By Meagan Moore, MusicWorx Intern
Edited by Theresa Kwong, Communications Consultant
My day started with a phone call to my mom. Afterwards, I met a friend for coffee and we chatted about life. I stopped by the bank to ask a question about my checking account, then I made a few phone calls for work. It sounds like a pretty average day, right? The common factor in all these interactions is that I used my voice to communicate throughout my day. For many people with Parkinson’s Disease, these types of interactions could be far more challenging.
Speech and Voice Impairments
One of the earliest and most frequent symptoms of Parkinson’s Disease (PD) are speech and voice impairments, impacting 89% of those diagnosed (Adams 1997, Jones & Burn, 2006b). For those affected, their voice may sound soft, monotone, breathy and hoarse, with strained articulation. With vocal impairments, simple interactions may be far more strenuous. When communication is broken due to difficulty speaking, it can cause feelings of frustration and embarrassment and ultimately result in avoidance of situations involving speaking (Perez-Delgado, 2007).
Voice production and communication can be improved for those with PD. A 2011 study found that when a person with PD is instructed to speak loudly and clearly, their speech tends to improve considerably. However, this improvement is dependent on external cues. Music-based activities like singing have been shown to improve internal cueing and communication. (Theodoros, D. G., & Ramig, L. O. 2011)
Singing with PD
One way to improve vocal production is through singing. Singing and making music stimulates areas of the brain related to thinking, feeling, moving, memory and more. For those with Parkinson’s, a sense of internalized rhythm is often diminished. Music helps to support rhythm through a process called ‘entrainment’ in which the brain synchronizes to music (Dolhun 2022).
Dr. Concetta Tomaino, co-founder of the Institute for Music and Neurological Function, explains that singing exercises vocal folds, keeps vocal folds flexible, and allows for the normalization of vocal tone. This is effective for people with PD as vocal folds often begin to stiffen up. Singing exercises also enhance articulation, volume of speech, and vocal projection (Parkinsons.org, 2018).
To hear Dr. Tomaino’s interview with The Parkinson’s Foundation, click here.
Simple Exercises to Improve Communication
Before beginning any vocal exercises, take a moment for mindfulness. Exercises like deep breathing help to connect mind and body and engage the diaphragm, which supports vocal volume and projection.
Practicing simple vocal exercises can help improve fluidity of speech, articulation, and volume. Vocal exercises can be done throughout your day- when you’re cooking breakfast, on a walk, or in the car. Five to ten minutes per day of gentle vocal exercises can positively impact vocal health and improve communication for those with PD.
- Humming up the scale, then going down the scale with an open vowel sound like ‘Ahh’ or ‘Oh’
- Sustained vowels (Aa, Ah, Oh, Oo, El, Ing)
Tongue twisters are a great tool for practicing articulation and clarity of speech. Using a metronome while practicing tongue twisters is a great way to get the most out of your practice!
- ‘The lips, the teeth, the tip of the tongue, and the roof of the mouth’
- ‘Seven sassy sailors sailed the seven salty seas’
- ‘Red leather, yellow leather’
References
Adams, S. G. (1997). Hypokinetic dysarthria in Parkinson’s disease. In M. R. McNeil (Ed.), Clinical management of sensorimotor speech disorders (pp. 261-285). New York: Thieme.
Perez-Delgado, F. D. C. (2007). The effect of music therapy voice protocol on speech intelligibility and mood changes of individuals diagnosed with Parkinson’s disease. A master thesis presented to the Florida State University College of Music.
Rachel Dolhun, MD Senior Vice President Medical Communications. “ASK THE MD: Music Therapy and Parkinson’s.” The Michael J. Fox Foundation for Parkinson’s Research | Parkinson’s Disease, https://www.michaeljfox.org/news/ask-md-music-therapy-and-parkinsons.
Theodoros, D. G., & Ramig, L. O. (2011). Communication and swallowing in Parkinson disease (D. G. Theodoros & L. O. Ramig, Eds.). Plural Pub.
Further Reading
Advocating for Music Therapy Practices
