Our voice is as distinctive as a fingerprint, and it reveals all: your age, or at least how old you sound, your physical and emotional well being, and mood. An “old” or sick sounding voice on an otherwise vibrant older person can be a distraction to listeners who are secretly wondering: what’s wrong with your voice? Now, perhaps more than ever we are reliant on our voices for maintaining connection with others, and if voice is impaired, individuals can feel an even greater sense of social isolation.
Presbyphonia is an age-related voice disorder that affects more than 10 million people in the United States. Presbylarynges (“old larynx”) is the term many Ear Nose and Throat (ENT) doctors use when diagnosing a voice problem in an older patient. A visual exam of the larynx may reveal age related changes to the vocal folds which can include stiffness and bowing, thinning due to reduced muscles mass and/or medications, or drying of the mucus membranes. In addition to laryngeal changes, the respiratory muscles may also stiffen or weaken in response to aging, and these physical changes can result in voice symptoms which may include breathiness, hoarseness, weakness, or difficulty projecting and vocal fatigue following voice use.
If you are someone with Parkinson’s disease, some of these voice symptoms may sound familiar, as PD also causes stiffness in the vocal folds and weakness and stiffness in the breathing muscles which may accelerate age-related changes.
Following an ENT consult, patients may be referred for a course of voice therapy treatment conducted by a speech-language pathologist. Voice therapy for non-PD patients typically consists of approximately 6-8 out-patient treatment visits with the goal of helping patients attain the best possible voice and relief from the most bothersome symptoms.
Parkinson’s patients typically undergo a more intensive therapy program, such as LSVT® LOUD or SPEAK OUT! and learn a set of exercises and strategies for self-cueing to adequate loudness, which to some extent they will need to perform for the rest of their lives due to the progressive nature of PD.
Regardless the cause of a voice problem, voice therapy typically includes an educational component along with the technical skills training component, and patients may be encouraged to eliminate some harmful voice habits like throat clearing or modify their diet to reduce the impact of acid reflux on the laryngeal mucosa.
Respiratory muscle training (RMT) using a handheld device can also help to improve strength and use of the breathing muscles, the power generators for voice. Parkinson’s patients who incorporate RMT into their daily speech practice may gain some secondary benefit with improved timing and co-ordination of breathing and swallowing.
Evidence indicates that physical conditioning plays an important role in maintaining vocal functioning as we age. Tony Bennett recorded an album shortly before his 90th birthday, giving testimony to the fact that a trained voice can continue to perform well throughout a lifetime.
“I’d like to prove that if you take care of yourself, you can actually not regret the fact that you’ve become an old-timer, but you can just still improve and actually get better.” Tony Bennett
Speech and Voice Practice at Home
Individuals with Parkinson’s have been fortunate during this time of physical distancing to have a variety of dance and exercise programs available over the internet. There are also options for speech and voice practice while home which include:
The LOUD Crowd® is an after-therapy speech class available for individuals with Parkinson’s who have completed SPEAK OUT! speech therapy. The Charlotte County, Florida group meets on ZOOM Thursdays at 1:30. If you have completed SPEAK OUT! and would like to join our group, please send an email to: firstname.lastname@example.org
The Parkinson Voice Project offers practice videos and a variety of other informational videos which can be found on their website: https://www.parkinsonvoiceproject.org/
LSVT Global is offering free introductory classes for LSVT® LOUD making this a great time to learn about their approach or to get a refresher if it has been some time since you completed therapy. LSVT LOUD Introduction and Interactive Voice Exercise Demonstration. Register HERE for LSVT LOUD introduction classes
The Voice Aerobics® family of products were designed to provide patients options for voice practice before, during, and after formal speech therapy. Please visit our website to view our products, and remember, anytime you purchase a product, a complimentary online coaching session is always included.
My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice