Wednesday, July 20, 2011

Parkinson’s and your voice: How Many Ways Can You Say Exercise?

Esercizio, ejercicio, ubung, Упражнение, Yùndòng, l'exercice, ekusasaizu

“Exercise Protects Brain in New Studies: Two new studies  add to the mountain of research indicating that physical activity in older people keeps their brains active and healthy as well. Both were reported at the Alzheimer's Association International Conference on Alzheimer's Disease, with simultaneous publication online in Archives of Internal Medicine :(Primary source: Archives of Internal Medicine Source reference:Larson E "Brains and aging" Arch Int Med 2011; DOI: 10.1001/archinternmed.2011.273.)”

So, once again, researchers, it seems , have come forward to inform us of what we most likely already know, and that is: exercise can benefit the brain. A suggestion was made that clinical research should now focus on "ways to change behavior" so that exercise becomes habitual in middle and late life. As someone who happens to be in mid-life, and works with many patients in late life, I would suggest that the earlier in life and as soon after a diagnosis of a chronic disease has been made, a prescription for exercise should be given. But, exercising the muscles involved in speech and swallowing can be a bit more elusive, as we are generally talking about small muscle groups that because of their placement in our anatomy, do not lend themselves well to  treadmills and cybex machines.


Within the field of speech-language pathology,  there is ongoing interest among researchers as to what role exercise may have in delaying or abolishing  speech, voice or swallowing symptoms that  result from injury or disease. Depending on a patient’s symptoms, specific exercise may focus on strengthening the tongue, respiratory muscles  and/or muscles of the larynx ( voice box). Patients may be instructed in a variety of exercises designed to strengthen the swallowing or voice mechanism, however, since the optimal recommendation for most types of exercise designed to improve these functions are still under investigation, the specific type, number of trials and repetitions may vary from therapist and setting .

The Lee Silverman Voice Treatment Method (LSVT®), is one type of voice therapy offered to patients with Parkinson’s  and which, as a result of their research, is delivered via a very specific protocol  Adherence to this delivery method is important and may help to reduce some of the variation mentioned above, and provide a more predictable result. At the conclusion of LSVT ® treatment, however, and without continuous feedback, it may remain difficult for some patients to judge if they are continuing to exercise and use their voice with an adequate amount of intensity to maintain improvements they have achieved in therapy. So, researchers are now developing various sorts of measuring devices to help therapist and patients monitor muscle strength changes and continued voice use outside of the therapy setting.

If you have been given voice, speech and/or swallowing exercises to perform, it is important that you complete them in the prescribed fashion. ( For ex: 10x’s 3x’s a day 5 times/week). It is also important that you and your therapist discuss whether it is expected that your condition will improve and remain stable after a course of  therapy which includes exercise or if you will be required to continue some regimen of exercise for the remainder of your life in order to retain the improvements or minimize further decline. If changes or decline in memory are also a component of your particular medical diagnosis, it may be beneficial to ask your therapist if the prescribed exercises are available in a recorded format. Or, better, yet, have your therapist or a family member record you while performing your voice and swallowing exercises, so that  you are able to perform them independently.
A group exercise class such as Voice Aerobics™ may help you retain improvements achieved in formal therapy and help you remain motivated and focused on improving or preserving  posture, breath support, and voice use.

 

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