{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:13:50Z","timestamp":1793708030192,"version":"4.6.1"},"reference-count":36,"publisher":"BMJ","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2024,5,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the clinical effectiveness of two speech and language therapy approaches versus no speech and language therapy for dysarthria in people with Parkinson\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The speech and language therapy interventions were delivered in outpatient or home settings between 26 September 2016 and 16 March 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>388 people with Parkinson\u2019s disease and dysarthria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants were randomly assigned to one of three groups (1:1:1): 130 to Lee Silverman voice treatment (LSVT LOUD), 129 to NHS speech and language therapy, and 129 to no speech and language therapy. LSVT LOUD consisted of four, face-to-face or remote, 50 min sessions each week delivered over four weeks. Home based practice activities were set for up to 5-10 mins daily on treatment days and 15 mins twice daily on non-treatment days. Dosage for the NHS speech and language therapy was determined by the local therapist in response to the participants\u2019 needs (estimated from prior research that NHS speech and language therapy participants would receive an average of one session per week over six to eight weeks). Local practices for NHS speech and language therapy were accepted, except for those within the LSVT LOUD protocol. Analyses were based on the intention to treat principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was total score at three months of self-reported voice handicap index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>People who received LSVT LOUD reported lower voice handicap index scores at three months after randomisation than those who did not receive speech and language therapy (\u22128.0 points (99% confidence interval \u221213.3 to \u22122.6); P&lt;0.001). No evidence suggests a difference in voice handicap index scores between NHS speech and language therapy and no speech and language therapy (1.7 points (\u22123.8 to 7.1); P=0.43). Patients in the LSVT LOUD group also reported lower voice handicap index scores than did those randomised to NHS speech and language therapy (\u22129.6 points (\u221214.9 to \u22124.4); P&lt;0.001). 93 adverse events (predominately vocal strain) were reported in the LSVT LOUD group, 46 in the NHS speech and language therapy group, and none in the no speech and language therapy group. No serious adverse events were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LSVT LOUD was more effective at reducing the participant reported impact of voice problems than was no speech and language therapy and NHS speech and language therapy. NHS speech and language therapy showed no evidence of benefit compared with no speech and language therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ISRCTN registry\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"ISRCTN12421382\" ext-link-type=\"isrctn\">ISRCTN12421382<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-078341","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T20:00:23Z","timestamp":1720641623000},"page":"e078341","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Lee Silverman voice treatment versus NHS speech and language therapy versus control for dysarthria in people with Parkinson\u2019s disease (PD COMM): pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial"],"prefix":"10.1136","volume":"386","clinical-trial-number":[{"clinical-trial-number":"isrctn12421382","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn12421382","registry":"10.18810\/isrctn"}],"author":[{"given":"Catherine M","family":"Sackley","sequence":"first","affiliation":[{"name":"School of Health Science, University of Nottingham, Queen's Medical Centre, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre \u00a0"},{"name":"Population Health Sciences, Addison House, King\u2019s College London, Guy\u2019s Campus, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7713-9834","authenticated-orcid":false,"given":"Caroline","family":"Rick","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit, University of Nottingham, Applied Health Research Building, University Park, Nottingham, UK"},{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian C","family":"Brady","sequence":"additional","affiliation":[{"name":"Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Woolley","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Burton","sequence":"additional","affiliation":[{"name":"School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smitaa","family":"Patel","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Masterson-Algar","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Bangor University, Bangor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avril","family":"Nicoll","sequence":"additional","affiliation":[{"name":"Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina H","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, London, UK"},{"name":"NHS Lothian"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Jowett","sequence":"additional","affiliation":[{"name":"Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Ives","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Beaton","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Dickson","sequence":"additional","affiliation":[{"name":"Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Ottridge","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, 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