My PT Story: New Zealand’s First LSVT BIG Certified Therapist

My PT Story: New Zealand’s First LSVT BIG Certified Therapist

By Tara Martin, Neurological Physiotherapist, LSVT BIG Certified Clinician

We recently interviewed Tara Martin, an expert physiotherapist from New Zealand who has a passion for serving people with Parkinson’s (PD). She has been a pioneer bringing LSVT BIG to New Zealand and continues to improve the lives of people with PD through exercise, technology, education, and advocacy.

Experience Before LSVT BIG

I trained in the UK at Brunel University graduating in 2001.  My journey to physiotherapy was a bit unusual as prior to this I had studied music and was intent on becoming an opera singer! After meeting my soon to be husband, I moved to the UK (where he is from) and looked to retrain.

I spent time whilst I was a music student working as a fitness instructor and gravitated towards this industry, but found my greatest satisfaction was working with people who wanted to use exercise to improve their function, not just to look good.

Things just went my way from there and I found volunteer work and later paid work as a physiotherapy assistant predominantly working in neurology, which opened the door to getting onto my physiotherapy degree program.

We stayed in the UK for another 10 years, and I worked in large teaching hospitals in London and in Manchester. This work experience was amazing and gave me very solid skills and a holistic understanding of the profession.

Passion for Parkinson’s

In 2007 we fancied a change and moved to beautiful Aotearoa, New Zealand.  I spent my first couple years here working across both a variety of sectors but again, mostly in neurology and older persons’ health.  During this time, I started completing some post-graduate education and became even more interested in PD and long-term conditions.

Like many I’m sure, I was frustrated and felt the health system I was working in did not meet their needs.  I had also started to learn about rhythmical auditory cueing for PD which was a natural fit for myself and my music background.

My LSVT BIG Certification

Then in 20ll our lives were little shaken up by the large and extended series of earthquakes in Christchurch, the city where we had made our home. Our city was literally brought to its knees, and the service I worked for completely changed to meet the rapidly changing landscape. So, I took that opportunity to make a change as well and resigned to carve a new path. 

I continued working towards my Master’s and headed back to my home state in the US to re-connect with family and train in a relatively new program called LSVT BIG.  I returned from the US to New Zealand, joined a private physiotherapy company working with people with neurological and aged-related conditions, and was the first person to bring LSVT BIG to New Zealand.  Since then, the number of LSVT Certified therapists has steadily grown.

Late last year I left my role in private practice and now work for a registered charity, still working with PD but with a different focus. I no longer have opportunity to provide LSVT BIG treatment myself, but I continue to mentor other therapists who do.

Impact of LSVT BIG on my practice

When I trained and started using LSVT BIG, I was also completing my master’s research project on a rhythmical auditory cueing program for people with freezing. The combination of both really made an impact on how I practice.  Most importantly, I became acutely aware of how much we undertreat people with PD and do not provide them with the tools to continue to look after themselves as part of our treatment program.

The condition is so complex and chronic that to try and fit into most typical models of care for physiotherapy are simply not going to work.  Also, the absolute privilege to be able to work with and observe someone so consistently revealed the extreme variability of the condition. This is just impossible to get a grip on without the intensity that LSVT BIG provides. We will often see much more and understand much more about their medication efficacy than a neurologist can ever appreciate in a fifteen-minute consultation!

Lastly, the structure of LSVT BIG protocol (set exercises, set functional tasks, intensity of treatment) is something I have used as a model for treating other conditions.

What would you like to share with other therapists?

Early intervention is best!  Hopefully as LSVT trained therapists we all know this by now, but I still find it a very hard message to sell in publicly funded healthcare model where we wait for functional problems to be bad enough to generate a referral. The evidence is very clear that we need to be involved from the start and to keep providing timely input. The only way I can see this changing is continued advocation for our profession and more close collaboration with neurologists – something we haven’t really gotten on top of here yet. But I’m working on it!

Next Steps

My new role at our local Parkinson’s charity has offered some exciting opportunities.  Firstly, we have just launched our Accreditation and Endorsement Programme.  I’m really excited about this and have been following closely the developments on a similar project with Parkinson’s Foundation in US.  There is a great opportunity for us to work more closely with exercise professionals and to imbed exercise as part of self-management early in diagnosis.

Another project I’ve been working for some time is the development of a rhythmical cueing app called Power of Rhythm. This is a therapy tool to use jointly with patients to help them regulate gait frequency and amplitude using music, but it can also be used for LSVT BIG exercises.  It is available on Android, and a new revised version will be available later in year on both iOS and Android platforms.  I am hoping to continue to use this a tool not only for my clinical but also for further research into the potential value of music and rhythm enhanced therapy programs (finally bringing in my music background!).

Final Note

I lastly just want to acknowledge all those therapists out there who have worked, and continue to work, through this pandemic. We are extremely fortunate here in New Zealand to have been able to keep COVID out and live a relatively normal existence.  Having gone through major upheavals with earthquakes I have some understanding of how hard it can be to keep going when everything seems out control.  Kia kaha!

Are you an OT or PT professional or student who would like to get certified in LSVT BIG?

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Tara Martin, Author

About the author:

Tara Martin, Neurological Physiotherapist, LSVT BIG Certified Clinician

Tara was the first LSVT BIG certified therapist in New Zealand. She has extensive experience working with people with Parkinson’s and other neurological conditions. She completed her Master’s research on freezing of gait in Parkinson’s and developed the Cued Up! programme using behavioural and rhythmical cue strategies to help manage freezing. She also was the innovator and co-creator of the Power of Rhythm app for assisting to manage gait walking problems related to Parkinson’s using rhythmical cueing and music.