Special Physical Therapy for Parkinsonians

Around 1990 Doctors Lorraine Ramig and Cynthia Fox pioneered the Lee Silverman Voice Treatment, an innovative and clinically-proven method for improving voice and speech in individuals with Parkinson disease.

Twenty years later principles of LSVT LOUD were applied to limb movement in people with Parkinson’s as LSVT BIG and have been documented to be effective. The BIG program is used to improve major motor skills to improve things like walking, limb movement and balance. This is based on the assumption that exercise may slow, halt or reverse the progression of Parkinson’s. It is felt that intensity matters and continuous exercise is necessary to regain function.

The program consists of 50-60 minute sessions, four times per week for four weeks. This combined with doing a home exercise program one to two times a day; helps clients with Parkinson’s improve their skills. The goal is for clients to use their “bigger” movements automatically in everyday living and for long-term carryover of increased amplitude.

This program requires a significant time commitment and an intensity level that may not be appropriate for all clients; however, the exercises and movements can be used in parts of regular physical therapy sessions as well.

Many times a person with Parkinson’s develops difficulty with balance. As a result, they begin not trusting their mobility. To avoid falling, they take smaller steps, shuffle their feet, and confine the movement of their arms, keeping them in close proximity to their body.

Physical therapy consisting of BIG exercises and movements is designed to encourage the person with Parkinson’s to use all of their muscles in an exaggerated fashion to contradict Parkinson’s tendency to diminish range of movement. The therapist shows how to take big steps, to really stretch the arms in all directions, bend, and make deep bows, walk, reach, step and twist.

Start exercising NOW—as soon as possible. Physicians rarely refer their patients to health and fitness programs at diagnosis because medications are very effective early on alleviating most of the symptoms and patients experience little change in function. Yet, according to recent surveys, it is at the time of diagnosis that patients often begin to consider lifestyle changes and seek education about conventional and complementary/alternative treatment options. Thus referrals to exercise, wellness programs as well as physical/occupational therapy would be best initiated at diagnosis, when it may have the most impact on quality of life.

Parkinson’s Resource Organization (PRO), through its WELLNESS VILLAGE (ParkinsonsResource.org/wellness-village) has just begun its campaign to populate the PHYSICAL THERAPY/BIG category with certified clinicians in your area. If you refer a physical therapist that has helped you improve your mobility issues we will thank you with a sheet of 20 Parkinson’s Resource Organization 45¢ postage stamps.

Welcome Stacy Hennis, PT, C/NDT, and New Beginning Physical Therapy, Inc. to the WELLNESS VILLAGE. If you live in or visit the Palm Desert area, Stacy (by appointment) will come to you.

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Comments

  1. Hi Jo,
    I enjoyed your interesting newsletter and want to let you know that Bernie was one of the first people in the area to experience the Think Big program. Our neurologist at USC referred us to USC Physical Therapy Associates. Out therapist had just been trained at the time and had developed the program. We didn’t have to pay but had to commit to getting to USC 4 days a week for 4 weeks. I was skeptical but didn’t have many alternatives, so reluctantly we made the commitment. Results were unbelievable. After 2 weeks he literally threw away his cane and was walking with a normal gait. We videotaped the entire experience so we have tangible evidence. The impact was greater than any of the meds he has taken–and lasted a while. Unfortunately, if you don’t use it, you lose it–and Bernie hasn’t kept it up. But when reminded he still can “walk big” and this is years later.

    Judy H (Los Angeles)

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