Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson's disease: A pilot randomised controlled trial (PD COMM pilot)

被引:29
|
作者
Sackley C.M. [1 ]
Smith C.H. [2 ]
Rick C.E. [3 ]
Brady M.C. [4 ]
Ives N. [3 ,23 ]
Patel S. [3 ,23 ]
Woolley R. [3 ,23 ]
Dowling F. [3 ,23 ]
Patel R. [5 ]
Roberts H. [6 ]
Jowett S. [7 ,24 ]
Wheatley K. [8 ,23 ]
Kelly D. [9 ]
Sands G. [11 ]
Clarke C.E. [7 ,10 ]
Molloy S. [12 ]
Pavel C. [12 ]
Rowbottom C. [12 ]
Tweedie E. [12 ]
Clarke P.C. [13 ]
Nicholl D. [13 ]
Siddiqui F. [13 ]
Kanakaratna C. [13 ]
Bennett R. [13 ]
Blachford K. [13 ]
Boughey A. [13 ]
Harrison T. [13 ]
Basso M.N. [13 ]
Pooler J. [13 ]
Round J. [13 ]
Smith A. [13 ]
Waszkiewicz C. [13 ]
Raw J. [14 ]
Vassallo J. [14 ]
Ansari A. [14 ]
Birtwell K. [14 ]
Brooke J. [14 ]
Finnigan K. [14 ]
Gillan N. [14 ]
Johnson E. [14 ]
Jowitt H. [14 ]
Kennedy A. [14 ]
Buccoliero R. [15 ]
Isles C. [15 ]
Meredith S. [15 ]
Stemp C. [15 ]
Ware L. [15 ]
Cooper S. [16 ]
Appleton S. [16 ]
Durman H. [16 ]
机构
[1] King's College London, Faculty of Life Sciences and Medicine, London
[2] University College London, Division of Psychology and Language Science, Faculty of Brain Sciences, London
[3] University of Birmingham, Birmingham Clinical Trials Unit (BCTU), Birmingham
[4] Glasgow Caledonian University, Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow
[5] Parkinson's UK West Midlands Regional Branch, London
[6] University of Southampton, Faculty of Medicine, London
[7] University of Birmingham, Institute for Applied Health Research, Birmingham
[8] University of Birmingham, Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham
[9] University of East Anglia, School of Rehabilitation Sciences, Norwich
[10] Sandwell and West Birmingham Hospitals NHS Trust, Department of Neurology, Clinical Neurology City Hospital, Dudley Road, Birmingham
[11] School of Health Sciences, University of Nottingham, Nottingham
关键词
Parkinson's disease; Pilot randomised controlled trial; Speech and language therapy;
D O I
10.1186/s40814-017-0222-z
中图分类号
学科分类号
摘要
Background: Speech-related problems are common in Parkinson's disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVT LOUD®). Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised controlled trial (RCT) of LSVT LOUD®, SLT and no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible. LSVT LOUD® is a standardised regime (16 sessions over 4 weeks). SLT comprised individualised content per local practice (typically weekly sessions for 6-8 weeks). Outcomes included recruitment and retention, treatment adherence, and data completeness. Outcome data collected at baseline, 3, 6, and 12 months included patient-reported voice and quality of life measures, resource use, and assessor-rated speech recordings. Results: Eighty-nine patients were randomised with 90% in the therapy groups and 100% in the control group completing the trial. The response rate for Voice Handicap Index (VHI) in each arm was ≥ 90% at all time-points. VHI was highly correlated with the other speech-related outcome measures. There was a trend to improvement in VHI with LSVT LOUD® (difference at 3 months compared with control: - 12.5 points; 95% CI - 26.2, 1.2) and SLT (difference at 3 months compared with control: - 9.8 points; 95% CI - 23.2, 3.7) which needs to be confirmed in an adequately powered trial. Conclusion: Randomisation to a three-arm trial of speech therapy including a no intervention control is feasible and acceptable. Compliance with both interventions was good. VHI and other patient-reported outcomes were relevant measures and provided data to inform the sample size for a substantive trial. © 2018 The Author(s).
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