Movement is Medicine

How The LSVT-BIG Program Helps Treat Parkinson’s Disease

Parkinson’s disease is a “progressive disease of the nervous systems marked by tremor, muscle rigidity and slow, imprecise movement. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine.” It commonly affects 4-6 million people worldwide.  It is most prevalent in Caucasian and Hispanic men over the age of 60, with a prevalence of twice as many men affected compared to women. It is diagnosed by motor symptoms including bradykinesia (slow movement), rigidity, tremor, as well as a positive response to dopamine replacement therapy.

Lee Silverman Voice Treatment- BIG (LSVT-BIG) is one part of a dual-treatment program for people diagnosed with Parkinson’s disease. At Excel Physical Therapy, LSVT-BIG is taught by a certified physical therapist. LSVT-BIG is defined as an “intensive amplitude-based exercise program for the limb motor system and re-education of the sensorimotor system.” In other words, as the name implies, the exercises are comprised of big, exaggerated movements.

A common presentation of people diagnosed with Parkinson’s is bradykinesia or small amplitude movements. This can include decreased arm swing or short step length (shuffling) while walking.  The LSVT-BIG program begins by addressing the person’s maximum amplitude of movement, meaning “the largest range of motion with the highest effort and the best biomechanics” that the patient is capable of. Then, specific exercises are given to increase their amplitude of movement with the goal of improving their overall gait pattern and balance to reduce their risk for falls. In other words, the exercises are focused on big, exaggerated movements.

The accelerated program is built to slow the disease progression by protecting dopamine neurons, restore connections in the brain, and specifically train the patient’s individual deficits. The LSVT-BIG program is a specific exercise program consisting of 16 one-hour sessions for four consecutive days per week for four weeks. Throughout the four weeks, patients are completing daily homework and carry over learned exercises for 30 days straight. This is followed by the coaching of five everyday tasks that the patient is having difficulty completing, such as sit-to-stand transfers or pulling keys out of pocket, all under close supervision of the licensed physical therapist.

Our team of certified experts is here to help slow the progression of the disease and enhance the quality of life. For more information about the LSVT-BIG program at Excel Physical Therapy, please see our location list to find a certified LSVT-BIG clinician near you.

More information can also be found at

By: Katie Kelly, PT, DPT, Excel Physical Therapy – Blue Bell



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