Objective: The aim of this two armed RCT is to evaluate how intensive singing improves the phonatory and respiratory muscle control of people with Parkinson’s disease (PD) and how the mutually supportive nature of group singing facilitates social interaction and improves wellbeing.

Background: As an effective intervention for voice and wellbeing for people with PD, group singing is attracting attention. Only a small number of studies have been completed in the past decade; all with methodological differences and an absence of RCT. LSVT® is the current voice treatment for PD. It is considered effective, but has limitations as insufficient availability, high cost related to the intensity of required client contact time and physical impairment can result in significant numbers dropping out.

Methods: This study is a two armed RCT quantitative study of people with PD randomised into a Choir group participating in singing, voice and respiration exercise and a Music group participating in watching and discussing music videos to control for the group effect. Both groups attended one weekly session over 9 consecutive weeks. Pre and post-treatment assessment included analysis of voice volume (SPL), quality and efficiency, glottic function and cognition as well as vital capacity and maximum sustained phonation. Self-reported measures including symptom severity, quality of life, depression/anxiety/stress and voice provided insight into participant’s perceptions.

Results: Pre and post analysis of SPL, voice quality, respiratory, glottal function, cognition showed significant within-group improvement for the Choir group, but not for the Music group. Significant between-group differences were observed in average and maximum SPL, VTI, SPI and glottal function. Significant within-group improvement was observed for the choir group for SPL, maximum sustained phonation, Jitter, RAP, Shimmer, Soft Phonation Index and self reported anxiety, PDQoL, VHI-10; VHI-10P (partner version); UPDRS Pt2. Significant between-group post-treatment improvements (p<0.05) were observed in peak air flow (PEF), aerodynamic resistance and average SPL (measured during conversation). Choir group and Music group attendance was over 96% during treatment suggesting that both groups found the nature and format of the activities enjoyable and worthwhile.

Conclusions: This study contributes further evidence of group singing as an effective voice intervention that has a high participation uptake and low drop out and provides further support for the use of group singing an effective alternative to LSVT®.

References: Abell, R. V., Baird, A. D., & Chalmers, K. A. (2017). Group singing and health-related quality of life in Parkinson’s disease. Health Psychology, 36(1), 55. Barnish, J., Atkinson, R. A., Barran, S. M., & Barnish, M. S. (2016). Potential benefit of singing for people with Parkinson’s disease: A systematic review. Journal of Parkinson’s Disease, 6(3), 473-484. Buetow, S. A., Talmage, A., McCann, C., Fogg, L., & Purdy, S. (2014). Conceptualizing how group singing may enhance quality of life with Parkinson’s disease. Disability and Rehabilitation, 36(5), 430-433. Di Benedetto, P., Cavazzon, M., Mondolo, F., Rugiu, G., Peratoner, A., & Biasutti, E. (2009). Voice and choral singing treatment: a new approach for speech and voice disorders in Parkinson’s disease. European Journal of Physical and Rehabilitation Medicine, 45(1), 13-19. Fogg-Rogers, L., Buetow, S., Talmage, A., McCann, C. M., Leão, S. H., Tippett, L., Purdy, S. C. (2016). Choral singing therapy following stroke or Parkinson’s disease: an exploration of participants’ experiences. Disability and Rehabilitation, 38(10), 952-962. Spielman, J., Ramig, L. O., Mahler, L., Halpern, A., & Gavin, W. J. (2007). Effects of an extended version of the Lee Silverman Voice Treatment on voice and speech in Parkinson’s disease. American Journal of Speech-Language Pathology, 16(2), 95-107. Stegemöller, E. L., Radig, H., Hibbing, P., Wingate, J., & Sapienza, C. (2016). Effects of singing on voice, respiratory control and quality of life in persons with Parkinson’s disease. Disability and Rehabilitation, 1-7. Tanner, M., Rammage, L., & Liu, L. (2016). Does singing and vocal strengthening improve vocal ability in people with Parkinson’s disease? Arts & Health, 8(3), 199-212. Vella-Burrows T, Hancox G. (2012) Singing and people with Parkinson’s: Canterbury Christ Church University. Yinger, O. S., & Lapointe, L. L. (2012). The Effects of Participation in a Group Music Therapy Voice Protocol (G-MTVP) on the Speech of Individuals with Parkinson’s disease. Music Therapy Perspectives, 30(1), 25-31.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/acoustic-respiratory-cognitive-and-wellbeing-comparisons-of-two-groups-of-people-with-parkinsons-disease-participating-in-voice-and-choral-singing-group-therapy-vcst-versus-a-music-apprec/