Parkinson's goes Big

The LSVT encourages a person with Parkinson's disease to really swing the arms, rock the heels and take large steps. LSVT also concentrates on the everyday activities important to the patients and for a golfer that meant working on his golf swing.
“The first thing we always focus on is doing everything really big,” Layhew said. “Then he gets used to it when he’s out in public.”
Parkinson disease typically causes tremors, slow movement, rigidity of limbs and poor balance. The disease can also affect speech and posture.
Speech and language pathologist Christine Garretson said many people with Parkinson disease initially aren’t aware of their condition until they learn about it from their spouses.
“One of the characteristics of Parkinson is the perception of how they sound,” Garretson said. “They think their spouse might need a hearing aid. It’s very common for them to think it’s their environment.”
She uses LSVT Loud to use those same principles of going big to get people with Parkinson to learn how to modulate their voices while speaking. The program begins with an “ahh” sound and then builds into homework that could include leaving voice messages or speaking to the receptionist.
“We get them to be intense and loud,” she said. “It’s bombarding them with being big and loud. We measure duration and level and then we adjust the pitch.”
The programs require a four-week commitment where a patient must attend four days a week during that month. He then performs the same exercises at home to get two sessions per day. Both LSVT programs include additional homework exercises.
“It’s retraining the brain,” Garretson said. “Voice problems affect the vast majority. Speech is what we do; it’s what makes us human — that ability to communicate.”
LSVT Loud also addresses swallowing problems frequently affecting Parkinson patients. Garretson said the exercises can help reduce the risk of choking and minimize embarrassment.
Sometimes a person with Parkinson makes it difficult to get in and out of his chair and cut his food so going out to dinner in public may be difficult aside from embarrasing and painful.
LSVT Big has conquered some of those problems.
LSVT Loud has been used for 15 years and many of the same principles are used for LSVT Big.
“LSVT is a great therapy for patients who need to improve their voice volume,” said Dr. Michael S. Okun, national medical director of the National Parkinson Foundation. “To make this therapy effective however, patients need to actively participate in many initial sessions and then in regular booster sessions.”
LSVT Big and LSVT Loud require regular exercise at home following the conclusion of the initial four-week sessions. During that time, one will continue tracking a patient's physical mobility, strength and balance during his booster session.
The improvements over the four weeks are enough to convince anyone to continue the exercises.
Both these exercises make a person with Parkinson's disease more confident in even simple activities like cutting his food and even getting out of his chair.