New research reveals how LSVT BIG helps people with Parkinson’s move faster and more confidently in everyday activities. To listen to the full interview on the Think BIG and LOUD Podcast, click HERE.
Moving Through Sludge: Understanding Bradykinesia
Imagine trying to put on your jacket, but every movement feels like you’re pushing through soft clay. Your brain sends the signal, your muscles respond, but there’s an invisible resistance slowing everything down. This is bradykinesia—the slowness of movement that affects millions of people living with Parkinson’s disease.
“When I’m taking my shower and I’m starting to use my washcloth, I feel like I’m moving through sludge,” one patient described to Dr. Barbara Doucet, an occupational therapist and researcher at Baylor University. “It’s the strangest feeling because I’m doing it normally, but it just feels like I’m pushing against this kind of sludge-like resistance.”
This powerful description captures what many people with Parkinson’s experience daily—and it’s exactly what drove three occupational therapy researchers to investigate whether a specific treatment called LSVT BIG could help people regain speed and independence in their daily lives.
The Research That Changes Everything
Dr. Barbara Doucet, Dr. Mark Blanchard, and Dr. Ingrid Franc recently published their research article “Effects of LSVT BIG® on Bradykinesia During Activities of Daily Living” in the Occupational Therapy Journal of Research. This research bridges a critical gap in Parkinson’s treatment. While previous studies showed that exercise and movement therapies could improve motor skills like posture, gait speed, and balance, no one had systematically measured whether these improvements actually translated to the activities people do every day—getting dressed, preparing meals, or caring for themselves.
“At the end of the day, occupational therapists always say it’s whether or not you can do the things you want to do that really make you healthy and give you quality of life,” explains Dr. Doucet.
Their study focused on three everyday tasks:
- Putting on a jacket
- Putting on socks
- Putting a pillowcase on a pillow
These seemingly simple activities become significant challenges for people with Parkinson’s, often taking considerably longer and requiring assistance from family members.
What is LSVT BIG?
LSVT BIG is an intensive, evidence-based physical and occupational therapy program specifically designed for people with Parkinson’s disease. The program runs for four weeks, with sessions four times per week, focusing on moving with larger movements in exercise and personalized functional tasks that are important to the individual.
“We’re looking at teaching someone to recalibrate their movement patterns from those slow movements to be able to make them more impactful, more intentional, and larger in scale,” explains Dr. Mark Blanchard, associate professor at William Carey University.
But LSVT BIG is more than just big exercises. The program follows a specific framework:
- First half of each session: Patients learn to make bigger, more powerful movements and begin to recalibrate their internal sense of what “normal” movement feels like through seven core whole body exercises.
- Second half of each session: Therapists help patients apply these bigger movements to functional skills that are meaningful daily activities—the things they specifically want and need to do.
“It’s that intensive program where we see a progression that initially starts with just teaching and learning the bigness of the movements, and then as it progresses, function starts to overlay,” says Dr. Blanchard.
The Results: 18 Seconds That Matter
The research revealed statistically significant improvements in the speed of daily tasks. Participants could put on their socks an average of 18 seconds faster after completing the LSVT BIG program. While 18 seconds might not sound dramatic, the impact goes far beyond the numbers.
“For those where getting dressed is one of those meaningful activities—to be able to get dressed more efficiently or improve that level of independence—it became very impactful and empowering to them,” Dr. Blanchard notes. “We saw that became very impactful and empowering to them, and the therapists reported that patients noticed the differences.”
Perhaps most surprisingly, the improvements extended even to tasks that patients hadn’t identified as personal goals. This suggests that LSVT BIG creates a fundamental change in how the brain controls movement, with benefits that generalize across many different activities.
The Ripple Effect on Families
The impact of bradykinesia extends far beyond the individual with Parkinson’s—it affects entire families. Dr. Ingrid Franc, who has 39 years of experience as an occupational therapist, witnessed this firsthand during her years providing home health care.
“It would frequently take so long to do basic things like putting on a shirt or putting on your shoes that a family member would just sort of automatically step in and start to help,” she recalls. This well-intentioned assistance, while understandable, can lead to physical deconditioning and emotional loss of confidence.
The time pressure creates stress for everyone. Getting ready for a doctor’s appointment becomes an anxiety-inducing race against the clock. Even joyful occasions—like preparing for a celebratory dinner—become loaded with stress as families build in extra time for basic tasks.
“The bradykinesia really did impact the whole family and the things that they would undertake and do, and how much joy they could find from doing the small things, the fun things, and the things you have to do,” Dr. Franc explains.
When someone completes LSVT BIG and can dress more quickly and independently, the benefits cascade through the family system. Less time spent on necessary tasks means more time for activities everyone enjoys.
Beyond the Numbers: Quality of Life
While the study measured speed improvements, the researchers emphasized that satisfaction and quality of life matter just as much as the numbers.
“It’s more about the individual. Each individual can perceive the importance of 18 seconds differently,” says Dr. Blanchard. “For those who where that is one of those meaningful activities—to be able to get dressed more efficiently—we saw that it’s impactful and meaningful, and the person often had a sense of improved self-efficacy that they could do those things.”
The research also highlighted an important aspect often overlooked: not every person with Parkinson’s presents the same way. While many people picture someone with tremors and a stooped posture, Parkinson’s affects people differently.
