IALP 2025

Effects of Expiratory Muscle Strength Training With EMST®150TM and the Water Resistance Voice Therapy in Parkinson’s Disease

Kelly Silverio Ms-SLP Ana Paula dos Santos Ms-SLP Jhonatan da Silva Vitor PhD-SLP Angelica Antonetti-Carvalho Ms-SLP Daniela Hencke Ms-SLP Marília Andrezzo Beck PhD-SLP, Associate Professor Alcione Brasolotto
Speech, Language and Hearing Disorder Department, Bauru School of Dentistry, USP - University of Sao Paulo, Brazil

Parkinson’s disease (PD) is a multisystem neurodegenerative disease that affects anatomical structures and neurotransmitters (Klingelhoefer, Reichmann,2017), negatively impacting respiration, phonation, articulation, prosody, and resonance, impairing oral communication (Darley et al, 1969). Accessible treatment methods must be explored to improve communication and, consequently, their quality of life. Purpose: To investigate and compare the effects of expiratory muscle strength training using EMST®150TM and water resistance voice therapy with a resonance tube on the vocal quality of individuals with Parkinson’s disease. Method: Twenty-two individuals with PD (Hoehn & Yahr scale=2.11; MoCA=25) presenting vocal complaints and hypokinetic dysarthria were divided into two groups: GEMST (6 men, +72.6 years old; 5 women, +71.2 years old) and GVOICE (7 men, +68.4 years old; 4 women, +73.7 years old). The GEMST underwent eight expiratory muscle strength training sessions using EMST®150TM, twice a week (5 breaths into the EMST®150TM, five sets). The GVOICE received water resistance voice therapy with a resonance tube (27cmx9mm), in eight 45-minute sessions, twice per week. Tube depth in water varied from 2cm to 9cm (habitual pitch/loudness, ascending/descending gliding, and functional sentences). Home practice was performed five days/week in both groups. The groups were assessed before/after the intervention: vocal intensity, Smoothed Cepstral Peak Prominence (CPPS), alpha ratio, and L1-L0 (vowel /a/ and counting). Comparisons between groups were performed using ANOVA and Tukey test (p<0.05). Findings: The GEMST group demonstrated a significant increase in vocal intensity (p=0.010) and CPPS values (p=0.001) in counting. No other statistically significant differences were observed in the remaining outcomes or the GVOICE group. Discussion: Expiratory Muscle Strength Training was more effective than Water Resistance Voice Therapy with a resonance tube improving vocal intensity, harmonic configuration, and signal periodicity in individuals with PD. Learning Outcomes: To understand the importance of respiratory training in individuals with Parkinson’s Disease, considering vocal quality.

Acknowledgment Grant #2018/19761-5 São Paulo Research Foundation (FAPESP)

References

Klingelhoefer, L., & Reichmann, H. (2017). Parkinson`s disease is a multisystem disorder. Journal of Neural Transmission, 124(6), 709–713. https://doi.org/10.1007/s00702-017-1689-6

Darley, F. L., Aronson, A. R., & Brown, J. R. (1969). Clusters of deviant speech dimensions in the dysarthrias. Journal of Speech and Hearing Research, 12(3), 462–496. https://doi.org/10.1044/jshr.1203.462