LSVT BIG or Lee Silverman Voice Therapy BIG

By Stacey Foley, DPT, MTC, Cert DN, LSVT BIG certified therapist

What does LSVT stand for?

The initial development of Lee Silverman Voice Therapy’s was for a woman named Lee Silverman who had a diagnosis of Parkinson’s Disease. This program’s development is to restore her normal voice by increasing loudness so she could communicate better. The principle was then added to movement of the body which is how LSVT BIG started.

What does LSVT mean in Physical Therapy?

LSVT uses the principles of using BIG motions and counting loudly to restore movement and voice to normal. Patients with Parkinson’s tend to talk quietly. Also, Their movements are small even though patients perceive their motions to be normal.

Illustration showing the symptoms of parkinson's disease which can be treated by LSVT BIG. JOI Rehab

LSVT BIG is used to treat people with Parkinson’s Disease

What is Parkinson’s and can LSVT treat it?

Parkinson’s disease is when nerves in the part of the brain that control movement become impaired or die. LSVT BIG is an intensive program that requires a certified therapist to take you through the program. When your physician sends a prescription for physical therapy, it is important that the patient understands the time commitment to participate in the program effectively.

LSVT BIG Treatment Plan

Patients will receive instruction to come four times a week for one-on-one sessions. The duration of the sessions is four weeks. The sessions are about one hour long and the focus is on learning the basic BIG exercises. Functional tasks, walking and breaking down difficult tasks into smaller parts are added into the program to increase ability to perform everyday tasks easier and bigger.

In order to get the desired results patients need to commit to doing exercises twice a day every day while in therapy. They have to remember it doesn’t stop when therapy is done. In order for patients to maintain gains achieved in therapy, the LSVT BIG program needs to be a part of their everyday routine. Patients sometimes return to physical therapy for tune ups. The tune-ups include: getting exercise progressions to include weights, uneven surfaces or hand flicking. Patient’s may also return if their Parkinson’s is worsening, and they need to learn adaptive ways to do the exercises while holding onto a chair or while seated.

LSVT BIG can be completed from a seated position. JOI Rehab

LSVT BIG is a physical therapy treatment plan for Parkinson’s Disease. JOI Rehab

What is Unique about LSVT Big Treatment Techniques?

The focus of the exercises is to increase amplitude of the movements with high intensity to recalibrate your body’s sensory perception in order to return to normal movement. Often patients are gave too many rest breaks while in therapy and in order to get a release of dopamine the effort needs to be high. Patients with Parkinson’s disease have a low amount of dopamine but the brain can be made to release dopamine through exercise which helps to slow the disease progression.

LSVT BIG Outcomes

Patient’s that participate in LSVT BIG program see improvements in their stride length, increased cadence and less freezing episodes with walking. Their balance and ability to dual tasks improves as well since the exercises require the patient to count loudly while performing the exercises with a rocking motion or a narrow base of support. Functional tasks include sitting to standing exercises. The goal is improvements in one of the core group of exercises that patients perform twice a day. Several of the exercises include static holds which helps to improve their posture as well trunk rotation.

Written By: Stacey Foley, DPT, MTC, Cert DN, LSVT BIG certified therapist

Stacey Foley is a physical therapist at the JOI Nassau Rehab Center.

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