LSVT BIG trains people with Parkinson's disease (PD) to use their body
more normally. 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
"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
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.
- "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.