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

来源：

Pilot and Feasibility Studies | / 4卷 / 1期

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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