Most people know that Parkinson’s disease affects movement. What is less widely understood is that Parkinson’s disease also impacts two of the most essential tools of human communication: voice and facial expression.
Hypophonia is a soft or reduced loudness voice. Hypomimia is often described as a ‘masked’ or reduced facial expression’. Combined, these can create significant social barriers that result in isolation, yet, these symptoms of Parkinson’s are not as frequently discussed.
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If you are a speech, physical, or occupational therapist treating people with Parkinson’s or other neurological conditions, you know that great outcomes require more simply taking a continuing education course. You need ongoing access to treatment tools, patient education resources, and fresh clinical ideas to keep therapy engaging and effective over time.
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Deep brain stimulation (DBS) can be an effective treatment for motor symptoms of patients with Parkinsons, Essential Tremor and Dystonia. However there have been mixed reports in the literature about its effects on speech, and the factors that contribute to speech changes post DBS.
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Receiving a Parkinson’s diagnosis can feel overwhelming and life changing. For many patients, hearing that it is a progressive disorder brings fear, discouragement, and a sense of hopelessness. In my experience working with individuals living with Parkinson’s disease, I have seen how easy it is for people to believe there is nothing they can do to improve their quality of life. But I have also witnessed something incredibly powerful hope restored through action.
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In recognition of ASHA’s National Speech Language Hearing Month, we sat down with Jen Walentas Lewon — clinical associate professor, LSVT LOUD practitioner, and self-described “consumer of voices” — to talk about what it means to do this work well.
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When you or someone you love is diagnosed with Parkinson’s disease, the search for help begins immediately. You talk to other people with Parkinson’s. You join support groups. You ask your neurologist. You search online. And over time, a list of recommendations begins to take shape including exercise programs, speech therapy, physical therapy, occupational therapy, nutrition, medications, and more.
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Many clinicians have long suspected there’s a relationship between feeding, swallowing, and speech–language development. This post isn’t about fully explaining that relationship. It’s about why it matters clinically and why it’s worth paying attention to.
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When Gary Rogliano received his Parkinson’s disease diagnosis in mid-2018, he found himself in unfamiliar territory. “I’ve never heard of Parkinson’s before that,” he recalled on a recent episode of LSVT Global’s Think BIG and LOUD podcast. “Had no idea where to go, who to talk to or anything.” What followed wasn’t a retreat into uncertainty — it was the beginning of a movement.
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One year ago, Sean Bulanda was taking roughly 300 steps a day — mostly between the couch and the bathroom. Today, he’s a stand-up comedian, a songwriter, a certified LSVT Big physical therapist, and the founder of a 2,200-member Parkinson’s support group. This is the story of what happened in between.
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When LSVT BIG first emerged as a rehabilitation protocol for Parkinson’s disease, its core insight was deceptively simple: train the nervous system to move bigger, and daily function follows. The intensive, amplitude-focused program, sixteen one-hour sessions over four weeks, works by retraining sensory perception alongside motor output, helping patients recognize that movements which feel exaggerated are, in fact, simply normal. That principle, it turns out, may travel well beyond Parkinson’s disease.
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