Feasibility of group voice therapy for individuals with Parkinson's disease.

PURPOSE The primary purpose was to demonstrate the feasibility of executing treatment tasks focused on increasing loudness in a group format for individuals with Parkinson's disease (PD). A second purpose was to report preliminary pre-to-post treatment outcomes for individuals with PD immediately after they complete the group program. METHODS The group intervention is described. Fifteen adults with PD who participated in the group and three clinicians leading the group provided feedback about the execution of the intervention. The participants also provided voice samples and self-ratings of voice handicap once before completing the 8-week voice group and once immediately after completing the voice group. Outcome measures included voice intensity, fundamental frequency (F0) mean, standard deviation and range, maximum phonation time, and listener judgment of loudness. RESULTS Feedback from the clinicians suggested that many, but not all, of the voice activities could be executed within a group setting. Participants with PD indicated they understood the focus of the group and that subjectively they felt the group was helpful for increasing loudness. Statistically significant increases occurred for voice intensity, F0 maximum, and F0 range. Voice handicap scores decreased significantly and 80% of the participants were judged louder post intervention. CONCLUSIONS Clinician and participant feedback indicated that it was feasible to execute most LSVT(®) tasks in a group format with some modifications. The preliminary outcome data indicate that the targeted behavior (voice dB and loudness) did change in the predicted direction as did several other measures. Future studies comparing outcomes of group intervention to the gold standard LSVT(®), and exploring retention of treatment gains over time, are needed. LEARNING OUTCOMES After reading the manuscript, readers will be able to: (1) Describe previous attempts at group intervention to improve voice for individuals with Parkinson's disease. (2) List three ways that the group intervention tried in this study differed from LSVT(®). (3) Identify three limitations to this study that must be addressed before advocating implementation of the group approach in clinical situations.