I am a PTA who has been practicing since 1987 and LSVT BIG Certified since 2009. Before getting certified in LSVT BIG, I had already discovered that my focus needed to be on getting patients with Parkinson’s moving as big as I could. I worked primarily in a long-term care facility where many patients were being placed in wheelchairs for “Fall Prevention”. I reminded the staff in the facilities that in most cases when the resident’s movement was limited, this actually increased the risk of falls due to overwhelming weakness and diminished balanced reactions. Then I came across some information on LSVT BIG. The philosophy of this program matched mine. I was then certified along with my supervising PT at the time. My first patient to use the LSVT BIG program with was my favorite story of all:
“Helen” was in her seventies and came to us requiring significant help from her husband for ADL’s, transfers, gait, etc. She came to our facility to see what this new program was about. Both Helen and her husband were excited about the things she would learn through LSVT BIG. She wanted to know if she could get strong enough to take a long cross-country trip with her husband at least one more time. Helen and her husband were faithful with not only coming in to her treatments, but also with practicing her homework. We emphasized to her that the magic was not in what she did in therapy. Since we only saw her one hour of the day, the magic would come with what she did throughout the rest of her day and how well she followed through. With all of our patients, we make sure they understand that they will be empowered to “change” their own lives not just for now but for always. We provide the tools, but they are the ones to “build” their life into what they desire it to be.
As is the story with many patients with or without Parkinson’s with fear of falling, Helen was very accustomed to moving “small”. With LSVT BIG, she gained the confidence to move outside her “box” that she had placed herself in. Helen learned about all the things that she was doing that inhibited her movement and how to break away from this tendency safely. At first, she needed her husband’s supervision, but later she became independent in her home. I later found that Helen made that trip with her husband! In addition, they were planning other trips together as well. She had continued her LSVT BIG exercises and was taking walks every day of the week.
Since 1987 I have seen so many changes in the treatment of Parkinson’s disease. A diagnosis to most patients that not only brought sorrow and the immediate thought of impending doom now is decorated with HOPE. In my observations, the single most important factor that has helped to change the course of Parkinson’s is the early referral and follow through with Physical Therapy. LSVT BIG provides not only the tools needed to improve the life of a patient in the short term but strives to train every therapist in the importance of long term follow up. When other therapists ask me about LSVT BIG I encourage them to be certified in LSVT BIG because it not only will allow them to help those with Parkinson’s, but the amazing concepts of effort, amplitude will carry over will apply to most of their treatment programs for other diagnoses. Education of our physicians on early referral to LSVT BIG is the key to see these patients upon diagnosis and to allow us to do what we do best…help our patients MOVE!
-- Rhonda Boeckman, PTA, BA