Feasibility and acceptability of Lee Silverman Voice Treatment for patients with hereditary ataxia

Objectives:
This study aimed to assess the feasibility and acceptability of Lee Silverman Voice Treatment (LSVT) provided via Skype for patients with hereditary ataxia.

Background:
There are currently no evidence based speech treatments available for people with hereditary ataxia. As a result, these patients are often not offered treatment despite significant impact on communication related quality of life. This study investigated whether LSVT, a speech treatment focusing on increasing loudness, can improve communication in these speakers.

Method:
20 patients were recruited to the study. An extended version of LSVT, consisting of 2 sessions a week over 8 weeks was provided via Skype. Two baseline (2 weeks apart) and two post-treatment measures (immediately following and 8 weeks after treatment) were collected. Materials included a range of speech tasks, questionnaires and a patient interview. Pre and post-treatment comparisons focused on acoustic and perceptual speech parameters, including voice quality, breath support, intelligibility and naturalness, as well as impact and communication participation.

Results
Results indicate improvements in breath support and in voice quality for sustained vowels and connected speech, both for acoustic and perceptual measures. Most of these improvements were maintained longer term. No changes were evident for intelligibility or naturalness, however, patient reported outcomes were positive for most participants, both in the speech and psychosocial domains. There were no negative reports with regard to fatigue, and the majority of patients preferred Skype delivery over face to face provision.

Conclusion
The study suggests, along with a recent pilot study by Vogel et al. (2019) that speech treatment can have a beneficial impact on communication in patients with hereditary ataxia and should therefore be provided by clinicians.