Motor and speech difficulties are among the most limiting symptoms of Parkinson’s disease, significantly affecting independence and quality of life.
While motor issues restrict freedom of movement, speech difficulties hinder the ability to express oneself and communicate with others. These two challenges, seemingly distinct, share neurological origins, mainly linked to muscle rigidity, bradykinesia, and coordination problems.
For patients and caregivers, understanding these aspects is vital. Recognizing how essential speech and walking are to living with dignity and hope underscores the need for an integrated approach to Parkinson’s that considers the mind-body connection.
Speech difficulties in Parkinson’s: an early symptom.
Speech challenges are very common in Parkinson’s, with an estimated 90% of patients experiencing reduced ability to communicate effectively.
The voice often becomes weak, monotone, or hoarse due to vocal cord rigidity. Internal laryngeal muscle contractions also cause frequent interruptions, even for simple breathing.
Scientific studies have analyzed vocal parameters like vowel percentage (%V) and articulation rate to understand these symptoms. Parkinson’s patients often exhibit a higher %V because consonants, requiring precise, complex movements, are harder to articulate due to muscle tension and slowness.
A recent study by the Universities of Naples and Padua found that %V increases with disease progression and is observable even in mild cases, making it a valuable marker for early diagnosis and tracking progression.
Notably, researchers at Kaunas University of Technology in Lithuania developed an AI-based system to analyze vocal signals as early indicators of speech alterations caused by Parkinson’s.
Speech therapy for Parkinson’s.
Like other muscles, speech can be trained through specific speech therapy techniques that improve voice quality, clarity, and communication ability.
An intensive method designed for Parkinson’s-related dysarthria is LSVT (Lee Silverman Voice Treatment), named after the first patient of Dr. Lorraine Ramig. This treatment includes guided sessions and homework to enhance vocal intensity, intonation, facial expressiveness, and swallowing.
Biofeedback techniques use computer monitors to show physiological parameters during speech, helping patients gain awareness and voluntarily adjust their speaking pace or voice tone.
Group therapies, such as Loud Crowd and SPEAK OUT, are gaining popularity. These include singing sessions and voice reinforcement exercises to boost vocal intensity.
For patients with severe speech impairments, technological devices for voice amplification or alternative communication tools can provide essential support.
Speech and motor rehabilitation.
Stimulating the ability to speak, improving vocal quality, and enhancing speech intelligibility require continuous linguistic training, just like motor rehabilitation.
Speech and walking are very similar in this regard, as both require exercises that, despite their simplicity, can make a significant difference.
Simple stretching exercises, performed comfortably while seated in a chair, are as easy to perform as the repetition of a word or a phrase with deep personal meaning.
Similarly, attempting to vocalize a musical scale, starting from very low notes and progressing to higher ones, is comparable to taking a short walk at home or outdoors. Both activities require effort, dedication, and support, but they help reduce stiffness in limbs and vocal cords, providing benefits for mood as well.
In this sense, non-invasive therapies aimed at improving walking in those living with Parkinson’s, such as the AMPS therapy provided by the Gondola® Home device, can help restore walking speed, improve voice tone, and enhance a sense of independence.
Regular use of the Gondola AMPS therapy allows patients to improve their ability to perform two tasks simultaneously, such as walking and talking.
Connections that improve life.
Having an increasingly faint voice or unclear word pronunciation affects quality of life just as much as losing the ability to move and walk independently. Often, this leads to withdrawing into oneself, giving up on attempts to regain a fuller life lived to the best of one’s abilities.
This is why many rehabilitation and improvement activities for speech and walking can be carried out in groups, such as singing classes, collective speech therapy programs, or walks with a caregiver or family member.
It is now well established that seeking help from trusted and caring individuals to face these difficulties benefits both the symptoms of the disease and psychological well-being.
Making a video call to a friend can be considered a language exercise, and asking them to meet and walk together can likely amplify the results. Some words may be lost, and some steps retraced, but every effort is an exercise that helps move forward with greater confidence.
Sources:
Speech disorders in Parkinson’s disease – characteristics, assessment and treatment, Lana Jerkić, Mirjana Petrović Lazić, Mile Vuković, University of Belgrade, Faculty for Special Education and Rehabilitation, 2021.
Skodda, W. Gronheit, and U. Schlegel, “Impairment of vowel articulation as a possible marker of disease progression in Parkinson’s Disease,” PLoS ONE, vol. 7, no. 2, pp. 1-8, 2012.
