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Dysarthria is an important and undertreated symptom in Parkinson disease (PD). The authors were interested in testing Lee Silverman voice treatment (LSVT LOUD) — a U.S.-developed intensive therapy involving speech tasks and vocal exercises aimed at increasing vocal volume — against both U.K. National Health Service speech and language therapy and no therapy. They conducted a pragmatic, multicenter, three-arm parallel-group, unblinded trial in outpatient or home settings. They assigned 388 participants at random to one of three groups (1:1:1); all analyses were based on intention to treat. The primary outcome measure was total score following 3 months of therapy on the self-reported voice handicap index, a patient-reported measure of communi…