Objective: To investigate the efficacy of EMT for the impaired loudness of speech in patients with PD, we conducted an open-label pilot trial of EMT.

Background: The mechanism of dysarthria in Parkinson’s disease (PD) has been described as a hypokinetic speech disorder characterized by impaired loudness. Expiratory muscle training (EMT) has a potential to improve this hypokinetic speech disorder through strengthening muscles involved in expiration.

Methods: Twenty PD patients with hypokinetic speech disorder were recruited and indicated to do breathing exercises by a fixed method with the training device (Threshold IMT®) three times a day for 4 weeks. We measured the maximal sound pressure level of the maximum loud voice (MSPL-l) and ordinary speech voice (MSPL-o) as primary outcome measures. Maximal expiratory pressure (MEP) was also measured. We compared pre- and post-training MSPL and MEP, and analyzed statistically using paired t-tests.

Results: The mean age of the subjects was 75.4 (standard deviation: SD 5.8) years and the mean disease duration was 9.1 (SD 5.4) years. The mean MSPL-l increased from 95.7 (SD 9.5) to 104.4 (SD10.1) dB and the mean MSPL-o also increased from 80.7 (9.4) from 83.2 (7.5) dB. Those improvements were statistically significant (P=0.002 and 0.047, respectively). MEPs were also improved significantly (P<0.0001) and the mean MEP was changed from 72.6 to 94.8 cmH20 (P<0.0001). There was no adverse event reported.

Conclusions: These data demonstrated a therapeutic efficacy of EMT for impaired loudness of speech in patients with PD. EMT was safe, low cost, and highly practical training for PD patient with a small voice.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/expiratory-muscle-training-for-the-impaired-loudness-of-speech-in-parkinsons-disease-an-open-label-study/