It is hypothesized that there are three features underlying the voice disorder in individuals with PD: (i) an overall amplitude scale down (75,76) to the speech mechanism (reduced amplitude of neural drive to the muscles of the speech mechanism), which results in hypophonia, hypoprosodia, and hypokinetic articulation; (ii) problems in the perception of vocal loudness and effort (77), which prevent the individuals with PD from accurately monitoring and scaling their vocal output; and (iii) difficulty in independently generating (internal cueing/scaling) the right amount of effort (78) to produce adequate vocal output (loudness, prosodic inflection, and amplitude of articulatory movement). The LSVT® has been designed to address these problems.
The LSVT® has five essential concepts: (i) focus on voice (increases the amplitude of phonatory output); (ii) improve sensory perception of vocal loudness and effort; (iii) administer treatment in a high effort style; (iv) administer treatment intensively; and (v) quantify treatment-related changes. Treatment techniques are
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