Wednesday, 10 July 2024
A major clinical trial, led by experts at the University of Nottingham, has shown the Lee Silverman Voice Treatment (LSVT LOUD®) is more effective than the current speech and language therapy provided by the NHS, when treating patients with Parkinson’s disease (PD).
The results of the NIHR HTA funded trial, which are published today in the BMJ, showed that LSVT LOUD® was more effective at reducing the participant’s reported impact of voice problems than no speech and language therapy, as well as the NHS delivered speech and language therapy.
The trial was led by experts from the Universities of Nottingham and Birmingham, along with colleagues at Sandwell and Dudley Hospital Trust, University College London, King’s College London, the University of Bangor, Canterbury Christ Church University and Glasgow Caledonian University.
It was carried out by NHS Speech and Language Therapy services across the UK and co-ordinated and analysed by the team at the Birmingham Clinical Trials Unit (BCTU) at the University of Birmingham.
The impact of speech and communication problems in people with PD can cause them to feel stigmatised. It can stop them going out, stop them socialising, and stop them doing day-to-day tasks such as shopping, which can have a detrimental impact on their quality of life. This is the first study of its kind to look at the most effective treatment options. The results clearly show that, delivered in this way, the LSVT LOUD® method is both effective and it can be cost effective. The NHS method as it is currently delivered is not effective. Now we have this data, we need to look at other factors and whether if different therapies are delivered in different ways, this would further impact the results.”
Building on a pilot study funded by The Dunhill Medical Trust, participants were recruited from 40 NHS sites across the UK and were randomised into three groups. One group received the LSVT LOUD®, one received the current NHS speech and language treatment and the third didn’t receive any therapy.
LSVT LOUD® is an effective speech treatment for people with PD and other neurological conditions. The treatment trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Patients are given voice exercises to do this.
The NHS treatment is a personalised programme delivered by a therapist and is less intensive. It is delivered over six to eight sessions rather than the LSVT LOUD® which is delivered in 16 sessions over four weeks.
Between September 2016 and March 2020, 388 people with PD and Dysarthria (difficulty speaking) took part in the trial. 130 were allocated to the LSVT LOUD® group, 129 to the NHS therapy group and 129 received none.
LSVT LOUD® consisted of four face-to-face or remote 50-minute sessions, each week delivered over four weeks, with additional home-based practice. The NHS speech and language therapy was determined by the local therapist in response to a participant’s individual needs, an average of one session every other week was delivered over 11 weeks.
The findings of the trial showed that LSVT LOUD® was more effective at reducing the impact of Dysarthria than no speech and language therapy and the NHS version. The NHS therapy showed no evidence of benefit compared to no speech and language therapy.
Adrian Wrigley, who has Parkinson's said: “Speech and language therapy research is very important to me personally, as I've seen first hand how the loss or reduction of our main communication tool leads to higher levels of frustration and anxiety not only for those of us with Parkinson's but our partners and friends. So the development of a treatment that works is very important for the Parkinson's community.”
The study was funded by the National Institute for Health Research, Health Technology Assessment programme.
Story credits
Public link once embargo lifts: https://www.bmj.com/content/386/bmj.q1254
More information is available from Professor Catherine Sackley, from the School of Health Sciences at catherine.sackley@nottingham.ac.uk
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
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