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Swallowing in Parkinson's Disease

​What is Parkinson’s Disease?

Parkinson’s disease is an illness that affects the part of your brain that controls how you move your body.

What are the Speech Problems in Parkinson’s Disease?

A change in speech may be the one of the first symptoms you will experience. This may include:

  • A soft or hoarse voice
  • Mumbled or unclear speech
  • Monotonous speech

These symptoms may make communication difficult both at work and at home. You may feel frustrated and avoid social interactions due to the changes to your speech and voice.

How can Speech Therapy Help With Communication?

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Your Speech Therapist will first assess your speech and communication difficulties. The therapist will suggest speech and voice exercises to help improve your communication abilities.
You may be:

  • Taught to do exercises that improve or maintain your speech function
  • Taught appropriate communication techniques that conserve energy, including non-verbal communication skills
  • Taught how to adjust the way you use your voice and how to speak
  • Required to involve your family members and friends to understand and help you with your speech outside of the therapy sessions
  • Referred by your doctor for the Lee Silverman Voice Treatment (LSVT). LSVT is a treatment that focuses on increasing vocal loudness. More information about this programme can be found here:

What are the Swallowing Problems in Parkinson’s Disease?

You may notice changes or difficulty with chewing, eating or swallowing. These changes can happen at any time. This may include:

  • Drooling
  • Difficulty chewing
  • Coughing or choking on food and drinks
  • Feeling of food stuck in the throat
  • Taking a long time to finish meals
  • Difficulty swallowing pills

These difficulties may cause discomfort while you are eating or drinking and may lead to further health problems, such as pneumonia. There is also a risk of silent aspiration, when food and fluids enter the airway without your knowledge.
There are currently no medications that are known to be effective in treating speech and swallowing problems in Parkinson’s Disease.

How can Speech Therapy Help People with Swallowing?

Your Speech Therapist will aim to reduce the discomfort and any health issues caused by swallowing problems. The therapist will also work to maintain your swallowing ability for as long as possible.

You may be recommended to:

  • Change fluid consistencies or food textures
  • Adjust sitting postures when they eat/drink
  • Do exercises to improve or maintain your swallowing function

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  • Use feeding techniques and/or swallowing strategies to ensure safe feeding and swallowing
  • Consider alternative methods for feeding such as using a nasogastric (NG) tube
  • For some people, further assessment such as a Videofluoroscopy study (VFS) or a Fibreoptic Endoscopic Evaluation of Swallowing (FEES) may be needed to check for food and/or fluids entering the airway silently

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  • After the assessment, you will be provided with recommendations of diet and fluid consistencies which are safe for swallowing, and strategies to help safe swallowing
  • Trial expiratory muscle strength trainer (EMST) which has been shown to be effective in improving swallowing ability in people with Parkinson Disease. You may wish to speak to your speech therapist whether EMST is a suitable treatment for you. More information can be found here:
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