Before LSVT Treatment

Sometimes.  This will depend on the facility from which you are receiving therapy as to whether a referral/script is necessary.  For the most part, it is very helpful and more often than not required.  The script can be written for an evaluation and treatment for speech, physical or occupational therapy (or all three).  The script does not need to be specific to LSVT treatment.

Yes.  It is considered best clinical practice, as recommended by the American Speech Language Hearing Association to have your vocal folds visualized prior to starting any type of voice therapy. Because LSVT LOUD is a voice treatment, the same recommendations apply to LSVT LOUD therapy. It is best if this evaluation can be conducted by an Ear Nose and Throat doctor (ENT), as they have the expertise and equipment to provide your LSVT LOUD clinician with the information he/she will need to recommend an optimal treatment plan without any contraindications. Parkinson disease can cause changes to the voice which may result in a hoarse, breathy voice that is reduced in loudness, but other conditions such as reflux, vocal fold paresis, or other more serious conditions can also cause these symptoms.

Your LSVT BIG Certified physical and/or occupational therapist should perform a thorough examination including review of your past medical history.  This therapist will determine if additional medical clearance is needed for participation in LSVT BIG.

No.  LSVT LOUD and LSVT BIG treatments can be integrated well into your daily activities.  In fact, your personalized goals in LSVT LOUD and LSVT BIG are to improve the quality of your communication and movements in your everyday activities and function (i.e., these are not just exercises you do at “therapy).   However, due to the intensive nature of the one month of treatment, we do recommend that other types of speech, physical or occupational therapies be put on hold for the focus of LSVT LOUD or LSVT BIG.  Other community based exercises or social activities can continue.  Your LSVT Clinician will work with you (and perhaps other coaches or instructors you work with) to integrate your louder voice and bigger movements into these activities.

Yes.  As part of the physical therapy (PT) or occupational therapy (OT) evaluation, your LSVT BIG clinician will take a detailed medical history and complete a physical evaluation.  Based on this, he or she can recommend the best course of action.  In many cases, people are able to proceed directly to LSVT BIG treatment with co-occurring orthopedic issues.  The LSVT BIG clinician can make adaptations to the exercises to ensure safety and pain free movements.  There are other times that the recommendation may be to first directly address the orthopedic issue with PT or OT, then follow-up with LSVT BIG.  This is why the skill and knowledge of a PT or OT is required to deliver LSVT BIG.

Continuing with daily exercise and activities is important while waiting to receive LSVT treatment.  The LSVT LOUD and LSVT BIG Homework Helper Videos can also be used as an introduction to the basic exercises, however, these are not a replacement for in-person treatment.

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