LSVT BIG - a specialized movement program for people with Parkinson's disease
LSVT® BIG is a movement based treatment program for people with Parkinson's disease (PD). It is based on the principle of neuroplasticity which means the brain can learn and compensate. It has been adopted from an existing speech therapy program for people with PD called the Lee Silverman Voice Treatment (LSVT). Research on LSVT has shown that it results in improvements in speech intelligibility and voice loudness. LSVT BIG works on the same principle, using a single therapy focus (BIGNESS of movement) to improve movement quality in PD. Research is showing the benefits of LSVT BIG to improve their ability to participate in activities of daily living.
Movement problems in Parkinson's disease
People with PD have trouble moving normally. Their movements are usually slower and smaller and they may shuffle or freeze when they walk. Some experience falls and problems with their balance. For most, movement problems can be overcome temporarily when they are "cued" or prompted (either by themselves or by another person or thing) to move better (i.e. "take a big step", "stand up straight").
How LSVT BIG works
The aim of the intensive LSVT BIG training is to improve people's ability to make bigger movements. These movements can then be generalized for different functional activities and situations. Initial results of the research show that LSVT BIG training leads to:
How is LSVT different from standard physical therapy for PD?
Traditional physical therapy for Parkinson's generally aims to improve flexibility, strength or balance to help actions like getting up from a chair, turning over in bed, or walking. This traditional approach breaks down each action but requires patients to remember multiple instructions for each movement goal. In LSVT, patients simply focus on one goal, to think BIG!
How does it work?
LSVT BIG is delivered by a specially trained physiotherapist over 16 therapy sessions (four sessions a week for four weeks). Participants are encouraged to perform a variety of BIG movements with BIG effort in a series of specifically designed exercises. The focus on one therapy goal (BIGNESS) makes it is easier for patients to participate in this intensive program.
If you are planning to consult with us because of Parkinsons, CVA, MS or other similar disorder, please download, print out and fill out, or have someone help you fill out the following questionnaires. Be sure to bring them in with you. Leave any question you do not understand or can't answer blank. Ensure you bring a complete list of your current Medications (med name, dosages) and a detailed Medical History.
Note: If you also have problems with balance, dizziness and/or vertigo, visit the Balance / Vestibular page to download additional forms located there.
Do you or anyone you know have Parkinsons Disease or similar Neurological Disorder?
While you’ve likely heard of Parkinson’s disease (PD), many people don’t know exactly what the condition is or how it manifests itself. The condition can occur when there is a loss of brain cells that produce a chemical called dopamine. It usually presents in people over the age of 60, but it can present earlier in life as well. About 500,000 people in the U.S. have Parkinson's disease, with about 50,000 people being diagnosed each year, according to the National Institute of Neurological Disorders and Stroke
The four common symptoms, according to the National Institute of Neurological Disorders and Stroke are: tremors, limb and trunk stiffness, bradykinesia (the slowing down of movement) and weak balance or coordination. Since PD symptoms exacerbate over time, as they become worse, patients can have trouble with simple tasks such as getting in and out of bed or the bathtub— or even walking and talking. People with PD may also experience “freezing,” where they have extreme difficulty starting to walk again after having stopped, or difficulty stopping walking once started. This may lead to falls in the home and when out in the community.
Some other PD symptoms can be: depression, constipation, trouble swallowing or chewing or difficulty sleeping. All of this can impact families and caregivers as well, since the need for constant care increases as the disease progresses. Indeed, Parkinson’s disease is estimated to have an economic burden on families and patients of $14.4 billion—$8.1 billion in medical expenses and $6.3 billion indirect costs, according to the Parkinson’s Action Network.
While there is no cure for PD, medications and other interventions such as Deep Brain Stimulation (DBS) have been found to provide dramatic relief from the symptoms. Physical therapy (PT) is another effective method of conservatively managing the symptoms of PD and improving quality of life.
Traditional PT has included general conditioning exercises, functional training, and gait and balance training, with the use of external cues to reduce the “shuffling” pattern of walking and improve the quality of movements – devices such as a metronome, laser lights, taped markers on the floor, mirrors and simplifying tasks are ways to do this. These methods of treatment have had varying degrees of success based on the severity of the PD symptoms in each patient.
Physical therapy can also help patients with Parkinson’s disease develop strategies to safely transfer to and from the bed, into the bathroom, and other activities of daily living. Caregivers and family members also need to be mindful when caring for patients with PD— it is important for caregivers and family members to take care of themselves physically and seek out groups and other means of emotional support.
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