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- Welcome my friends to the "Bob and Brad" podcast.
My name is Mike Kenitz,
I'm a PT assistant,
and today I'm coming up need by...
- Bob Schrupp.
- This guy over here.
Today, we're interviewing Sierra Corbin,
who is a speech linguist pathologist from Oregon.
Is that how she said it?
- Oregon, right.
- We were saying it wrong.
She corrected us. - Right.
- She also has a YouTube channel called "Sierra Speech,"
where she offers free speech video programs.
So, if you wanna work on your speech at all,
you can go check it out there.
So, without further ado, here's Sierra.
All right, we're gonna get into Parkinson's a little bit.
So, how can someone improve their voice
if they have Parkinson's?
- Yeah, so Parkinson's affects the voice,
speech and swallowing.
Up to 90% of people will eventually get
disorders in these areas.
And that's because,
you know, there is a decrease in dopamine,
which affects automatic motor movements,
but it also affects kind of the whole brain.
It's not just a dopamine thing.
- Sure.
- Brainstem, the newer brain
and you know things like insomnia,
mood disorders, motivation,
those are all impacted.
And so, we have a lot of considerations.
But when it comes to just the motor side of it,
because there's that decrease in movement,
that's kind of a rigidity and a stiffening,
people don't move as much.
Well, that's the same with your vocal chords
and your vocal mechanism
and your lungs and your respiration.
So, they start to get quiet and mumbly.
Either talking more slowly or more rapidly.
So, that's kind of how it affects Parkinson's.
And there are two primary treatments for it.
One is Lee Silverman Voice Treatment.
That's the one that has the most research to back it up.
- The loud one, right?
- Loud. Yeah, LSVT LOUD.
Yep. And that was developed just for Parkinson's,
which is pretty incredible.
And Speak Out is newer than LSVT,
but it uses the same concepts.
So they're both basically using this concept
of switching to a different motor tract
because Parkinson's affects the automatic motor system.
You then use a volitional motor system.
- Sure. - You're overriding it
and telling your body, I'm gonna move.
And it does work.
It's pretty incredible to see the changes with that.
So they're both intensive programs.
- It seems like they have trouble with air also?
- With Parkinson's? - Yeah.
Yes, exactly.
So it also affects your respiratory systems.
Yep. - Sure.
- But all of your muscles are affected
and that's why you can sound quiet and breathy.
And that's why folks will rush to get their speech out
because they're running out of breath.
- So Parkinson's tends to progress.
- Yeah. - Can you stay ahead of it?
- That's a really, really good question.
And I want everyone with Parkinson's
or a progressive disorder to hear this.
As your disease progresses, you can improve and maintain
your skills with these programs.
They have really good outcomes.
- That's a big deal.
- It's huge. - Yeah.
- But the thing is, you wanna start early.
- Sure.
- We see the most progress when folks come in,
they just start noticing a difference
because it takes a lot to integrate volition
when you're used to just talking
without even thinking about it.
- Sure.
- So it's, it's kind of twofold.
It's integrating the use of loudness or intent
depending on which program you're doing.
And it's a strengthener.
So you're actually doing the exercises daily.
And when folks do that, when they go through
the one-on-one program with you,
and then they continue doing their maintenance,
they can even improve after they've discharged from you
because they're strengthening up their voice.
- So maintenance is also daily.
- Say that one more time.
- Maintenance is also daily.
- Yes.
Yeah, and then there are maintenance groups too, so
- Sure. - It's picking out a house
that has the weekly loud crowd
that you're expected to go to.
And that helps a lot
because then we get our patients in front of us.
We can say, have you been doing your homework?
Remind them how to do the exercises and things like that.
Obviously there's a progression.
You're not gonna just keep getting better
and better and better. - Sure
- But you can maintain and prevent a lot of decline.
- So if you're a speech therapist,
do you just learn this, these programs in school?
Or is this like a continuing ed course?
- That's a really good question.
They are not taught in school.
They're actually either a certification
or a separate training that you have to pay for.
Unless your university clinic
like ours at the University of Oregon
gets a grant from the Parkinson Voice Project.
And we have a free training for our students
which is pretty cool.
- That is nice. - Yeah.
- Yeah.
- Why don't you give me free programs?
- Right? (Sierra laughs)
- Your high voice. (Mike laughs)
- One thing about that is that with Parkinson's,
there's often a cognitive side too
where the cognition changes and processing speed.
And the thing that, the reason these work so well
is because it decreases the cognitive load
in just focusing on one thing, being loud or using intent.
And in doing so, you have slower speech,
you have over over articulation, you take a bigger breath.
- Sure. - Because you don't
have to focus on each thing independently.
You had wanted to know the difference between them
but it doesn't matter--
I mean, we can go over that or--
- Yeah.
- Yeah. Would you mind saying the big major differences
between the two programs?
- Sure. They are very similar.
They have very similar outcomes.
So I think as far as which one you do,
it just depends on your exposure.
Maybe you had a mentor that,
you know, was certified in one or the other.
I am not LSVT certified.
I worked on it in graduate school, so I have exposure to it.
And a lot of my colleagues are certified,
but I am a Speak Out provider.
Speak Out is less sessions,
it's three times a week instead of four,
which financially is nice for our patients.
- Sure. - And it, you know,
has similar outcomes.
Speak Out includes cognitive tasks.
So you're working on cognition with your voice output,
while LSBT has functional phrases.
So they actually use phrases dedicated
to what you wanna say.
And Speak Out has a loud crowd that's integrated.
Every single person is expected to go to a loud crowd group.
And the Parkinson Voice Project pushes and supports
their clinicians a lot in trying to maintain these groups
so people have somewhere to go afterwards.
So I would say I love Speak Out, I'm a huge proponent of it,
but they're both really amazing programs.
- Do you wanna mention your YouTube channel for us?
- Yeah, yeah. So I created an online voice program
for folks who just wanna change the way that they sound.
And it works on all of those things we talked about today
but in greater detail.
And it has specific exercises
and it is backed up by the research and the evidence
and, you know, the science that--
- Supports it? - Supports motor change.
Sorry, that supports, again, I have an 18 month old,
I don't sleep very well. - Yeah. Understood
- So it uses dosage and specificity and all of those things,
but it's really simple to understand and to do.
And it's super fun.
I even brought on a friend who was a professional singer
to do some of the modeling and yeah.
It's on my YouTube channel.
- How long is it?
- I wanna say the videos themselves are about two hours,
but they're in little videos
so you can pick and choose which ones you want to do.
- I see. I gotcha.
- Yeah, and it's totally free
to anybody who wants to improve their voice.
There's a PayPal link if you wanna support it.
- And your channel is called Sierra Speech on YouTube?
- Yep.
- We'll link that for everyone watching this episode
- or listening. - Sure.
- Thank you.
- All right, well is there anything else we can do for you?
- I was so happy to get to do this.
Thank you so much. I love your channel.
- Well, we love you.
- Thank you.
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