6, and 12 months included patient-reported voice and quality of life measures, resource use, and assessor-rated speech recordings.

Results: Eighty-nine patients were randomised with 90% in the therapy armgroups and 100% in the control grouparm completing the trial. The response rate for Voice Handicap Index (VHI) in each arm was ≥90% at all time-points. VHI was highly correlated with the other speech-related outcome measures. There was a trend to improvement in VHI with LSVTLSVT LOUD® (difference at 3 months compared with control: -12.5 points; 95%CI -26.2, 1.2) and SLT (difference at 3 months compared with control: -9.8 points; 95%CI -23.2, 3.7) which needs to be confirmed in an adequately powered trial.

Conclusion: Randomisation to a three-arm trial of speech therapy including a no intervention control is feasible and acceptable. Compliance with both interventions was good. VHI and other patient-reported outcomes were relevant measures and provided data to inform the sample size for a substantive trial.

Trial registration: International Standard Randomised Controlled Trial Number Register: ISRCTN75223808 registered 22 March 2012

Key Words: Parkinson's disease; pilot randomised controlled trial; speech and language therapy

Original language	English
Journal	Pilot and Feasibility Studies
Volume	4
Issue number	30
DOIs	https://doi.org/10.1186/s40814-017-0222-z
Publication status	Published - 10 Jan 2018

Keywords

Parkinson's disease
pilot randomised controlled trial
Speech and language therapy

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Cite this

Sackley, C. M., Smith, C. H., Rick, C., Brady, M. C., Ives, N., Patel, S., Woolley, R., Dowling, F., Patel, R., Roberts, H., Jowett, S., Wheatley, K., Kelly, D., Sands, G., Clarke, C. E., & PD COMM Pilot Collaborative Group (2018). Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: a pilot randomised controlled trial (PD COMM pilot). Pilot and Feasibility Studies, 4(30). https://doi.org/10.1186/s40814-017-0222-z

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title = "Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson{\textquoteright}s disease:: a pilot randomised controlled trial (PD COMM pilot)",

abstract = "Background: Speech-related problems are common in Parkinson{\textquoteright}s disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVTLSVT LOUD{\textregistered}). Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised, controlled trial (RCT) ofcomparing LSVTLSVT LOUD{\textregistered}, SLT andversus no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible. LSVTLSVT LOUD{\textregistered} is a standardised regime (16 sessions over 4 weeks). SLT comprised individualised content per local practice (typically weekly sessions for 6-8 weeks). Outcomes included recruitment and retention, treatment adherence and data completeness. Outcome data assessedcollected at baseline, 3, 6, and 12 months included patient-reported voice and quality of life measures, resource use, and assessor-rated speech recordings. Results: Eighty-nine patients were randomised with 90% in the therapy armgroups and 100% in the control grouparm completing the trial. The response rate for Voice Handicap Index (VHI) in each arm was ≥90% at all time-points. VHI was highly correlated with the other speech-related outcome measures. There was a trend to improvement in VHI with LSVTLSVT LOUD{\textregistered} (difference at 3 months compared with control: -12.5 points; 95%CI -26.2, 1.2) and SLT (difference at 3 months compared with control: -9.8 points; 95%CI -23.2, 3.7) which needs to be confirmed in an adequately powered trial. Conclusion: Randomisation to a three-arm trial of speech therapy including a no intervention control is feasible and acceptable. Compliance with both interventions was good. VHI and other patient-reported outcomes were relevant measures and provided data to inform the sample size for a substantive trial.Trial registration: International Standard Randomised Controlled Trial Number Register: ISRCTN75223808 registered 22 March 2012Key Words: Parkinson's disease; pilot randomised controlled trial; speech and language therapy",

keywords = "Parkinson's disease, pilot randomised controlled trial, Speech and language therapy",

author = "Sackley, {Catherine M.} and Smith, {Christina H.} and Caroline Rick and Brady, {Marian C.} and Natalie Ives and Smitaa Patel and Rebecca Woolley and Francis Dowling and Ramilla Patel and Helen Roberts and Sue Jowett and Keith Wheatley and Debbie Kelly and Gina Sands and Clarke, {Carl E} and {PD COMM Pilot Collaborative Group}",

year = "2018",

month = jan,

day = "10",

doi = "10.1186/s40814-017-0222-z",

language = "English",

volume = "4",

journal = "Pilot and Feasibility Studies",

issn = "2055-5784",

publisher = "Springer Verlag",

number = "30",

}

Sackley, CM, Smith, CH, Rick, C, Brady, MC, Ives, N, Patel, S, Woolley, R, Dowling, F, Patel, R, Roberts, H, Jowett, S , Wheatley, K, Kelly, D, Sands, G, Clarke, CE & PD COMM Pilot Collaborative Group 2018, 'Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: a pilot randomised controlled trial (PD COMM pilot)', Pilot and Feasibility Studies, vol. 4, no. 30. https://doi.org/10.1186/s40814-017-0222-z

TY - JOUR

T1 - Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease:

T2 - a pilot randomised controlled trial (PD COMM pilot)

AU - Sackley, Catherine M.

