In our latest episode of Think BIG and LOUD, host Beth Peterson sat down with Dr. Suzana Simoes, Physical Therapist and Director of Rehabilitation services at Florida Pace Centers, to explore a model of care that is quietly transforming how frail older adults stay safe, mobile, and connected in their own communities.
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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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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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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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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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As LSVT® Certified Clinicians, you’ve seen how transformative LSVT LOUD® and LSVT BIG® can be for people living with Parkinson’s and other neurological conditions. After the intensive, one-on-one therapy ends, though, many of your patients ask, “What’s next?” That’s where LOUD for LIFE and BIG for LIFE come in.
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If you are a physical (PT) or occupational therapist (OT) working with older adults or neuro populations, you are most likely familiar with LSVT BIG® treatment approach, which is built on a very specific treatment dose: 60‑minute, individual sessions, 4 days per week for 4 weeks, for a total of 16 visits. This “dose” is not a preference or arbitrary in nature; it is the parameter used in the research on LSVT BIG that results in clinically significant improvements in amplitude, gait, and functional mobility in people with Parkinson’s.
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If you’re an ortho or sports physical therapist (PT), Parkinson’s disease (PD) may seem like a “neuro” issue—important, but not your primary focus. Yet many patients you treat for rotator cuff tears, arthritis, lumbar pain, and sports injuries either already have PD or will develop it during your career. You may be one of the first professionals who can spot early signs and change their long-term trajectory.
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When working with individuals diagnosed with Down syndrome, physical therapy often focuses on more than just movement—it’s about building confidence, independence, and quality of life. This case study highlights the progress of one patient who began therapy in June 2025 with concerns about balance, functional mobility, and endurance.
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