LSVT-BIG for people with Parkinson’s Disease

What is LSVT-BIG?

LSVT-BIG is an exercise based, high intensity program working on principals of neuro-plasticity and motor learning, scientifically proven to have effects in re-training movement patterns.

LSVT–BIG stemmed from a voice training program called Lee Silverman Voice Training or LSVT – LOUD. It is a program designed specifically for individuals with Parkinson’s Disease (PD) and is based on changing the amplitude of movement used to perform daily tasks in order to elicit more ‘normal’ functional and successful movement patterns.

Why is BIG important in Parkinsons?

BIG training targets the pathology of Parkinsons that typically results in bradykinesia (slowness of movement), and hypokinesia (reduced amplitude of movements). It is not uncommon that individuals with this disease do not readily recognize their movement patterns changing and becoming smaller or less efficient. The BIG program teaches clients to move with bigger amplitude, and to recognize how much effort is required for them to make functional movements successful and purposeful. BIG training also targets other functional areas that tend to decline in individuals with PD including balance and freezing, postural control, range of motion, and aerobic fitness.

What are the benefits of LSVT-BIG?

Studies have been completed on the LSVT-Big program for 30 years and have shown that partaking in the LSVT big program results in faster walking with bigger steps, improved balance, increased trunk rotation, improved bed mobility, and more! When compared to Nordic pole walking, regular home exercise and even regular physiotherapy sessions, the LSVT BIG program shows more positive physical changes that last longer.

LSVT-BIG has shown the most functional gains in people when they are first diagnosed with the disease, as they can learn better movement patterns before a significant decline. However, the program is adaptive and individualized and can even be done in sitting, so it is appropriate, and shown to be effective, at all stages of the disease.

What does the program involve?

Should you choose to partake in the LSVT-BIG program it will require a month long commitment to therapeutic exercise sessions and home exercises.

You will have an initial intake assessment with one or two of Active Living’s physiotherapists and will work one on one with these individuals throughout your course of treatment. The entirety of the program involves 1 assessment, 16 1-hour long sessions over the course of 4 weeks (4 apts per week) and one discharge session. It also requires 1 homework session on every treatment day, and two homework sessions on non-treatment days.

The cost of this program is $2070 ($115 per appointment, can be put through extended health benefits).

Each session involves guided exercises at a high intensity, with lots of repetition so that movement patterns become ingrained in the brain. Please wear comfortable clothes so you can work up a sweat and lots of water to stay hydrated!

How do I maintain these gains after 1 month of training?

The BIG strategy has shown effects can generalize across many tasks and carryover into everyday living; however, it is important to refresh and maintain.

Active Living Fitness Center offers group fitness classes “staying active with Parkinson’s”. These classes include helpful hints and cues so that you continue to use the principals learned in LSVT-BIG while you're exercising.

You may also wish to follow up with your physiotherapist to ensure gains are being maintained, or to learn other strategies to use as your disease progresses. These can be made on an individual basis and can occur as often as needed. Many individuals will follow up with a physio every 6 months for a re-assessment, and may book more frequent appointments as needed or when new goals are outlined.

Who do I speak to?

If you have any questions, comments, concerns or inquiries about LSVT-BIG, or if you would like to sign up, please ask for Andrea. If unavailable please leave your name and number with Ashley (ashley@activeliving.physio) and Andrea (andrea@activeliving.physio) will contact you at the earliest convenience.