PRF Cruise: Vignette from Voice Aerobics On Board

Voice Aerobics on Board Freedom of the Seas

by Kate O’Neill

Mary Spremulli, our outstanding, dynamic Voice Aerobics instructor posed and answered a series of questions in her enlightening session on voice and swallowing difficulties in PD.  She then led the class in a series of exercises.

Why Does PD cause swallowing problems? It is an inter-related system- changes in the vocal folds make them stiffer, the tongue gets less coordinated, losing strength. Patients have reduced sensory awareness and all these issues lead to swallowing disorders.

People with PD may swallow too late in the respiratory cycle- swallowing while exhaling.  We intuitively know that breathing takes precedence over swallowing- one catches the breath before being able to drink.

Why exercise breathing muscles?

Pursed lipped breathing traps air in the lungs, slowing down breathing, promoting a slower more rhythmic  exchange of air.

Parkinsonian face: we make judgments about people by their facial expression.  Studies of nurses observing people with PD found they perceived people as unapproachable and less friendly.

What can I do to strengthen my own voice?

Therapy never ends- we exercise forever, so to can we augment our voices- hence Mary began voice aerobics.  She’s created several products- a DVD, CD  and playing cards-

Voice aerobics is a whole body approach incorporating basic exercise and voice therapy.  It’s a home-based program.  Even patient’s with Lewy-body dementia are able to practice the exercises- focusing heavily on posture.

Self-education and self-empowerment- puts the control of symptoms in patient’s hands

Though the illness focuses on the loss of movement, communication commonly suffers as the voice comes under the affects of illness.  When the voice is focused on, patients are more able to be present.

Mary Spremulli begins Voice Aerobics- a voice exercise program.  Everyone shifts to face the screens on the other side of the room.   Mary’s wearing a microphone that drapes to her mouth, so her hands are free.  She wears a red t-shirt, Bermuda-length navy shorts, white socks and tennis shoes.  Her flawless skin gives no hint of her age.

-Everyone has a DVD in their bags

All people have been given two devices: a breather- strengthens the muscles- respiratory muscles, and an expiratory tool to improve respiration- thereby decreasing the probability of inspiring things other than air.

She describes the 57 minute program on her DVD.  This afternoon we will do 10 minutes or so of the program.  These exercises are relaxing- Breath work begins with posture.  Sitting up straight in seats, we inhale and exhale with pursed lips: exaggerating the rounded lips: breathing out is twice as long as the breath in.  Exhaling now with a shh sound- tightening the abs. This time we resonate making a hmm sound as we exhale. This time, we inhale as arms come chest level, holding the stretch. Inhale with hands clenched, rising with breath.

The screen shows Mary in a classroom full of white haired people wearing gym shoes.

We are making E sounds as we raise and lower our shoulders- she notes she would like to see our teeth as we ascend and descend from low to high notes. Now O sounds as arms rise out from our shoulders, going up and down.  These warm up exercise stretch the vocal cords. Hands and arms rise in a ahh

-Look friendly- Mary coaches, prodding all to smile as we emit and e-sound.

Program Two is to power up the voice.  Mary’s instructed us to focus on the movement of the voice- moving.  We mimic her sounds. . .  much like choir practice.

Mary prompts us to perform the sounds when engaging in daily activity- not having to break for a distinct time to do voice practice.  Leg lifts: as the leg rises the voice goes up higher notes.  Voices fill the conference room; heads dip as she does. Vowel sounds next; exaggerating movement of the face. These are to the beat; eiou: sounds like some American Indian  folk song- performed with motions, there’s a drum beat on the DVD, and the recorded version wishes us- Happy Trails

The cool down means shoulder rolls and stretches with slow inhales and exhales, adding glides while moving upwards, then downwards. Shoulders are tied to the voice- stretching our vocal cords then shortening them. We rotate with hands clasped from left to right. Oh, Oh me, Oh my, Oh no. Ohm.

On the DVD, class members wear blue t-shirts.  Mary concludes with pursed lip inhales and exhales.  We are strangely invigorated.





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