Improving speech and gait in Parkinson's disease.

Among the symptoms that most limit independence and quality of life in people with Parkinson's Disease are motor disturbances and speech difficulties.

If the former reduce freedom of movement, the latter make it difficult to express oneself and communicate with other people. These two types of problems, which seem very different from each other, actually stem from the neurological alterations due to the disease, mainly related to muscle rigidity, bradykinesia, and difficulty in coordination.

It is essential for patients and caregivers to understand this and not underestimate how essential language and walking are to living with hope and dignity at each stage of the disease. Caring for them, day in and day out, confirms the importance of a integrated approach to Parkinson's, which takes into proper consideration the connection between mind and body.

Language changes in Parkinson's disease: among the earliest symptoms.

Difficulties in language are very common among people with this neurological condition-in fact, it is estimated that about 90% of patients see a decrease in their ability to communicate effectively with others.

The voice becomes faint, monotonous or hoarse due to the hardness of the vocal cords causing alterations in intonation, while the contraction of the internal muscles of the larynx forces frequent interruptions, even if only for catch one's breath.

It is not surprising, therefore, that scientific studies focus on parameters such as vowel percentage (%V) and articulation speed to study symptoms and understand how to deal with them. It has been observed that people with Parkinson's Disease tend to pronounce a higher percentage of vowels than healthy individuals. This is because consonants, which require more complex and precise articulatory movements, are more difficult to produce precisely because of muscle tension and slowness.

A study conducted recently by the University of Naples and Padua showed that the increase in vowel percentage correlated with the number of years since the onset of the disease and was detectable even in patients with very mild symptoms.
This makes it an interesting parameter both for early diagnosis and for giving indications of disease progression.

Not surprisingly, some scientists at the’Kaunas University of Technology in Lithuania have been working on an artificial intelligence-based system capable of analyzing and evaluating speech signals as early symptoms of disease-related speech impairment.

Training with speech therapy for Parkinson's disease.

Exactly as with other muscles, speech can also be trained with speech therapy techniques specifics, which improve voice quality, make the words spoken during speeches more understandable, and thus increase communication ability.

One of the intensive methods designed specifically to help people with dysarthria in Parkinson's Disease is LSVT, or the Lee Silverman Voice Treatment, named after the patient on whom Dr. Lorraine Ramig first noticed results. The treatment involves guided sessions and homework to improve vocal intensity, intonation, facial expressiveness and swallowing.

Le biofeedback techniques instead show through computers and monitors the progress of physiological parameters during speech, so as to help the patient gain awareness and voluntarily slow the pace of speech or revise the pitch of the voice.

Also beginning to spread now are the group therapies (Loud Crowd and SPEAK OUT) where people come together for class exercises that include singing sessions and vocal reinforcement to improve vocal intensity.

For patients with severe speech impairment, however, there are technological devices to amplify the voice or tools to alternative augmentative communication that can support them in their relationship with others.

Language and motor rehabilitation.

Stimulating the ability to speak, improving vocal quality and speech intelligibility, requires continuous language training such as motor rehabilitation.

Language and walking in this are very much related and require performing exercises that in their simplicity can make a big difference.

The small stretching exercises to do from the comfort of a chair are as easy to perform as the repetition of a word Or a phrase with deep personal meaning.

Similarly, trying to make a musical scale with one's own voice, starting from very low notes to higher notes, is like trying to do a walk indoors or outdoors. Both activities require effort, dedication and support but help reduce stiffness in limbs and vocal cords, bringing benefits to mood as well.

As such, non-invasive therapies for improving gait in Parkinson's Disease sufferers such as the AMPS therapy delivered by the device Gondola® Home can help restore speed in walking, improve the tone of voice and sense of independence. In fact, regular use of Gondola AMPS therapy enables patients to improve their ability to perform two tasks simultaneously, e.g. walking and talking.

Connections that help you live better.

Having an increasingly feeble voice or imprecise pronunciation of words affects the quality of life as much as no longer being able to move and walk independently. People often end up closing in on themselves, giving up attempts to regain a full life, lived to the fullest extent possible.

That is why many of the activities to rehabilitate and improve speech and gait can be done in groups, such as singing classes, group speech therapy programs, and walks with a caregiver or family member.

It is now proven that get help in facing these difficulties from people we trust and care about brings benefits for both the symptoms of the disease and psychological well-being.

Making a video call with a friendly person can be considered an exercise for language, and asking them to meet and walk together probably amplifies the result.Some words will be lost, some steps will have to be redone, but every effort is an exercise that helps you move forward with more confidence.

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