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Singing Therapy: Comparing and Contrasting the Outcomes of Parkinson’s Disease and
Aphasia

Marissa Sierra

Department of Speech-language Pathology, Northeastern State University

SLP-5853: Voice & Resonance

Dr. Janette Quarles

February 23, 2022

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Singing Therapy: Comparing and Contrasting the Outcomes of Parkinson’s Disease and
Aphasia

Only recently has singing been considered as a therapy strategy or vocal exercise, which

in some cases has shown to be just as or more beneficial than traditional approaches. There have

been several studies that investigate the outcomes of singing and how it may positively affect

both the physical and emotional aspects of an individual. Specifically in Parkinson’s disease and

Aphasia, there have been correlations between these factors and how they impact a person

participating in some type of singing activity.

Results of Parkinson’s Studies and How it Correlates with Singing

Studies that investigated the impact of singing related to Parkinson’s disease found a

positive increase in social-emotional along with physical factors of a person with Parkinson’s

(PWP). In the article, Group singing improves the quality of life for people with Parkinson’s: an

international study (2021), the researcher aimed to “determine whether there are differences in

the effects of a group singing intervention on Quality of life” (Irons et al., 2021, pg. 652). The

study found that after administering a questionnaire to participants before and after the study,

feelings and attitudes seemed to improve. They found that group singing can reduce sigma,

anxiety, stress, and enhance social support in older adults with Parkinson’s (Irons et al, 2021).

Significant findings are shown below:

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Table 1

Quality of Life Factors Pre-intervention Post-intervention

Stigma 20 SD 15.51 SD

Anxiety 6.51 SD 4.46 SD

Stress 11.91 SD 9.65 SD

Social Support 16.99 SD 11 SD

According to the results of the study, negative emotions, attitudes, and feelings seemed to be

reduced after 6-weeks of group singing.

An additional article looks at the communication aspect of how singing can affect

Parkinson’s disease. The Effects of Participation in a Group Music Therapy Voice Protocol (G-

MTVP) on the Speech of Individuals with Parkinson’s Disease (2010) found that participants that

were present for group singing showed the intensity of conversational speech and could better

maintain vocal functioning (Yinger & Lapointe, 2010). Another article investigated Health-

Related Quality of life. Group singing and Health-Related Quality of Life in Parkinson’s

Disease (2017) showed that physical, emotional, and social perspectives could be improved in

group singing. Mood, cognitive functioning, flow-on effects, sense of self, physical improvement

(voice quality), social motivation (decrease in loneliness) all showed to be improved after

singing intervention (Chalmers & Abell et al, 2017). Vocal intensity showed to be the primary

outcome in Parkinson: A controlled Trial of singing-based Therapy for Parkinson’s Disease

(2019). Those participating every week had an improved outcome more than those who only

joined monthly. Those that participated monthly, regressed, while those who were weekly

participants significantly improved in the intensity of vocal intensity (Tamplin et al, 2019). There
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was a significant finding of 64.8 SD to 68.8 SD versus 63.2 SD to 61.4 SD in monthly singing.

When looking at the results of The Effects of a Choral Singing Intervention on Speech

Characteristics in Individuals with Parkinson’s Disease: An Exploratory Study Data (2019), it

shows a significant positive change in speech intelligibility and vowel production. It is stated that

it may have a greater impact than traditional vowel articulation therapy and speech intelligibility

(Higgins et al, 2019).

Results of Aphasia Studies and How it Correlates with Singing

When looking at an overview of Aphasia correlating to singing, researchers seem to

focus on more of a cognitive and fluency approach for Aphasia. In the study of Speak along

without the song: what promotes fluency in people with aphasia? (2019), researchers look at how

fluency may improve in individuals with Aphasia and how singing may improve that. Results

showed that people with Aphasia overall benefitted from unison over solo production and

rhythmic speech over singing with repeating unfamiliar lyrics. It was also noted that a person

with aphasia who shows a striking improvement in fluency when singing familiar songs will not

necessarily benefit from singing with new songs or lyrics (Kershenbaum et al, 2019). This could

also explain why a study from Enjoyment in a recreational sing-along group for people with

aphasia and their caregivers (2018), showed that participants in group singing for individuals

with aphasia enjoyed songs that were familiar to them versus unfamiliar songs and in “sing-

alongs”. It was still presented that there was a positive impact on word-finding skills and

memory (Mantie-Kozlowski, 2018). The article Please don’t stop the music: Song completion in

patients with aphasia (2016), further supports the correlation of singing and how it benefits

melodic output and word production and how singing should be used to implement recovery of
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language functions. Social activity and communication improvements were also a positive

benefit of singing for people with Aphasia. Another positive factor of the singing may not

necessarily be the singing itself, but the social aspect of it. The article Effect of choir activity in

the rehabilitation of aphasia: a blind, randomized, controlled pilot study (2017) investigates this

piece. This study found that people with Aphasia that join any social gathering benefit from the

social interaction (Zumbansen et al, 2017). The reduction of psychological stress also showed to

be a pattern in research. The article ‘Stroke a Chord’: The effect of singing in a community choir

on mood and social engagement for people living with Aphasia following a stroke (2013),

supports that psychological distress after participating in the choir increases confidence, peer

support, enhance mood, increased motivation, and changes in communication.

