LSVT Treatment General

We feel strongly that the earlier you start, the better. Many people with early PD are surprised to learn that one arm does not swing as much as the other, that their posture has changed, or that their steps have become smaller; or that the voice that they perceive as being within a normal loudness level, is perceived by others as being too quiet.

Because of this, it is important to be thoroughly evaluated by an LSVT BIG Certified Clinician, who may video tape your movement or test you in challenging situations which will “unmask” these PD related changes; or by an LSVT LOUD Certified Clinician, who may record your voice in a variety of speaking situations which could demonstrate these PD related changes.  The therapist will also perform a detailed interview to help you consider subtle changes in your movement, communication, confidence, or activity level which have occurred as a result of PD.

Further, it is important to maintain the ability to participate in things that are important to you, whether it is related to your work, your family or leisure activities which you enjoy.  LSVT BIG and LSVT LOUD can help you do just that.

For more information, watch our free On Demand webinar titled

“Newly Diagnosed with Parkinson Disease: “I’m doing well; why do I need therapy?”.

Yes.  LSVT LOUD can be used to improve communication and LSVT BIG can be used to help improve function in individuals with all stages of Parkinson disease.  The first step is to seek an evaluation from an LSVT Certified Clinician who can individually evaluate a person’s potential response to LSVT LOUD or LSVT BIG.  We often see that individuals even with advanced PD can improve in their communication to express their needs and emotions and improve their independence and safety with important skills such as getting in and out of bed, arising from chairs, toileting, dressing, and walking.

The LSVT LOUD clinician can tailor reading and conversation activities to meet each individual’s level of function and communication goals.  The LSVT BIG clinician can also work with patients to adjust exercise positions to ensure safety both in the clinic and with home exercises.

For more information, watch our free On Demand webinar titled

How LSVT LOUD and LSVT BIG Benefit Persons with Advanced Parkinson Disease

No.  The LSVT Homework Helper Video Series is not a replacement for individual treatment from an LSVT BIG or LSVT LOUD Certified Clinician. These exercise videos were developed to support people in their home exercise practice during and after the one-month of LSVT BIG or LSVT LOUD treatment.   It is important to understand that the exercises in the video series are only a part of a much more complex and customized treatment protocol, and the feedback given in one on one therapy by an LSVT Certified Clinician is vital to your success, and essential for learning how to produce safe, healthy movements and voice.

Yes, but not in the same treatment session.  LSVT BIG and LSVT LOUD are two different treatments. LSVT BIG is a physical or occupational therapy.  LSVT LOUD is a speech therapy.  Each are delivered in 60 minute individual treatment sessions, four consecutive days per week for four weeks by LSVT BIG or LSVT LOUD Certified Clinicians.

If you receive LSVT BIG and LSVT LOUD in the same month, you will have a one hour session of LSVT LOUD followed by a one hour session of LSVT BIG, or vice versa.   You can also receive LSVT BIG one month, followed by LSVT LOUD another month, or vice versa.

Please discuss the options with your LSVT BIG and LSVT LOUD Certified Clinicians during your evaluations to come up with a plan that best suits your needs.

Either a physical therapist (PT) or occupational therapist (OT) can provide the full LSVT BIG protocol.  You may also find that your needs are most comprehensively addressed when both PT and OT provide LSVT BIG as a team. This might be the case when you have difficulties, for example, with fine motor tasks such as buttoning or writing or activities of daily living in addition to difficulties with balance, walking, and posture.  An open discussion with your doctor and therapists will help you make the decision that is right for you.

Yes. LSVT BIG and LSVT LOUD Certified Clinicians work in a variety of practice settings, including the home.  When you search our FIND A CLINICIAN directory, look for an LSVT Certified Clinician who works in the home health setting. This will be listed in their directory details under “Areas of Practice.”  If in doubt, contact the clinician who is of interest to you to find out more about the options he/she provides for treatment delivery.

LSVT LOUD is the only voice and speech treatment for people with PD that has over 20 years of research data, including 3 randomized controlled trials.  These studies have demonstrated the effectiveness for improving voice and speech for people with PD.

The LSVT LOUD treatment techniques were developed to specifically address the voice and speech challenges noted by people with PD.  This includes motor changes (soft, monotone voice), sensory changes (misperception of how loud one’s own voice is) and subtle changes that make learning a bit slower in PD. The program is also delivered in a high effort, intensive mode that is consistent with principles of motor learning and neuroplasticity.

Programs that are not LSVT LOUD, but use the word “loud” or suggest they are “based on” or “modified” versions of LSVT LOUD will not provide the same treatment outcomes that the researched based protocol has documented.  To learn more about the unique and powerful research behind LSVT LOUD, visit our Research section of website.

LSVT BIG is the a standardized physical or occupational therapy intervention which comprehensively incorporates all types of exercise (aerobic, strengthening, stretching, etc.) in a way that is consistent with current research and which targets the key motor symptoms (slower/smaller movements, impaired balance, coordination and posture) and sensory changes (misperception of how big one’s own movement is) in PD.

In addition, LSVT BIG is more complex and functionally relevant than a general exercise approach. It always includes task specific training with the purpose of directly teaching people how to specifically apply improved movement gained through exercise into function. For example, in LSVT BIG, a person may improve their arm movement and strength through the core LSVT BIG exercises, but they will also then practice using those improved arm movements in function, such as reaching to open cupboards, closing doors, washing their hair, and so on.

As part of the LSVT BIG or LSVT LOUD Training and Certification Course, faculty discuss the role of LSVT Certified Clinicians in a variety of practice settings.  You will learn when and how the LSVT BIG and LSVT LOUD protocols can be successfully bridged across treatment settings as the person with PD recovers and makes progress.

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