we suggest that LSVT encourages acceptance of and comfort with increased loudness and the ability to self-monitor vocal loudness. Addressing this apparent sensory mismatch between vocal effort and vocal output may contribute to generalization and maintenance of treatment effects. Finally, treatment that is simple, redundant, and intensive may help accommodate the processing speed, memory, and executive function deficits observed in some individuals with IPD. It may also promote overlearning and internalization of the vocal effort required for normal loudness
Our 15 years of research have generated the first short- and long-term efficacy data for speech treatment (Lee Silverman Voice Treatment; LSVT/LOUD) in Parkinson’s disease. We have learned that training the single motor control parameter amplitude (vocal loudness) and recalibration of self-perception of vocal loudness are fundamental elements underlying treatment success. This training requires intensive, high-effort exercise combined with a single, functionally relevant target (loudness) taught across simple to complex speech tasks. We have documented that training vocal loudness results in distributed effects of improved articulation, facial expression, and swallowing. Furthermore, positive effects of LSVT/LOUD have been documented in disorders other than Parkinson’s disease (stroke, cerebral palsy). The purpose of this article is to elucidate the potential of a single target in treatment to encourage cross-system improvements across seemingly diverse motor systems and to discuss key elements in mode of delivery of treatment that are consistent with principles of neural plasticity.