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Open Access Study protocol

Lee Silverman voice treatment versus standard NHS speech and language therapy versus control in Parkinson’s disease (PD COMM pilot): study protocol for a randomized controlled trial

Catherine M Sackley1, Christina H Smith2, Caroline Rick3, Marian C Brady4, Natalie Ives3, Ramilla Patel5, Helen Roberts6, Francis Dowling3, Sue Jowett7, Keith Wheatley8, Smitaa Patel3, Debbie Kelly1, Gina Sands1* and Carl Clarke9

Author Affiliations

1 School of Rehabilitation Sciences, University of East Anglia, Earlham Road, Norwich NR4 7TJ, UK

2 Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, Wakefield Street, London WC1N 1PF, UK

3 Birmingham Clinical Trials Unit (BCTU), University of Birmingham, Hospital Drive, Birmingham B15 2TT, UK

4 Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK

5 Parkinson’s UK West Midlands Regional Branch, Head office, 215 Vauxhall Bridge Road, London SW1V 1EJ, UK

6 Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK

7 School of Health and Population Sciences, University of Birmingham, University Road West, Birmingham B15 2TT, UK

8 Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Hospital Drive, Birmingham B15 2TT, UK

9 School of Clinical and Experimental Medicine, University of Birmingham, Vincent Drive, Birmingham B15 2TT, UK

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Trials 2014, 15:213  doi:10.1186/1745-6215-15-213

Published: 7 June 2014

Abstract

Background

Parkinson’s disease is a common movement disorder affecting approximately 127,000 people in the UK, with an estimated two thirds having speech-related problems. Currently there is no preferred approach to speech and language therapy within the NHS and there is little evidence for the effectiveness of standard NHS therapy or Lee Silverman voice treatment. This trial aims to investigate the feasibility and acceptability of randomizing people with Parkinson’s disease-related speech or voice problems to Lee Silverman voice treatment or standard speech and language therapy compared to a no-intervention control.

Methods/Design

The PD COMM pilot is a three arm, assessor-blinded, randomized controlled trial. Randomization will be computer-generated with participants randomized at a ratio of 1:1:1. Participants randomized to intervention arms will be immediately referred to the appropriate speech and language therapist. The target population are patients with a confirmed diagnosis of idiopathic Parkinson’s disease who have problems with their speech or voice. The Lee Silverman voice treatment intervention group will receive the standard regime of 16 sessions between 50 and 60 minutes in length over four weeks, with extra home practice. The standard speech and language therapy intervention group will receive a dose determined by patients’ individual needs, but not exceeding eight weeks of treatment. The control group will receive standard care with no speech and language therapy input for at least six months post-randomization. Outcomes will be assessed at baseline (pre-randomization) and post- randomization at three, six, and 12 months. The outcome measures include patient-reported voice measures, quality of life, resource use, and assessor-rated speech recordings. The recruitment aim is at least 60 participants over 21 months from 11 sites, equating to at least 20 participants in each arm of the trial. This trial is ongoing and recruitment commenced in May 2012.

Discussion

This study will provide information on the feasibility and acceptability of randomizing participants to different speech and language therapies or control/deferred treatment. The findings relating to recruitment, treatment compliance, outcome measures, and effect size will inform a future phase III randomized controlled trial.

Trial registration

International Standard Randomised Controlled Trial Number Register: ISRCTN75223808 registered 22 March 2012.

Keywords:
Parkinson’s disease; Speech and language therapy; Lee Silverman Voice Treatment; Randomized controlled trial; LSVT®