“With the advent of more technology, more research, what has been learned is that the way Parkinson’s presents in people can be very individualized,” explains Dr. Doucet. “There are people with Parkinson’s who don’t have tremors but might have impaired speech patterns. There’s other people who have extremely poor posture but don’t have as much weakness overall.”
This individuality makes person-centered care essential. LSVT BIG addresses this by having patients identify their own meaningful goals from the start.
What This Means for Healthcare Providers
For clinicians working with people who have Parkinson’s, this research offers important guidance:
- Start with function early. Don’t wait several weeks to understand what’s meaningful to your patients. Ask about their goals during the evaluation process.
- Don’t get bogged down in exercises alone. While the large amplitude movements are crucial, integrate functional activities as soon as patients begin to automatize the movements.
- Make improvements visible and quantifiable. Being able to see and measure time improvements in daily tasks is more tangible and motivating than abstract concepts like “fall prevention.”
- Focus on what patients want to do better. “You’re going to do these exercises so that you can improve your speed at how you do certain activities that are important and meaningful to you,” is a more positive and motivating message than focusing on preventing negative outcomes.
For People Living with Parkinson’s: What You Should Know
If you or someone you love has Parkinson’s, here’s what the researchers want you to know about LSVT BIG:
- It’s more than exercises. While the program includes upbeat, fun exercises, it’s tailored specifically to your needs and the tasks you find frustrating or challenging.
- The benefits last. LSVT BIG teaches you a set of exercises that can stay with you throughout your life. When you hit a difficult period, these exercises can be modified and tweaked but will continue to work for you.
- Speed improvements are real. By the end of the four-week program, you’ll likely be faster and more efficient at the things you need and want to do. Improving the speed of necessary tasks means more time for the activities you enjoy.
- Community support continues. Many areas offer “BIG for LIFE” groups after the intensive program ends. These group sessions provide ongoing support, social connection, and opportunities to meet others living with Parkinson’s.
The Role of Physical Activity
Throughout the conversation, all three researchers emphasized one consistent message: physical activity is crucial for maintaining independence with Parkinson’s.
“The evidence points to physical activity as having the biggest impact on independence in your basic activities of daily living,” says Dr. Franc. “What’s called multimodal exercise—activity that would include balance challenges, stretching, moving, and strengthening—is what makes a difference.”
Options include LSVT BIG, but also Parkinson’s-specific programs like Rock Steady Boxing, dance classes, and other structured exercise programs.
Perhaps equally important: keep doing what you can still do. Dr. Franc advises gently asking family members to step back sometimes, allowing you to maintain your abilities by continuing to perform tasks independently, even if they take longer.
For Care Partners: How to Help
Dr. Doucet, who is herself a care partner to her husband diagnosed with Parkinson’s seven years ago, offers this advice:
- Be the biggest cheerleader. Provide psychosocial support throughout the journey. Your encouragement matters enormously.
- Watch for the invisible symptoms. Parkinson’s isn’t just a motor disease. Be alert for signs of depression, anxiety, or social withdrawal. These non-motor symptoms require attention too.
- Encourage movement consistently. Be the coach who says, “Let’s go for our walk today. Let’s get our steps in.” Regular physical activity with an elevated heart rate can have tremendous effects.
- Balance independence with support. Know when to step in and when to step back. Allowing extra time for someone to complete tasks independently—even when you could do it faster—helps maintain their physical abilities and emotional confidence.
Looking Ahead: The Future of Parkinson’s Research
All three researchers are continuing their work to improve quality of life for people with Parkinson’s and their families.
Dr. Doucet recently received a community grant from the Parkinson’s Foundation to create a weekly walking group that also serves as a support group. “The connection and the ability to speak with others who are in the same situation—the care partners are also involved—has been so therapeutic from what we’ve seen thus far,” she shares.
Dr. Blanchard envisions future prospective studies with control groups to better understand the specific mechanisms of improvement and to compare LSVT BIG with other interventions.
Dr. Franc is working on projects examining the self-esteem effects of LSVT BIG and further validating assessment tools for measuring functional improvements.
But for now, the message is clear: LSVT BIG provides measurable improvements in the speed and efficiency of daily activities, translating motor improvements into real-world function that enhances quality of life for people with Parkinson’s and their families.
Key Takeaways
- Bradykinesia, or slowness of movement, feels like moving through sludge or resistance and significantly impacts daily life for people with Parkinson’s
- LSVT BIG is an intensive four-week program that teaches people to recalibrate their movements and apply them to meaningful daily activities
- Research shows statistically significant improvements in the speed of daily tasks like dressing, with benefits extending even to non-targeted activities
- The impact extends beyond the individual to reduce stress and time pressure on entire families
- Physical activity, particularly multimodal exercise, is essential for maintaining independence
- Care partners play a crucial role in providing support while balancing independence with assistance
To learn more about LSVT BIG or to find certified therapists in your area, visit lsvtglobal.com.
Research Citation: Doucet, B. M., Blanchard, M., & Franc, I. (2025). Effects of LSVT BIG® on Bradykinesia During Activities of Daily Living. OTJR: Occupation, Participation and Health. Advance online publication. https://doi.org/10.1177/15394492251367275