Medical Health Encyclopedia

Speech Therapy. Speech therapy may help those who develop a monotone voice and lose volume, particularly in combination with medications. There are no well-conducted studies comparing specific speech therapies, but the Lee Silverman Voice Treatment (LSVT) appears to be an example of an effective technique. It has five major components:

• Focus on the voice ("think loud/think shout").
• High effort (pushes patients to overcome limitations).
• Intensive treatment (16 sessions in one month).
• Calibration (learning to know and accept the amount of effort needed to produce normal sound so it becomes automatic).
• Quantification (continuous feedback to objectively document success).

LSVT may not only help speech but may even improve swallowing.

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Equipment and Devices. A number of devices can be helpful for maintaining stability and preventing falls. The following are some examples:

• Rails installed where the patient needs support in getting up or down, such as along the bed and in the bathroom.
• Walkers with locking wheels. (Walkers do not appear to be helpful for freezing.)
• Chairs with straight backs, firm seats, and arm rests.
• Firm mattresses and satin sheets or less expensive sheets with high thread counts. (These are useful for helping patients slide out of bed.)