{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:24:31Z","timestamp":1776403471902,"version":"3.51.2"},"reference-count":62,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although speech and voice disorders are common in Parkinson's disease (PD), there is insufficient evidence to support the effectiveness of behavioural speech therapies in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to examine the effects of a new tele\u2010rehabilitation program, a combining of conventional speech therapy and singing intervention, on voice deficits in patients with PD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>This study was a three\u2010armed, assessor\u2010masked, randomised controlled trial. Thirty\u2010three people with PD were randomly assigned to the combination therapy, conventional speech therapy, or singing intervention group. This study followed the Consolidated Standards of Reporting Trials guidelines for non\u2010pharmacological treatment. Each patient participated in 12 tele\u2010rehabilitation sessions over 4 weeks. The combination therapy group received speech and singing interventions simultaneously (respiratory, speech, voice, and singing exercises). Voice intensity as a primary outcome and the voice handicap index (VHI), maximum frequency range, jitter and shimmer as secondary outcomes were evaluated 1 week before the first intervention session, 1 week after the last intervention session and 3 months after the last evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>The results of repeated measures analysis of variance showed a significant main effect of time on all outcomes in all three groups after treatment (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). There was a significant group effect for voice intensity (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), VHI (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), maximum frequency range (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.014) and shimmer (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). The combination therapy group demonstrated a significant outperformance in the VHI and shimmer than the speech therapy (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.038) and singing intervention (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) groups. The results of this study also indicated that combination therapy group compared to singing intervention group had a larger effect on voice intensity (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), shimmer (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and maximum frequency range (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implication<\/jats:title><jats:p>The results demonstrated that combining speech therapy with a singing intervention delivered through tele\u2010rehabilitation might be more effective in improving voice problems in patients with PD.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Parkinson's disease (PD) is a neurological disorder that frequently causes disturbances in speech and voice, which negatively affect patients\u2019 quality of life. Although speech difficulties occur in 90% of patients with PD, evidence\u2010based treatment options for speech and language problems in these patients are limited. Therefore, further studies are required to develop and assess evidence\u2010based treatment programs.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this study adds<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The findings of this study showed that a combination therapy program including conventional speech therapy approaches and individual singing intervention provided through tele\u2010rehabilitation may have a greater effect on the improvement of voice problems in people with PD compared to speech therapy and singing intervention alone.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Tele\u2010rehabilitation combination therapy is an inexpensive and enjoyable behavioural treatment. The advantages of this method are that it is easy to access, appropriate for many stages of voice problems in PD, requires no prior singing training, encourages voice health and self\u2010management and maximises treatment resources available to people with PD. We believe that the results of this study can provide a new clinical basis for treatment of voice disorders in people with PD.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12900","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T03:31:13Z","timestamp":1686195073000},"page":"1752-1767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three\u2010arm randomised controlled trial"],"prefix":"10.1111","volume":"58","author":[{"given":"Zeinab","family":"Mohseni","sequence":"first","affiliation":[{"name":"Rehabilitation Research Center, Department of Speech Therapy, School of Rehabilitation Sciences Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2823-5197","authenticated-orcid":false,"given":"Reyhane","family":"Mohamadi","sequence":"additional","affiliation":[{"name":"Rehabilitation Research Center, Department of Speech Therapy, School of Rehabilitation Sciences Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Amir Hasan","family":"Habibi","sequence":"additional","affiliation":[{"name":"Department of Neurology School of Medicine Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arezoo","family":"Saffarian","sequence":"additional","affiliation":[{"name":"Rehabilitation Research Center, Department of Speech Therapy, School of Rehabilitation Sciences Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamile","family":"Abolghasemi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","first-page":"62","article-title":"Comparing of two Farsi passages in laboratory evaluation of mean and fundamental frequency variations range","volume":"21","author":"Aghajanzadeh M.","year":"2012","journal-title":"Auditory and Vestibular Research"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.32598\/irj.19.1.1107.1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2217\/nmt.15.16"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/mtp\/miw042"},{"key":"e_1_2_9_6_1","volume-title":"Clinical measurement of speech and voice, Cengage Learning","author":"Baken R.J.","year":"2000"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-160837"},{"key":"e_1_2_9_8_1","unstructured":"Boersma P.&Weenink D.(2011)Praat: doing phonetics by computer [Computer program]. 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