A 3-month music-based recreation program added to stable speech-language therapy in institutionalized patients with Parkinson's disease: a feasibility study

Abstract

Dysphonia and dysphagia are highly prevalent in late-stage Parkinson's disease (PD), particularly among patients residing in long-term care facilities, yet evidence for rehabilitation interventions in this population remains extremely limited. With increasing longevity, more patients progress to advanced stages marked by frailty, long disease duration, and treatment-resistant symptoms, making the development of effective therapeutic strategies an urgent clinical priority. Here, we conducted an uncontrolled, single-arm, open-label exploratory pre–post feasibility study to evaluate a 12-session group music recreation program added to stable ongoing speech-language therapy in institutionalized patients with Parkinson's disease. Twenty-five of 32 enrolled patients attended at least three of the 12 scheduled sessions and completed pre- and post-program assessments. Outcomes included Maximum Phonation Time (MPT), mean sound pressure, Vocal Handicap Index (VHI), modified water swallowing test (MWST), repetitive saliva swallowing test, Dysphagia Severity Scale, swallowing visual analog scale, and a dysphagia screening questionnaire. In unadjusted Wilcoxon signed-rank analyses, nominal pre–post changes were observed in MPT and MWST, and VHI showed a non-significant trend toward reduction; however, no outcome remained statistically significant after Bonferroni correction. Other swallowing measures and subjective swallowing outcomes did not show clear improvement. These findings suggest that adding group music recreation to stable speech-language therapy is feasible in institutionalized patients with PD and may provide hypothesis-generating signals for selected voice and structured water-swallowing outcomes; controlled studies are needed to determine efficacy.