Effectiveness of Speech Language Pathology Interventions in Managing Hypokinetic Dysarthria in Parkinson's Disease: A Comprehensive Systematic Review

• Heba Salama

  Doctorat of Philosophy speech therapist at Alexandria University, Alexandria, Egypt

  Author

Hypokinetic dysarthria is a prevalent non-motor symptom affecting up to 90% of Parkinson's disease (PD) patients, characterized by reduced vocal loudness, monotone speech, and significantly decreased intelligibility. These speech impairments severely impact patients' quality of life, leading to social isolation and depression. This systematic review evaluates the clinical efficacy of intensive speech programs, specifically Lee Silverman Voice Treatment (LSVT LOUD), compared to traditional speech therapy approaches. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, and PsycINFO for studies published between January 2010 and July 2024. The analysis of 28 eligible studies demonstrated that LSVT LOUD achieves significant and clinically meaningful improvements in sound pressure level (increases of 5-10 dB) and speech intelligibility (20-30% improvement). Furthermore, telehealth delivery models show non-inferior outcomes compared to traditional face-to-face sessions, enhancing accessibility. The findings indicate that intensive speech programs act as effective neurobehavioral interventions that stimulate neuroplasticity rather than mere muscle training. Practical implications suggest that policymakers should mandate insurance coverage for these intensive programs to reduce the overall healthcare burden. In conclusion, intensive speech-language pathology interventions are highly effective for managing hypokinetic dysarthria in PD. However, there is an urgent need for culturally adapted versions, particularly for non-English speakers, and further integration with emerging technologies like AI and mobile applications to ensure long-term maintenance and personalized treatment.

Atalar, M. S. (2023). Hypokinetic dysarthria in Parkinson's disease: A narrative review. Retrieved from PubMed: https://pubmed.ncbi.nlm.nih.gov/37899809/

Baumann, A., et al. (2018). Neural correlates of hypokinetic dysarthria and efficacy of high-intensity voice treatment. Retrieved from PubMed: https://pubmed.ncbi.nlm.nih.gov/30444176/

Fox, C. M., Ramig, L. O., Ciucci, M. P., Sapir, S., McWhorter, D. H., & Farley, A. M. (2006). Intensive voice treatment (LSVT LOUD) for Parkinson's disease: A randomized controlled trial. *Movement Disorders, 21*(10), 1683–1688. https://doi.org/10.1002/mds.21005

Fox, C., Ebersbach, G., Ramig, L., & Sapir, S. (2012). LSVT LOUD and LSVT BIG: behavioral treatment programs for speech and body movement in Parkinson disease. Parkinson’s disease, 2012(1), 391946.

Gison, A., et al. (2025). Intensive speech therapy for hypokinetic dysarthria in Parkinson's disease. Retrieved from PubMed: https://pubmed.ncbi.nlm.nih.gov/39846566/

Kratz, E., Scheffer, J., Volc, D., & Seebacher, B. (2025). Comparing face-to-face and online LSVT® LOUD speech training using LSVT® Coach in patients with Parkinson’s disease: a pilot randomised controlled trial. BMC neurology, 25(1), 183.

Lansford, K. L., Liss, J. M., Caviness, J. N., & Utianski, R. L. (2011). A cognitive‐perceptual approach to conceptualizing speech intelligibility deficits and remediation practice in hypokinetic dysarthria. Parkinson’s Disease, 2011(1), 150962.

Lee, S. H., Kim, J., & Kim, H. J. (2025). Smartphone Application–Based Voice and Speech Training Program for Parkinson Disease: Feasibility and Satisfaction Study With a Preliminary Rater-Blinded Single-Arm Pretest and Posttest Design. Journal of Medical Internet Research, 27, e63166.

Maas, J. J., de Vries, N. M., IntHout, J., Bloem, B. R., & Kalf, J. G. (2024). Effectiveness of remotely delivered speech therapy in persons with Parkinson's disease–a randomised controlled trial. EClinicalMedicine, 76.

Nogles, T. E., & Galuska, M. A. (2023). Middle cerebral artery stroke. In StatPearls [Internet]. StatPearls Publishing.

Ramig, L. O., Halpern, A., Spielman, J., Fox, C., & Freeman, K. (2018). Speech treatment in Parkinson's disease: Randomized controlled trial. *Movement Disorders, 33*(1), 21-29. https://doi.org/10.1002/mds.27460

Saleem, S., Miles, A., & Allen, J. (2026). Effects of LSVT LOUD and EMST in individuals with Parkinson’s disease: a two arm non-randomized clinical trial. International Journal of Speech-Language Pathology, 28(1), 140-154.

Sackley, C. M., Rick, C., Brady, M. C., Woolley, R., Burton, C., Patel, S., ... & Clarke, C. E. (2024). Lee Silverman voice treatment versus NHS speech and language therapy versus control for dysarthria in people with Parkinson’s disease (PD COMM): pragmatic, UK based, multicentre, three arm, parallel group, unblinded, randomised controlled trial. bmj, 386.

Scott, A. M., Clark, J., Cardona, M., Atkins, T., Peiris, R., Greenwood, H., ... & Glasziou, P. (2025). Telehealth versus face-to-face delivery of speech language pathology services: A systematic review and meta-analysis. Journal of telemedicine and telecare, 31(9), 1203-1215.

Steurer, H., Albrecht, F., Gustafsson, J. K., Razi, A., Franzén, E., & Schalling, E. (2024). Speech and neuroimaging effects following HiCommunication: a randomized controlled group intervention trial in Parkinson’s disease. Brain Communications, 6(4), fcae235.

Sturkenboom, I. H., Talebi, A. H., Maas, B. R., de Vries, N. M., Darweesh, S. K., & Kalf, J. G. (2024). Specialized allied health care for Parkinson’s disease: state of the art and future directions. Journal of Parkinson’s Disease, 14(s1), S193-S207.

Sun, M., Tang, F., Wen, S., Wang, S., & Jiang, H. (2026). Effects of Telehealth Interventions for People With Parkinson Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR mHealth and uHealth, 14(1), e70994.

Theodoros, D. G., et al. (2024). Telehealth versus face-to-face delivery of speech language pathology services. *Journal of Telemedicine and Telecare*. Retrieved from https://journals.sagepub.com/doi/abs/10.1177/1357633X241272976

Ulster University. (2024). Voice assisted technology as a tool for speech problems in Parkinson's disease. Retrieved from https://pure.ulster.ac.uk/en/publications/voice-assisted-technology-as-a-tool-for-speech-problems-in-parkin/

Zhang, L., et al. (2025). Effect of treatment of hypokinetic dysarthria in Parkinson's disease. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241742/

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