Clinical Practice Guideline for the Management of Patients With Parkinson's Disease
Working Group of the Clinical Practice Guideline for the Management of Patients With Parkinson's Disease. (2017).
Madrid (Spain): Ministry of Health, Social Services and Equality; Institute of Health Sciences of Aragon, (Clinical Practice Guidleine of the NHS).
This guideline provides recommendations on the management of Parkinson's Disease from assessment through treatment. Recommendations specific to communication, language, and swallowing are provided in this summary. Recommendations are based on systematically searched scientific literature to the extent possible and based on expert opinion when evidence was lacking.
Ministry of Health, Social Services and Equality (Spain)
<div>"The evaluation of the use of the [Lee Silverman Voice Treatment] LSVT technique for managing swallowing difficulties in persons with Parkinson's disease is recommended" (Good Clinical Practice √ , p. 104).</div>
<div>"A multi-discipline approach is recommended to manage swallowing disorders in persons affected by PD. It would be especially advisable to form coordinated work teams that include healthcare professionals specialized in endocrinology and nutrition, physical medicine and rehabilitation, hospital pharmacy, as well as speech therapists, dietitians/nutritionists, nurses, and occupational therapists, in order to promote the synergy among the tasks of rehabilitation, education, and nutritional support" (Good Clinical Practice √, p. 104).</div>
<div>"Speech therapy should be made available to persons with Parkinson's disease. Special attention should be given to:</div>
<ul>
<li>improvement of voice volume and tone range, including speech therapy programs such as LSVT (speech therapy using the Lee Silverman Voice Treatment technique);</li>
<li>teaching strategies to optimize intelligibility of language;</li>
<li>guarantee that the effective instruments of communication are maintained over the course of the disease, including the use of assisting technologies; and</li>
<li>review and manage to support the safety and effectiveness of chewing and to minimize the risk of choking" (Grade D, p. 99).</li>
</ul>
<div>"Facilitating the improvement of cognitive functions in patients with Parkinson's disease using tools developed by multi-discipline teams is recommended (Good Clinical Practice √; p. 107).</div>
<div>"The use of the chin-tuck technique together with thin liquids to reduce the incidence of pneumonia as a result of aspiration should not be considered as the first line of action in patients with [Parkinson's disease] PD and swallowing disorders" (Good Clinical Practice √, p. 104).</div>
<div>It is recommended that individuals with Parkinson's disease who experience mild cognitive deterioration be evaluated for different cognitive interventions, including cognitive stimulation, prior to establishing pharmacological treatment (Good Clinical Practice √).</div>
<div>"The evaluation of the use of the [Lee Silverman Voice Treatment] LSVT technique and the evaluation of the results of patients with [Parkinson's disease] PD affected by speech and language disorders, especially in the most clinically relevant variable, intelligibility of speech, is recommended" (Good Clinical Practice √, p. 99).</div>
<div>"The evaluation of the use of video-assisted swallowing therapy to improve swallowing in persons with Parkinson's disease is recommended" (Grade B, p. 104).</div>
<div>Speech therapy should be made available to persons with Parkinson's disease with special attention given to the review and management of swallowing to minimize the risk of choking (Grade D).</div>
