What is LSVT BIG®?
This research-based physical and occupational therapy treatment protocol uses an intensive
amplitude-based exercise regimen to help re-educate the sensorimotor system of individuals
affected by Parkinson’s disease (PD). Research has shown LSVT BIG results in:
– Faster walking with bigger steps
– Improved balance
– Increased trunk rotation
– Improvements in activities of daily living such as bed mobility
– Improved UPDRS Motor Score
LSVT BIG targets bradykinesia, or slow movement, as well as hypokinesia, or small movements,
which negatively affect mobility, balance, and function with normal daily activities. Research has
shown that the early and intensive exercise is vital in optimal symptom management and
improvement in motor function in people with PD.
LSVT BIG® Treatment Consists of:
LSVT BIG is provided by a certified physical and/or occupational therapist for individual, hour long
sessions, four times a week for four weeks as supported by scientific research. Patients will be
instructed in a series of large amplitude movements using the whole body, and then will practice
applying these bigger, more normal movements in functional activities that are important to the
individual. In this way, LSVT BIG is customized to the unique needs, goals and abilities of each
patient. Patients also practice daily at home for maximal and sustained results.
Start Exercising Now – As Soon As Possible.
Physicians often do not refer patients at initial diagnosis because medications are fairly effective at
managing early symptoms. However, the LSVT BIG program has been shown to actually improve
motor function in PD, even in very early stages of the disease. Thus, referrals to the program would
be best initiated at diagnosis, when it may have the most impact on quality of life; however, it can still
be beneficial even if a patient has been diagnosed for a number of years.
What is LSVT LOUD®?
LSVT LOUD® is an effective speech treatment for individuals with Parkinson disease (PD) and other
neurological conditions. Published research data support improvements in vocal loudness,
intonation, and voice quality for individuals with PD who received LSVT LOUD®, with improvements
maintained up to two years after treatment. Recent research studies have also documented the
effectiveness of this therapy in improving the common problems of disordered articulation,
diminished facial expression and impaired swallowing. Additionally, two brain imaging studies have
documented evidence of positive changes in the brain following administration of the therapy.
LSVT LOUD® improves vocal loudness by stimulating the muscles of the voice box (larynx) and
speech mechanism through a systematic hierarchy of exercises. Focused on a single goal “speak
LOUD!” – the treatment improves respiratory, laryngeal and articulatory function to maximize
speech intelligibility. The treatment does not train people for shouting or yelling; rather, LSVT
LOUD® uses loudness training to bring the voice to an improved, healthy vocal loudness with no
LSVT LOUD® Treatment Consists of:
Treatment is administered in 16 sessions over a single month (four individual 60 minute sessions per week). This intensive mode of administration is consistent with theories of motor leaning and skill
acquisition, as well as with principles of neural plasticity (the capacity of the nervous system to
change in response to signals), and is critical to attaining optimal results. The treatment not only
simulates the motor system but also incorporates sensory awareness training to help individuals with
PD recognize that their voice is too soft, convincing them that the louder voice is within normal limits,
and making them comfortable with their new louder voice.
Not Just for Parkinson’s – Get LOUD Now For Best Results
Patients are trained to self-generate the adequate amount of loudness to make their speech
understood. While LSVT LOUD® has been successfully administered to individuals in all stages of
PD, the treatment has been most effective among those who are in early or middle stages of the
condition. LSVT LOUD® has also been applied to individuals with sub-types of PD (Shy-Drager
syndrome, multi-system atrophy and progressive supranuclear palsy), however the largest dataset is
for individuals with Idiopathic Parkinson disease (IPD). Recently, LSVT LOUD® has been applied to
select individuals with stroke, multiple sclerosis, Down syndrome, and cerebral palsy with positive