Major trial explores most effective speech therapy for people with Parkinson's disease

A trial at the Birmingham Clinical Trials Unit has shown Lee Silverman Voice Treatment to be more effective than current NHS therapy for Parkinson's patients.

An elderly man holding the hand of a hospital patient.

A major clinical trial undertaken at the University of Birmingham Clinical Trials Unit (BCTU) has shown that the Lee Silverman Voice Treatment (LSVT LOUD®) is more effective than current speech and language therapy provided by the NHS for patients with Parkinson's disease (PD).

Funded by the NIHR Health Technology Assessment and published today in the British Medical Journal, the trial revealed 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-provided speech and language therapy.

The trial was led by experts from the Universities of Birmingham and Nottingham, as well as Sandwell and Dudley Hospital Trust, University College London, King's College, London, University of Bangor, Canterbury Christ Church University and Glasgow Caledonian University. It was carried out in NHS speech and language therapy (SLT) services across the UK and coordinated and analysed by the BCTU team at the University of Birmingham.

Academics across different University of Birmingham departments collaborated on the trial, such as Professor Sue Jowett and Zainab Abdali from the Health Economics Unit, and Natalie Rowland, Rebecca Woolley and Ryan Ottridge from BCTU.

PD COMM is the first large-scale pragmatic trial that compares two commonly used speech and language therapies against no treatment and also against each other. The results from this trial will provide evidence to help guide clinical decision making.

Natalie Rowland, Reader in Clinical Trials, Birmingham Clinical Trials Unit

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. 

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. 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 offering. The NHS SLT therapy showed no evidence of benefit compared to no speech and language therapy.

The study was funded by the National Institute for Health Research, Health Technology Assessment programme, and can be read in full here: https://www.bmj.com/content/386/bmj.q1254