A healthy living blog from Marshfield Clinic

Movement therapy can improve Parkinson’s symptoms

Man warming up with stretches for movement therapy through the LSVT BIG program

LSVT BIG therapy gets patients with Parkinson’s disease to identify how much effort they need to move normally.

Parkinson’s disease is a movement disorder that leads to problems with talking, walking, balance and everyday tasks. Symptoms include tremors, slowness of movements and muscle stiffness.

There is no cure but a combination of drug and therapy treatments can help improve Parkinson’s symptoms. One such therapy program is LSVT BIG, which helps manage Parkinson’s slowly debilitating symptoms. Three Marshfield Clinic physical therapists, certified in LSVT BIG, explain.

LSVT – Lee Silverman Voice Treatment – is named for a Parkinson’s patient whose family got her connected with researchers working to improve voice volume that is too soft or quiet, said Physical Therapist Ann Hall.

“Research produced LSVT LOUD, a voice therapy that helps Parkinson’s patients improve vocal loudness and quality,” Hall said. “LSVT BIG is the program physical and occupational therapists use to help Parkinson’s patients maintain functional movements like walking or standing after sitting.”

Therapy sessions are rigorous

A series of exercises is used to help Parkinson’s patients overcome bradykinesia and hypokinesia, conditions that make movements smaller and slower.

“Patients don’t perceive they are taking smaller steps,” said Physical Therapist Karna Sandok. “When patients don’t move easily or move at all, over time they lose their ability to do things for themselves. Our goal is to get patients to identify how much effort they need to move normally.”

Man practicing movement therapy through the LSVT BIG program

Each session consists of patients doing seven maximal exercises and five functional tasks.

LSVT BIG incorporates seven maximal daily exercises and five functional tasks therapists individualize for patients. The program follows an intensive schedule that includes 60-minute therapy sessions four consecutive days a week for four weeks, with 20-30 minutes of home exercise to do in between sessions.

“We work on walking and gait patterns and do functional tasks like putting on a jacket or buttoning a shirt,” Sandok said. “Sessions can be rigorous for older patients because it’s often a big increase in their normal activity level.”

Benefits of therapy can last 6-9 months

Starting LSVT BIG soon after Parkinson’s diagnosis is best, but people with the disease longer can still benefit.

“We’re seeing patients within a month of their diagnosis and patients who’ve had Parkinson’s for 25-30 years,” said Physical Therapist Ashley Detterbeck-Stauber. “The program is effective no matter when the diagnosis was made.”

Benefits from one 4-week session can last six to nine months.

“Home exercises extend the benefits,” Detterbeck-Stauber said. “We teach exercises they can do twice a day for the rest of their lives.”

To learn more about LSVT BIG therapy for you or a loved one, talk with your doctor.

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