5.3 Methodological considerations .1 Participants and intervention
5.3.3 Clinical implications and future research
The purpose of this study was to examine the possible changes in prosody in individuals with Parkinson’s disease after a group singing intervention. Based on the current findings it can be said that a singing intervention may provide a potential rehabilitation method of voice and speech parameters in people with
40
PD. Because some of the statistically significant observations after the intervention concern the prosodic capacity in a variable, singing seems to function as a potential cue for a person with PD to implement the prosodic features the person has but has not been able to use due to the disease.
After the group sessions, an improvement was observed in some variables but it remains unclear at this point if the change is noticeable in daily communication. Duration and intensity of the intervention may have an impact on this as well as the individual stage of disease and variability in symptoms of the
participants. Due to these, it might be practical to assess the status of vocal skills of each participant and offer individual speech and language therapy in addition to the singing intervention carried out in a group setting. Individual sessions could concentrate more on the individual needs while the group setting could provide opportunities to practise communication. This kind of combination could increase the probability that the skills learned either in individual sessions or group singing settings are transferred to the daily communication environments.
Previous research concerning singing has provided information of the potential of singing in speech and voice rehabilitation in people with PD. In addition, it has been suggested that rhythmic auditory cueing could be utilized in the rehabilitation of language-related deficits in PD (Bella, Benoit, Farrugia, Schwartze &
Kotz, 2015). Approaches utilizing rhythmic auditory cueing have been found effective in improving gait and stride length, sensorimotor timing abilities and speech intelligibility in people with different types of dysarthrias (Pilon, McIntosh & Thaut, 1998; Späth et al., 2016). Thus, the current intervention could be modified by including exercises which practise rhythm. Metronomes or smartphone applications with similar functions could be utilized to provide needed external cues.
Future research with a control group would provide us more information about the effectivity of the singing interventions and about performance of healthy controls in similar tasks. In addition, the results from follow-up measurements of the participants in the current intervention will provide us information about the long-term effects of current intervention. Based on the observations made in the current study, singing seems to offer a potential rehabilitation method for voice and speech deficits in PD but more research is needed.
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Appendix 1 – Results of fundamental frequency f0 and its variation f0SD