ParkinSong: Outcomes of a 12-Month Controlled Trial of Therapeutic Singing Groups in Parkinson’s Disease

Article type: Research Article

Authors: Tamplin, Jeanette^{a; *} | Morris, Meg E.^{b; c} | Marigliani, Caterina^d | Baker, Felicity A.^{a; e} | Noffs, Gustavo^f | Vogel, Adam P.^{f; g; h}

Affiliations: [a] Faculty of Fine Arts and Music, The University of Melbourne, Southbank, Victoria, VIC, Australia | [b] School of Allied Health, Human Services & Sport, La Trobe University, Bundoora, Victoria, VIC, Australia | [c] Healthscope, Victorian Rehabilitation Centre, Glen Waverly, Australia | [d] Parkinson’s Victoria, Surrey Hills, Victoria, VIC, Australia | [e] Centre for Music and Health, Norwegian Academy of Music, Oslo, Norway | [f] Centre for Neuroscience of Speech, The University of Melbourne, Carlton, Victoria, VIC, Australia | [g] Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany & Center for Neurology, University Hospital Tübingen, Germany | [h] Redenlab, Australia

Correspondence: [*] Correspondence to: Dr Jeanette Tamplin, PhD, Creative Arts & Music Therapy Research Unit, Faculty of Fine Arts and Music, The University of Melbourne, 234 St Kilda Road, Southbank, Victoria, 3006, Australia. Tel.: +61 3 8344 3003; E-mail: [email protected].

Note: [Statistical analysis: ] was conducted by Dr. Sue Finch in collaboration with Dr. Tamplin from The University of Melbourne.

Abstract: Background:Parkinson’s disease (PD) frequently causes progressive deterioration in speech, voice and cognitive aspects of communication. These affect wellbeing and quality of life and are associated with caregiver strain and burden. Therapeutic singing groups can ameliorate PD-related communication disorders and increase social interaction and wellbeing for caregivers and care recipients. Objective:To analyse the effects of ParkinSong group singing sessions on Parkinson’s communication and wellbeing outcomes for people with PD and caregivers over 12 months. Methods:A 4-armed controlled clinical trial compared ParkinSong with active non-singing control conditions over 12 months. Two dosage levels (weekly versus monthly) were available for each condition. ParkinSong comprised high-effort vocal, respiratory and speech exercises, group singing, and social interaction. PD-specific outcomes included vocal loudness, speech intelligibility, maximum phonation time, respiratory muscle strength, and voice related quality of life (QoL). Wellbeing outcomes were also measured for caregivers and care recipients. Results:We recruited 75 people with PD and 44 caregivers who attended weekly ParkinSong, monthly ParkinSong, weekly control or monthly control groups. We found significant improvements in the primary outcome of vocal loudness (p = 0.032), with weekly singers 5.13 dB louder (p = 0.044) and monthly singers 5.69 dB louder (p = 0.015) than monthly controls at 12 months. ParkinSong participants also showed greater improvements in voice-related QoL and anxiety. Caregivers who attended ParkinSong showed greater reductions in depression and stress scores. Conclusions:This 12-month controlled clinical trial of ParkinSong demonstrated improvements in speech loudness and voice-related QoL for participants with PD, and enhanced wellbeing for both caregivers and care recipients. No adverse effects were reported over 12 months and improvements were sustained.

Keywords: Clinical Trial Registry number: ACTRN12617000528358

Keywords: Parkinson’s disease, movement disorders, rehabilitation, communication, speech, loudness, singing, music therapy, voice-related quality of life, non-motor symptoms

DOI: 10.3233/JPD-191838

Journal: Journal of Parkinson's Disease, vol. 10, no. 3, pp. 1217-1230, 2020