BACKGROUND: respiratory, postural and vocal manifestations, associated to stages in Parkinson's Disease and their possible interrelations. PURPOSE: to review the literature in order to describe breathing, posture and voice characteristics associated with stages in PD and their possible interrelations. CONCLUSION: Etiology of respiratory disease is multifactorial in PD, such as obstructive, restrictive, related to bradykinesia, rigidity and postural changes, muscle weakness, abnormalities of the laryngeal muscles; antiparkisonian impact from medication. Flexion position alters body dynamics, interfering in the stomatognathic functions and thoracoabdominal relationships. Vocal changes may come occur from the early stages with a decrease in maximum phonation times and vocal intensity, incomplete glottic adduction, glottic chink, vocal tremor and instability; disturbances of frequency and intensity, and changes in voice quality. Deficits in respiratory muscle strength are reflected in the lower respiratory support to vocal production and consequently in decrease of vocal intensity and maximum phonation times. Similarly, the flexion position generates biomechanical disadvantage concerning respiratory activity, with lower growth and reduced lung volumes, and deficits in diaphragmatic excursion. Respiratory, postural and / or vocal disorders, as PD progresses, according to their stages, tend to show greater impairment, demonstrating effects on verbal and nonverbal communication.
Parkinson Disease; Voice; Respiration; Posture