“YiJinJing, Wohu Pushi” Posture‐Voice Therapy for Dysarthria in Parkinson's Disease Patients Following Subthalamic Nucleus Deep Brain Stimulation: A Randomized Controlled Trial

Background Dysarthria in Parkinson's disease (PD) is difficult to treat, especially post–subthalamic nucleus deep brain stimulation (STN‐DBS), as therapies like LSVT show variable efficacy and limited accessibility. “Yi Jin Jing, Wohu Pushi” posture‐voice therapy (YJJ‐WPVT), emphasizing postural coordination, offers a promising yet underexplored alternative. The objective of this study is to evaluate the effectiveness of YJJ‐WPVT versus Lee Silverman Voice Treatment (LSVT) and no training for dysarthria in PD patients post‐STN‐DBS. Methods This is a prospective, parallel‐assignment, unblinded, randomized controlled trial with follow‐up at 6 months. The trial was conducted at the Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Patients ≥ 18 years with idiopathic PD treated with STN‐DBS, native Chinese speakers, and Voice Handicap Index‐10 (VHI‐10) > 10. Participants were randomized 1:1:1 to YJJ‐WPVT ( n = 11), LSVT ( n = 11), or no training ( n = 12). Both intervention groups received 16 sessions over 4 weeks. LSVT included sustained phonation, pitch glides, and structured speech tasks with daily home practice. YJJ‐WPVT followed a similar 4‐week protocol and emphasized posture correction through lunges, clawing posture, and tiger roar vocalization. Primary outcomes were changes in Voice Handicap Index‐30 (VHI‐30) and sound pressure level (SPL) at 1 month. Results Of 68 patients screened, 34 were enrolled (mean age: YJJ‐WPVT 62 [8] years; LSVT 65 [5]; untreated 60 [6]). At 1 month, YJJ‐WPVT showed significantly lower VHI‐30 total scores by five points (95% CI −8.7 to −1.3; p = 0.04) versus no training, with a nonsignificant SPL increase (1.8 points; 95% CI −1.3 to 4.9; p > 0.05). YJJ‐WPVT improved MPT, jitter, shimmer, and HNR at 1 and 6 months, along with VHI functional subscores. Motor symptoms, swallowing function, and quality of life also improved, with YJJ‐WPVT outperforming LSVT in swallowing and showing slight motor function benefits. Adverse effects (fatigue, hoarseness) were mild and transient. Conclusions YJJ‐WPVT is a safe, effective alternative for dysarthria in PD post‐STN‐DBS, with added swallowing and motor benefits. Larger multicenter trials are warranted.