Session Information
Date: Thursday, June 23, 2016
Session Title: Parkinson's disease: Clinical trials, pharmacology and treatment
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate the feasibility of a full scale trial on the effectiveness and cost-effectiveness of two types of speech and language therapy (SLT) for people with Parkinson’s (PwP) who have voice or speech problems.
Background: Parkinson’s affects ∼120,000 people in the UK with over two thirds reporting speech-related problems. The NICE guidelines recommend SLT for PwP but current provision is low (37%).
Methods: PD COMM Pilot was run at 11 hospitals around the country. PwP who had self or carer-reported problems with their speech or voice were eligible to join the trial. Participants were randomised to LSVT, NHS SLT or no intervention. Outcome measures included: Voice Handicap Index; Assessment of Intelligibility of Dysarthric Speech; vocal loudness; comprehensibility assessments; PDQ-39; Voice related Quality of Life Scale; Living with Dysarthria questionnaire; EuroQol EQ-5D; and carer quality of life (Parkinson’s disease Carers’ Quality of Life Questionnaire). Assessments were completed before randomisation and at 3, 6 and 12 months after randomisation.
Results: 89 PwP – 78% men, mean age 67 (8.8) years, mean time since diagnosis 5.5 (3.8) years – were randomised into the trial. Most had mild Parkinson’s (Hoehn and Yahr ≤2). Table 1 shows the Voice Handicap Index score at baseline and 3 months. 5 PwP withdrew from the treatment (3 LSVT and 2 NHS SLT) and study. The majority of questionnaires were completed with no missing data (>85% form completeness at each time point).
| Mean Difference (95% CI) | |||||
| LSVT | NHS SLT | No Intervention | LSVT vs No Intervention | NHS SLT vs No Intervention | |
| Baseline | N = 26 | N = 28 | N = 26 | -0.7 (-12.2 to 10.8) | -0.2 (-13.0 to 12.7) |
| 41.7 (20.2) | 42.2 (25.5) | 42.4 (21.0) | p=0.9 | p=1.0 | |
| 3 months | N = 22 | N = 22 | N = 28 | -12.5 (-26.2 to 1.2) | -9.8 (-23.2 to 3.7) |
| 33.5 (22.4) | 36.2 (21.2) | 46.0 (25.1) | p=0.07 | p=0.2 | |
| Change from Baseline at 3 months | N = 20 | N = 21 | N = 25 | -7.8 (-17.3 to 1.7) | -6.3 (-14.4 to 1.8) |
| -6.0 (16.7) | -4.4 (13.0) | 1.8 (14.1) | p=0.1 | p=0.1 | |
Conclusions: PD COMM Pilot determined that a full scale phase III randomised controlled trial was feasible, the interventions were acceptable and the measures were completed with little missing data. Using the data from the Voice Handicap Index, a study to determine the efficacy of each active intervention is likely to require about 550 PwP.
To cite this abstract in AMA style:
C.M. Sackley, S. Patel, R. Woolley, N.J. Ives, C.E. Rick, F. Dowling, K. Wheatley, C. Smith, M. Brady, C.E. Clarke. PD COMM Pilot: A pilot randomised controlled trial of Lee Silverman voice treatment (LSVT) versus NHS speech and language therapy versus no intervention in Parkinson’s [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/pd-comm-pilot-a-pilot-randomised-controlled-trial-of-lee-silverman-voice-treatment-lsvt-versus-nhs-speech-and-language-therapy-versus-no-intervention-in-parkinsons/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/pd-comm-pilot-a-pilot-randomised-controlled-trial-of-lee-silverman-voice-treatment-lsvt-versus-nhs-speech-and-language-therapy-versus-no-intervention-in-parkinsons/