Syncopation in musical terms is described as “a disturbance or interruption of the regular flow of rhythm.” A placement of rhythmic stresses or accents where they wouldn’t normally occur. (Source Wikipedia)

Syncopation is often used by dance teachers to mean improvised or rehearsed execution of step patterns that have more rhythmical nuances than “standard” step patterns. It takes advanced dancing skill to dance syncopations in this sense and when dancing to the disparate threads contained within the music, hands, torso, and head can independently move in relation to a thread, creating a fluidly syncopated performance of the music.

Syncopated Movements and Parkinson’s disease

Two movement disorders which may impact normal function for persons with Parkinson’s disease are dyskinesia and dystonia.

Dyskinesia is described as the distortion or impairment of voluntary movement and can express itself twisting or “wiggly” movements of the arms, legs, trunk, or oral-facial muscles.

Dystonia is a condition of abnormal muscle tone or spasm that causes impairment of voluntary muscle movement, and can also, for some patients, be quite painful. Dystonia can occur in the toes, neck, oral-facial muscles and laryngeal muscles, causing the voice to sound strained or breathy.

Some individuals with Parkinson’s experience dyskinesia or dystonia as a wearing off effect of medication or as an associated motor symptom of PD, particularly in later stages of PD.

These abnormal movements often interfere with normal function, and because normal and abnormal cannot co-exist, the functional impact of dyskinesia and dystonia can make it more difficult to both talk AND walk and in some instances can also have a negative effect on swallowing function due to mis-timing between breathing and swallowing.

Speech Breathing

When speaking, we are always speaking on the breath out (exhalation), and if dyskinesia causes a PWP to hold the breath or breathing muscles contract, they may report a feeling of “running out of breath.” If laryngeal dystonia causes the vocal folds to open or close in an asynchronous way, voice may sound strained or breathy.

Patients with oral-facial dyskinesia, dyskinesia of the trunk, or laryngeal dystonia may have more difficulty effectively carrying out speech and voice practice. No patient should ever feel that they are to blame, or that they are doing something “on purpose,” but rather, therapists, like the dance or music teacher,  may need  advanced skills to be able to recognize these motor symptoms and help the patients achieve  their goal of functional communication despite these disparate movements

If you suffer from dyskinesia or dystonia, it is always important to discuss this with your neurologist. Often time’s symptoms can be reduced with better timing of medication, with additional medications, or in some instances in response to DBS (Deep Brain Stimulation) surgery. Therapists can help patients track their symptoms and report these to the patient’s physician. 

To learn more about dyskinesia and current treatments visit:

Speech Practice @ Home

Every time you get up from a seating surface to walk to another room, count the steps in a loud “ah” voice. If you are walking independently use a big arm swing and big steps.

Read headlines from the newspaper, dictate your grocery list or phone numbers. Use your loud “ah” voice and stay loud enough for others to hear you. Use your Hi-Volt® 4 PD audio CD and voice activated light bracelet for feedback and guided practice.

Upcoming Webinar

PN Medical, Manufacturer of The Breather® Respiratory Muscle Trainer presents the 3rd in a series of webinars helping learners understand the benefits and applications of respiratory muscle training.

  • Causes, prevalence and implications of respiratory muscle weakness.
  • Specific Respiratory Muscle Treatment strategies to effectively treat patients in a variety of clinical settings.
  • View realistic therapist and patient demonstration videos to improve RMT outcomes 
  • The protocol using The Breather as an evidenced-based tool to treat RMW.
  • Develop a measurable goal and progress note for specific disciplines (RT, ST, OT, PT) utilizing RMT to treat RMW
  • Develop patient/client-specific discharge plans for carryover of gains achieved during treatment.

There is no fee. To learn more or to register visit:


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

Voice Aerobics the heART and Science of Voice Practice