Intensive voice treatment (the Lee Silverman Voice Treatment [LSVT^®LOUD]) for individuals with Wilson’s disease and adult cerebral palsy: two case reports

Abstract

Objective: In this case report, we aimed to examine the effects of an intensive voice treatment (the Lee Silverman Voice Treatment [LSVT^®LOUD]) for Wilson’s disease (WD), and adult cerebral palsy (CP), and dysarthria.

Method: The participants received LSVT^®LOUD four times a week for 4 weeks. Acoustic, perceptual (GRBAS) analyses were performed and data from the Voice Handicap Index (VHI) were obtained before and after treatment.

Results: Besides the Harmonics-to Noise Ratio (HNR) value (dB) of the participant with WD, for both participants’ fundamental frequencies (Hz), jitter (%), and shimmer (%) values showed significant differences (p < .05) after therapy. Both participants showed significant improvements (p < .05) in the duration (s) and the sound pressure level (dB, SPL) of sustained vowel phonation (/a/), in SPL (dB) of pitch range (high and low /a/) and reading and conversation (p < .01). There was a positive improvement in the high-frequency values (Hz) of both participants but not in the low-frequency values (Hz) in the participant with WD. Perceptual analysis with GRBAS judgements of sustained vowel (/a/) and paragraph reading of two participants also showed improvement. After therapy, perceived loudness of the participants’ voice increased.

Conclusions: The findings provide some preliminary observations that the individuals with WD and the adult individuals with CP can respond positively to intensive speech treatment such as LSVT^®LOUD. Further studies are needed to investigate speech treatments specific to WD and adult CP.

Keywords:

• LSVT-LOUD
• dysarthria
• Wilson’s disease
• adult Cerebral Palsy

Acknowledgments

We thank Elçin Tadıhan Özkan, and Elif Meryem Ünsal, for rating the GRBAS scale, Ömer Bilen for statistical advices. We are grateful for the careful corrections and the suggestions of the anonymous reviewer. This work was supported partly by the Einstein Foundation, Einstein Guest Researchers to foster academic freedom under Grant EGR-2019-554.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Notes on contributors

Esra Ertan

Esra Ertan (PhD) is a speech and language therapist, working at Humboldt University, Faculty of Language, Literature and Humanities, Department of German Studies and Linguistics-Phonetic and Phonology as a researcher. Her main research focuses are voice and voice disorders, and speech acoustics.

Hakan I. Gürvit

Hakan I. Gürvit (MD) is a professor of neurology at Istanbul University, Istanbul Faculty of Medicine. His research interests are behavioral neurology, movement disorders, and cognitive neuroscience.

Haşmet H. Hanağası

Haṣmet H. Hanağası (MD) is a professor of neurology at Istanbul University, Istanbul Faculty of Medicine. His research interests are movement disorders, Alzheimer's disease, dementia.

Başar Bilgiç

Baṣar Bilgiç (MD) is a professor of neurology at Istanbul University, Istanbul Faculty of Medicine. His research interests are dementia, Alzheimer's disease, movement disorders, neuroimaging.

Müge A. Tunçer

A. Müge Tunçer (PhD) is a speech and language therapist, working as a lecturer and researcher at Muğla Sıtkı Koçman University. Her research focuses are acquired language disorders, research methods, aphasia.

Cemil Yılmaz

Cemil Yılmaz is a speech and language therapist and doctoral student at Anadolu University. His research focuses are speech acoustics and perception.