LSVT stands for “Lee Silverman Voice Treatment.” The LSVT LOUD program was designed for Lee Silverman, a woman with Parkinson’s disease who was dealing with voice impairment. The goal of the program is to increase vocal loudness to a healthy, normal loudness so the patient can improve communication with others. The exercises in the program target loudness, but also improve pitch, breath support, and dysarthria.
LSVT LOUD was created for Parkinson’s Disease, but can be useful for other neurological disorders (i.e. Multiple Sclerosis) on a case-by-case basis. Over 25 years of research and randomized control trials through the National Institute of Health (NIH) have shown improvements in loudness, vocal quality, articulation, breath support, and increased intelligibility. Additionally, the principles of LSVT LOUD have been used to develop the LSVT BIG program,which has shown documented improvements of faster walking and bigger steps, improved balance, and increased trunk rotation..
How does the program work?
LSVT LOUD consists of high frequency, high intensity, and high effort practice. The goal is to achieve normal, healthy vocal loudness in everyday life. The exercises address bowing of vocal chords, the ability to physically get loud, and to retrain the patient to use a loud voice.
How long does the program last?
The program is four weeks long and the patient comes to therapy four consecutive days per week. Each session lasts 60 minutes. Outside of therapy, the patient also performs home exercises. Patients do home exercises twice per day on non-therapy days and once per day on therapy days.
When is the LSVT LOUD program appropriate?
LSVT LOUD can be completed at anytime during the disease process. But, studies show the sooner LSVT LOUD is completed, the more beneficial and effective the treatment. Research shows the increased vocal loudness after completion of LSVT LOUD can last for 2+ years if daily practice is continued post-treatment.
What type of exercises will I be doing?
Using their “LOUD” voice, patients perform a series of sustaining the sound “AH” at different pitches. The patient also practices a series of functional phrases that he or she selects. The patient selects phrases that they say on a daily basis and that are meaningful to them. The aim is that the patient can generalize the practiced loudness to everyday speech. Other hierarchical verbal expression tasks are completed to practice using the LOUD voice in different settings. These tasks start at the word level and advance to the conversation level by the end of the program.
Why is LSVT LOUD better than regular voice therapy?
LSVT LOUD was specifically created for Parkinson’s Disease. The program gives repetitive, intensive practice with an increased number of sessions. The goal is for the patient to have a greater increase in vocal loudness and longer lasting results than with typical speech/voice therapy. General voice therapy may only be two to three times per week, for 30-45 minutes. Additionally, it does not typically have the intense and repetitive practice LSVT LOUD does.
How do I get started?
To get started with the LSVT LOUD program, you first need a prescription for the program from your doctor. This may come from your primary care physician or your neurologist. Then contact a facility that has LSVT LOUD trained therapists. You can search for an LSVT Certified Clinician near you on the LSVT Global website.
Elizabeth Uchtman, M.S., CCC-SLP, is the lead speech pathologist and primary outpatient speech pathologist at Gateway Rehabilitation Hospital. Elizabeth has been a speech pathologist for over two years, with experience in skilled nursing facilities, acute care settings, and inpatient rehabilitation settings. She graduated from Miami University with a Master of Science degree in speech pathology in 2016. Elizabeth is certified in LSVT LOUD and has a passion for working with adults with diagnoses of voice disorders, aphasia and dysphagia. She holds her Certificate of Clinical Competence (CCC) in Speech-Language Pathology, Ohio state licensure, and Kentucky state licensure.