{"id":17006,"date":"2020-04-29T10:00:37","date_gmt":"2020-04-29T08:00:37","guid":{"rendered":"https:\/\/neurologiaclinica.es\/parkinsons-disease-how-can-i-improve-my-voice-during-confinement\/"},"modified":"2025-04-17T12:46:37","modified_gmt":"2025-04-17T10:46:37","slug":"parkinsons-disease-how-can-i-improve-my-voice-during-confinement","status":"publish","type":"post","link":"https:\/\/neurologiaclinica.es\/en\/parkinsons-disease-how-can-i-improve-my-voice-during-confinement\/","title":{"rendered":"Parkinson&#8217;s disease: How can I improve my voice during confinement?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">People with voice alterations caused by Parkinson&#8217;s disease (PD) or other neurological alterations, present a <strong>reduction in the amplitude of the movements of the systems that act in the act of phonation, speech, and ultimately the quality and communicative and social effectiveness<\/strong>. During confinement due to the <strong>COVID19<\/strong> pandemic and the consequent decrease in our social interaction, we run the risk of losing volume and clarity of voice. <\/p>\n\n<h4 class=\"wp-block-heading\">What should we consider to have a healthy and effective voice mechanism?<\/h4>\n\n<p class=\"wp-block-paragraph\"><strong>We need the phonatory and muscular system to be hydrated<\/strong> (ingest 1.5 to 2 liters of water); if we do not give it the necessary amount of water it will not work with the elasticity and effectiveness we need: we will have a hoarse voice, the sensation of incompetence will be greater and it will not respond correctly when we put it &#8220;on the move&#8221;.<\/p>\n\n<p class=\"wp-block-paragraph\">The activity of the phonorespiratory mechanism is maintained and strengthened by using it: <strong>speaking and emitting voice is the best work for our voice<\/strong>.<\/p>\n\n<p class=\"wp-block-paragraph\">The phonorespiratory activity improves and is maintained with activities at a high level of effort (speaking high; each person has his or her own level).<\/p>\n\n<h4 class=\"wp-block-heading\">What voice problems do PD patients have?<\/h4>\n\n<p class=\"wp-block-paragraph\"><strong>The greatest difficulty for people with PD occurs at the moment of starting to speak<\/strong>. For example, when there is a high noise level in a room and we have to adapt our voice level to maintain a dialogue with someone, it is not necessary to think &#8220;I am going to raise my voice&#8221;. In the case of Parkinson&#8217;s patients, the brain activity that activates the mechanisms of action (onset) does not work properly, hence the need to start working early in the course of the disease.  <\/p>\n\n<p class=\"wp-block-paragraph\">It is a priority <strong>when dysphonia appears due to a neurological problem to tell our brain &#8220;I start and I control my voice&#8221;.<\/strong> In this way we begin to <strong>reinforce the phonorespiratory biomechanics in early stages<\/strong> of the disease, in addition to stimulating the motor processes involved in phonation. <\/p>\n\n<h4 class=\"wp-block-heading\">What voice treatment techniques do we use in speech therapy?<\/h4>\n\n<p class=\"wp-block-paragraph\">We work with the <strong>&#8220;Voice Training Lee Silverman&#8221; method<\/strong> (specific for patients with Parkinson&#8217;s and parkinsonism). These treatments are performed <strong>in person<\/strong> (in the office) <strong>or from home<\/strong> (through a simple video call). This technique was developed by Dr. Lorraine Ramig and Dr. Cynthia Fox in Colorado (United States) at the end of the 1980s. It is a validated method, which presents a high level of evidence regarding its efficacy. It is also endorsed by national and international institutes in the USA and the United Kingdom.      <\/p>\n\n<h3 class=\"wp-block-heading\">It is based on 5 key points:<\/h3>\n\n<p class=\"wp-block-paragraph\">1. Focuses on voice<\/p>\n\n<p class=\"wp-block-paragraph\">2. By maximizing effort (speaking LOUD)<\/p>\n\n<p class=\"wp-block-paragraph\">3. Treatments are intensive (every day for four weeks).<\/p>\n\n<p class=\"wp-block-paragraph\">4. Adjusting the voice level in the relationship (patient&#8217;s perception and environmental demands.<\/p>\n\n<p class=\"wp-block-paragraph\">5. Quantification of voice quality and intensity.<\/p>\n\n<h4 class=\"wp-block-heading\">In addition to this method, other voice therapy techniques can be used:<\/h4>\n\n<ul class=\"wp-block-list\"><li>Semi-occluded Vocal Therapy Techniques (TVSO)<\/li><li>Manual and respiratory therapy techniques<\/li><li>Myofunctional and biofeedback therapy<\/li><\/ul>\n\n<h4 class=\"wp-block-heading\">Is speech therapy treatment effective?<\/h4>\n\n<p class=\"wp-block-paragraph\"><strong>Early and specific treatment for PD, as well as for parkinsonisms, is sensitive and reliable in its results<\/strong>. The first step is to <strong>consult with your neurologist<\/strong> to determine when to start working and what methodology to use. To decide the best treatment for each person we must <strong>adjust the constancy and the level of demand of the exercises to the patient&#8217;s reality at that moment<\/strong>. The objective is that the central nervous system should be stimulated with voice exercises, so that the affected person integrates them as part of their daily life in an autonomous way.   <\/p>\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:23% auto\"><figure class=\"wp-block-media-text__media\"><img decoding=\"async\" src=\"https:\/\/neurologiaclinica.es\/wp-content\/uploads\/2019\/01\/MAMEN-VICENTE-TORCAL.jpg\" alt=\"\" class=\"wp-image-1307\"\/><\/figure><div class=\"wp-block-media-text__content\">\n<h3 class=\"wp-block-heading\">Author:  <\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/neurologiaclinica.es\/que-hacemos\/unidad-de-neuro-rehabilitacion\/equipo-unidad-de-neuro-rehabilitacion\/carmen-vicente-torcal\/\" class=\"rank-math-link\">Carmen Vicente Torcal, Speech Therapist<\/a>, <a href=\"https:\/\/neurologiaclinica.es\/que-hacemos\/unidad-de-neuro-rehabilitacion\/equipo-unidad-de-neuro-rehabilitacion\/\" class=\"rank-math-link\">Neuro-rehabilitation Team<\/a><\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>People with voice alterations caused by Parkinson&#8217;s disease (PD) or other neurological alterations, present a reduction in the amplitude of the movements of the systems that act in the act of phonation, speech, and ultimately the quality and communicative and social effectiveness. During confinement due to the COVID19 pandemic and the consequent decrease in our [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":16238,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[652,557,558],"tags":[653,732,715,678,731,665,683,588],"class_list":["post-17006","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19-en","category-neuro-rehabilitation","category-parkinsons-and-movement-disorders","tag-covid19-en","tag-loss-of-voice","tag-neuro-rehabilitation-en","tag-neurology-madrid","tag-parkinson-covid-en","tag-ruber-international","tag-ruber-neurology","tag-speech-therapy"],"_links":{"self":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17006","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/comments?post=17006"}],"version-history":[{"count":1,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17006\/revisions"}],"predecessor-version":[{"id":17007,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/posts\/17006\/revisions\/17007"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/media\/16238"}],"wp:attachment":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/media?parent=17006"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/categories?post=17006"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/tags?post=17006"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}