Swallowing Outcomes Following Voice Therapy in Multiple System Atrophy with Dysphagia: Comparison of Treatment Efficacy with Parkinson's Disease.
Alyssa Park, Su-Jeong Jang, No-Eul Kim and 4 others
PMID 33666739WHAT IT FOUND
After 16 LSVT-LOUD voice therapy sessions, 13 patients with Parkinson’s disease or MSA-C had better swallowing scores on a thin-liquid X-ray test.
The study was small and uncontrolled, and MSA-C swallowing gains were not clearly kept at follow-up.
Key findings
01Thirteen patients with Parkinson’s disease or MSA-C received 16 LSVT-LOUD sessions over one month, with follow-up about three months later.
02Across both groups, maximum phonation time and pharyngeal swallowing scores showed significant change over time after treatment.
03In the MSA-C group, swallowing scores improved right after treatment but did not show significant improvement from pretest to follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
There was no control group, so it cannot show whether changes were due to LSVT-LOUD alone. Only 13 patients were studied, 6 with Parkinson’s disease and 7 with MSA-C. The sample is small. Baseline NIH Swallowing Safety Scale scores were low severity. That leaves little room to show improvement on that measure. MSA-C swallowing improvements were not significant at follow-up. Maintenance is uncertain. All participants were taking antiparkinson medication, which was not changed. Ongoing medication effects cannot be separated from the therapy. Follow-up was only about three months. The authors describe the work as a pilot study.
The easy way to misread this
Do not conclude that LSVT-LOUD is proven to improve swallowing in MSA-C. The study had no control group and only 13 patients, and MSA-C swallowing scores were not significantly better at follow-up than before treatment.