Compare & Contrast

Parkinson’s and Aphasia show many similarities when it comes to the outcomes of

singing and what it may affect. A large piece that they share is that people with Parkinson’s and

Aphasia that are included in some type of singing activity benefit on an emotional and social

level. They come out of singing therapy with an improved perspective on their quality of life and

a renewed sense of self. They feel as if they are not alone with a social support group. Not only

does singing show improvement in psychological factors, but also factors of communication.

Those from both Parkinson’s and Aphasia singing groups showed to have improved

communication skills. There are very few differences in the outcomes of Parkinson’s and

Aphasia singing therapy, but there is more of a focus on cognitive factors and fluency with

Aphasia and more physical benefitting factors of Parkinson’s disease. Aphasia singing therapy
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targets memory and word retrieval, while Parkinson’s singing therapy may have benefits for

vocal intensity and respiration.

Conclusion and Recommendations

The overall recommendation that comes from the studies is that it is encouraged for people with

Parkinson’s and Aphasia to join choir groups because it does show more of a benefit socially

than solo singing therapy and helps motivate participants. Most of the researchers stated that

there is a need for more research on singing that correlates with positive outcomes of people with

Parkinson’s and Aphasia. Researchers mentioned that they struggled in obtaining a large sample

size. It is recommended that those participating in singing therapy join weekly to acquire the

most out of their singing therapy. Significantly, Parkinson’s and Aphasia can greatly benefit

from singing activities. Although there may be differences in targets and contrasting reasons

behind the therapy, singing therapy serves the same purpose to both socially and emotionally

support individuals with Parkinson’s or Aphasia in hopes they can gain some of what they have

lost.
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References

Abell, R. V., Baird, A. D., & Chalmers, K. A. (2017). Group singing and health-related quality
of life in parkinson’s disease. Health Psychology, 36(1), 55–64.
https://doi.org/10.1037/hea0000412

Irons, J. Y., Hancox, G., Vella-Burrows, T., Han, E.-Y., Chong, H.-J., Sheffield, D., & Stewart,
D. E. (2020). Group singing improves quality of life for people with parkinson’s: An
international study. Aging & Mental Health, 25(4), 650–656.
https://doi.org/10.1080/13607863.2020.1720599

Tamplin, J., Morris, M. E., Marigliani, C., Baker, F. A., & Vogel, A. P. (2019). ParkinSong: A
controlled trial of singing-based therapy for parkinson’s disease. Neurorehabilitation and
Neural Repair, 33(6), 453–463. https://doi.org/10.1177/1545968319847948

Higgins, A. N., & Richardson, K. C. (2018). The effects of a choral singing intervention on
speech characteristics in individuals with parkinson’s disease: An exploratory study.
Communication Disorders Quarterly, 40(4), 195–205.
https://doi.org/10.1177/1525740118783040

Yinger, O. S., & Lapointe, L. L. (2012). The effects of participation in a group Music Therapy
Voice Protocol (G-MTVP) on the speech of individuals with parkinson's disease. Music
Therapy Perspectives, 30(1), 25–31. https://doi.org/10.1093/mtp/30.1.25

Zumbansen, A., Peretz, I., Anglade, C., Bilodeau, J., Généreux, S., Hubert, M., & Hébert, S.
(2016). Effect of choir activity in the rehabilitation of aphasia: A blind, randomised,
controlled pilot study. Aphasiology, 31(8), 879–900.
https://doi.org/10.1080/02687038.2016.1227424

Mantie-Kozlowski, A., Mantie, R., & Keller, C. H. (2018). Enjoyment in a recreational sing-
along group for people with aphasia and their caregivers. Aphasiology, 32(5), 518–537.
https://doi.org/10.1080/02687038.2018.1427208

Kasdan, A., & Kiran, S. (2018). Please don’t stop the music: Song completion in patients with
aphasia. Journal of Communication Disorders, 75, 72–86.
https://doi.org/10.1016/j.jcomdis.2018.06.005

Kershenbaum, A., Nicholas, M. L., Hunsaker, E., & Zipse, L. (2017). Speak along without the
song: What promotes fluency in people with aphasia? Aphasiology, 33(4), 405–428.
https://doi.org/10.1080/02687038.2017.1413487

Tamplin, J., Baker, F. A., Jones, B., Way, A., & Lee, S. (2013). ‘stroke a chord’: The effect of
singing in a community choir on mood and social engagement for people living with
aphasia following a stroke. NeuroRehabilitation, 32(4), 929–941.
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