AU - Smith, Christina H.

AU - Rick, Caroline

AU - Brady, Marian C.

AU - Ives, Natalie

AU - Patel, Smitaa

AU - Woolley, Rebecca

AU - Dowling, Francis

AU - Patel, Ramilla

AU - Roberts, Helen

AU - Jowett, Sue

AU - Wheatley, Keith

AU - Kelly, Debbie

AU - Sands, Gina

AU - Clarke, Carl E

AU - PD COMM Pilot Collaborative Group

PY - 2018/1/10

Y1 - 2018/1/10

N2 - Background: Speech-related problems are common in Parkinson’s disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVTLSVT LOUD®). Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised, controlled trial (RCT) ofcomparing LSVTLSVT LOUD®, SLT andversus no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible. LSVTLSVT LOUD® is a standardised regime (16 sessions over 4 weeks). SLT comprised individualised content per local practice (typically weekly sessions for 6-8 weeks). Outcomes included recruitment and retention, treatment adherence and data completeness. Outcome data assessedcollected at baseline, 3, 6, and 12 months included patient-reported voice and quality of life measures, resource use, and assessor-rated speech recordings. Results: Eighty-nine patients were randomised with 90% in the therapy armgroups and 100% in the control grouparm completing the trial. The response rate for Voice Handicap Index (VHI) in each arm was ≥90% at all time-points. VHI was highly correlated with the other speech-related outcome measures. There was a trend to improvement in VHI with LSVTLSVT LOUD® (difference at 3 months compared with control: -12.5 points; 95%CI -26.2, 1.2) and SLT (difference at 3 months compared with control: -9.8 points; 95%CI -23.2, 3.7) which needs to be confirmed in an adequately powered trial. Conclusion: Randomisation to a three-arm trial of speech therapy including a no intervention control is feasible and acceptable. Compliance with both interventions was good. VHI and other patient-reported outcomes were relevant measures and provided data to inform the sample size for a substantive trial.Trial registration: International Standard Randomised Controlled Trial Number Register: ISRCTN75223808 registered 22 March 2012Key Words: Parkinson's disease; pilot randomised controlled trial; speech and language therapy

AB - Background: Speech-related problems are common in Parkinson’s disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVTLSVT LOUD®). Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised, controlled trial (RCT) ofcomparing LSVTLSVT LOUD®, SLT andversus no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible. LSVTLSVT LOUD® is a standardised regime (16 sessions over 4 weeks). SLT comprised individualised content per local practice (typically weekly sessions for 6-8 weeks). Outcomes included recruitment and retention, treatment adherence and data completeness. Outcome data assessedcollected at baseline, 3, 6, and 12 months included patient-reported voice and quality of life measures, resource use, and assessor-rated speech recordings. Results: Eighty-nine patients were randomised with 90% in the therapy armgroups and 100% in the control grouparm completing the trial. The response rate for Voice Handicap Index (VHI) in each arm was ≥90% at all time-points. VHI was highly correlated with the other speech-related outcome measures. There was a trend to improvement in VHI with LSVTLSVT LOUD® (difference at 3 months compared with control: -12.5 points; 95%CI -26.2, 1.2) and SLT (difference at 3 months compared with control: -9.8 points; 95%CI -23.2, 3.7) which needs to be confirmed in an adequately powered trial. Conclusion: Randomisation to a three-arm trial of speech therapy including a no intervention control is feasible and acceptable. Compliance with both interventions was good. VHI and other patient-reported outcomes were relevant measures and provided data to inform the sample size for a substantive trial.Trial registration: International Standard Randomised Controlled Trial Number Register: ISRCTN75223808 registered 22 March 2012Key Words: Parkinson's disease; pilot randomised controlled trial; speech and language therapy

KW - Parkinson's disease

KW - pilot randomised controlled trial

KW - Speech and language therapy

U2 - 10.1186/s40814-017-0222-z

DO - 10.1186/s40814-017-0222-z

M3 - Article

SN - 2055-5784

VL - 4

JO - Pilot and Feasibility Studies

JF - Pilot and Feasibility Studies

IS - 30

ER -

Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: a pilot randomised controlled trial (PD COMM pilot)

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Keywords

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