LSVT BIG® and LSVT LOUD®
Parkinson’s Disease (PD) impacts a person in many ways. Some of the hallmarks of PD are smallness and slowness of movement referred to as Bradykinesia and Hypokinesia and softness and slowness of speech.
LSVT BIG® and LSVT LOUD® are intensive, amplitude focused physical, occupational and speech therapy protocols which have been developed and scientifically researched over the past 25 years with funding from the National Institutes of Health (NIH). These protocols are specific to effecting the principle symptoms of Parkinson’s Disease which are smallness and slowness of movement and softness of voice and slow soft voice quality.
Many First State Rehab At Home physical and occupational therapists are certified in LSVT BIG and the speech language pathologist are certified in LSVT LOUD. Tom Gangemi, one of the Founders of First State, has been an LSVT BIG faculty member since 2011. He has trained thousands of clinicians in this special clinical protocol and has treated hundreds of people with Parkinson’s Disease.
LSVT BIG is a standardized treatment protocol that is customized to the unique goals of each person including both gross and fine motor skills. LSVT BIG can be adapted or progressed in order to meet each person’s needs across a range of disease severity and presenting impairments.
Research on LSVT BIG has documented improved ratings on tests of motor functioning of people with Parkinson’s Disease including:
- Faster walking with bigger steps
- Improved balance
- Increased trunk rotation
- Improvements in activities of daily living such as dressing, bathing, eating and writing.
LSVT BIG uses large amplitude (Be BIG!) training to bring out improved, healthy movement that is more normal.
Treatment is administered in 16 sessions over a single month (four individual 60 minute sessions per week). This intensive mode of administration is consistent with theories of motor learning and skill acquisition, as well as with principles of neural plasticity (the capacity of the nervous system to change in response to signals), and is critical to attaining optimal results. The treatment not only stimulates the motor system but also incorporates sensory awareness training to help individuals with PD recognize that their movements are too small, convincing them that the bigger movements are within normal limits, and making them comfortable with their new bigger, faster and safer walking, dressing and eating.
LSVT LOUD is an effective speech treatment for individuals with Parkinson disease (PD) and other neurological conditions. LSVT LOUD, named for Mrs. Lee Silverman (Lee Silverman Voice Treatment – LSVT) was developed in 1987 and has been scientifically studied for nearly 20 years with funding support from the National Institute for Deafness and other Communication Disorders (NIDCD) of the National Institutes of Health. Published research data support improvements in vocal loudness, intonation, and voice quality for individuals with PD who received LSVT LOUD, with improvements maintained up to two years after treatment. Recent research studies have also documented the effectiveness of this therapy in improving the common problems of disordered articulation, diminished facial expression and impaired swallowing. Additionally, two brain imaging studies have documented evidence of positive changes in the brain following administration of the therapy.
LSVT LOUD improves vocal loudness by stimulating the muscles of the voice box (larynx) and speech mechanism through a systematic hierarchy of exercises.
Focused on a single goal “Speak LOUD!” – the treatment improves respiratory, laryngeal and articulatory function to maximize speech intelligibility. The treatment does not train people for shouting or yelling; rather, LSVT LOUD uses loudness training to bring the voice to an improved, healthy vocal loudness with no strain.
Treatment is administered in 16 sessions over a single month (four individual 60 minute sessions per week). This intensive mode of administration is consistent with theories of motor learning and skill acquisition, as well as with principles of neural plasticity (the capacity of the nervous system to change in response to signals), and is critical to attaining optimal results. The treatment not only simulates the motor system but also incorporates sensory awareness training to help individuals with PD recognize that their voice is too soft, convincing them that the louder voice is within normal limits, and making them comfortable with their new louder voice.