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LSVT Treatments at Gunnison Valley Health

LSVT treatments are evidence-based therapy prgrams that are specifically designed to treat Parkinson's disease (PD). The two LSVT programs are BIG and LOUD. LSVT BIG is the physical and occupational therapy component while LSVT LOUD is the speech therapy treatment. These treatments can only be provided by physical, occupational or speech therpists who are certified in either LSVT BIG or LOUD. Gunnison Valley Health is proud to have certified therapists on staff in both treatments.


LSVT BIG trains people with Parkinson's disease (PD) to recallibrate the way they move. People living with PD or other neurological conditions often move differently, with gestures and actions that become smaller and slower. They may have trouble with getting around, getting dressed and with other activities of daily living. LSVT BIG effectively trains improved movements for any activity, whether “small motor” tasks like buttoning a shirt or “large motor” tasks like getting up from sofa or chair or maintaining balance while walking. The treatment improves walking, self-care and other tasks by helping people “recalibrate” how they perceive their movements with what others actually see. It also teaches them how and when to apply extra effort to produce bigger motions – more like the movements of everyone around them.

LSVT BIG treatment is customized to each person's specific needs and goals, it can help regardless of the stage or severity of your condition. That said, the treatment may be most effective in early or middle stages of your condition, when you can both improve function and potentially slow further symptom progression. Beginning your work with LSVT BIG before you've noticed significant problems with balance, mobility or posture will often lead to the best results, but it's never too late to start. LSVT BIG can produce significant improvements even for people facing considerable physical difficulties.

"Community-based fitness programs can be very helpful for people with PD, providing not only exercise but also friendship, encouragement and support. However, it’s important to know that these programs do not take the place of receiving individualized physical or occupational therapy." - LSVT Global


Through these sessions, LSVT BIG treatment trains people to increase the size (amplitude) of their movements from head to toe. These improvements may also extend to smaller tasks, like buttoning or writing.

Positive Results for People with LSVT

  • One-on-one and is tailored to each person’s own abilities and goals
  • Holistic approach addresses not only movement issues but also takes into account non-motor symptoms including emotional changes and cognitive changes.
  • Helps people "recalibrate" to recognize when their movements are smaller or slower than they think
  • Designed to help people apply what they learn in treatment sessions to more comfortable, confident movements in everyday life

What LSVT BIG Improves

  • Faster walking with bigger steps and arm swings
  • Better balance and more ability to twist at the waist
  • Helps people with buttoning their clothes, writing and other smaller-movement (small motor) tasks
  • Helps people with large (large motor) movements like dressing, getting up from a seat and getting into bed

Ultimately, LSVT BIG helps improve the mismatch between what you feel you're doing and what you're actually doing, making you more confident, comfortable and empowered. With one month of hard work, LSVT BIG can open doors to a more active and independent life.


LSVT LOUD is an effective speech treatment for people with Parkinson's disease (PD) and other neurological conditions. Named for Mrs. Lee Silverman (Lee Silverman Voice Treatment), a woman living with PD, it was developed by Dr. Lorraine Ramig and has been scientifically studied for over 25 years with support from the National Institute for Deafness and other Communication Disorders within the National Institutes of Health (NIH) and other funding organizations. LSVT LOUD trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people "recalibrate" their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.

LSVT LOUD has also helped people with atypical parkinsonisms, such as progressive supranuclear palsy (PSP), and has recently shown promise for adults with speech issues arising from stroke or multiple sclerosis and children with cerebral palsy or Down syndrome.


The goal of LSVT LOUD is for individuals to "rev up" their stronger voice with daily practice so they can use it comfortably in daily communication. Further, this will become a life-long habit of practice, even after sessions of treatment are completed. This concentrated approach is critical for the positive changes LSVT LOUD achieves, consistent with what studies on motor learning and neuroplasticity (the ability for your brain and nervous system to adapt and evolve) show is most effective.

Speech treatments for people with Parkinson's disease have historically been focused on articulation and speech rate and have been given at a low-intensity dosage. LSVT LOUD takes a very different approach, focusing on the singular target of increasing vocal loudness to normal levels and delivering the treatment in an intensive, high-effort manner.

LSVT LOUD is built on three key strategies to make the treatment as effective as possible:

  • Target - Vocal Loudness
    • These strategies are consistent with the most effective, evidence-based strategies for learning and neuroplasticity (the brain's ability to change).
  • Mode - Intensive Dosage and High Effort
    • Intensive and high-effort treatment that encourages people to achieve more by always working harder (e.g., “louder, longer”). Sessions are tailored to your individual communication goals.
  • Calibration
    • "Recalibrating" sensory feedback so people recognize their new, louder voices are within normal limits. This increases the likelihood that people with PD will feel comfortable with and use their louder voice at home, work and play.

What LSVT LOUD Improves

  • Improves communication by helping you speak with a voice and volume that's easy for others to hear and understand.
  • Helps the person develop and become comfortable with a voice that they can use without strain at a loudness they'll know sounds normal to friends and family.
  • Improves articulation and the tone of one's voice.

Contact Gunnison Valley Health - LSVT Big & Loud

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