Despite its unusual non-descript name, the LSVT BIG and LSVT LOUD®  programs have earned quite the reputation for advancing treatment options available to people with Parkinson’s disease.

6 Jun 2023

Caregiver facing patient conducting mouth exercises

Origins of LSVT

Named after a woman with Parkinson’s who was experiencing voice impairment, the protocols of the Lee Silverman Voice Treatment (LSVT) LOUD®  program were originally developed by Dr Lorraine Ramig who was motivated to improve her patient (Lee Silverman’s) speech so that her husband and children could understand her better. The effectiveness of Dr Ramig’s approach has been scientifically studied and supported by research for over the past 30 years and has since expanded to address the physical challenges of Parkinson’s to include an occupational therapy program called LSVT BIG®.

Both programs focus on exaggerated limb movements and speech volumes to overcome some of the symptoms of Parkinson’s and improve motor performance in everyday tasks. 

The principles of LSVT LOUD®

Difficulty in being understood due to low volume is a common experience for people with Parkinson’s. This can lead to a reluctance to speak and social isolation.  LSVT LOUD® therapy uses specific exercises and practical activities to increase a person’s loudness and speech clarity to improve their communication success.

LSVT LOUD® reframes motor learning and recalibrates sensory feedback.  This assists people with Parkinson’s to move their vocal loudness back into the normal conversational range.

The treatment is built on exercises that strengthen the voice box and speech system so that neurological pathways from the brain to the muscles in the throat are redefined. 

LSVT LOUD® is a proven rehabilitation technique for helping people with Parkinson’s and is considered to be Gold Standard in voice treatment. Research has shown that this approach to improving communication achieves the desired effects that last longer than any other therapy technique.

What is LSVT BIG®

Similar to the basic principles of LSVT LOUD®, LSVT BIG uses amplified movements to improve walking, balance, strength, flexibility, self-care and confidence.

People living with Parkinson’s often move differently with gestures and actions becoming smaller and slower. LSVT BIG® effectively conditions patients to undertake any activity whether it be a small motor task like buttoning a shirt or writing a letter, or a large motor task like getting up from the couch, getting into bed or maintaining balance while walking.

Ultimately LSVT BIG® uses a lot of progressive challenges, repetition and practice to help people identify the mismatch between what they feel they are doing and what they are actually doing. This approach helps people recognise that these larger movements are in fact, very normal.

How are the LSVT LOUD® and LSVT BIG® programs delivered?

The delivery process of the LSVT LOUD® and LSVT BIG® programs have been validated by years of research and follow a standardised format that is administered over a minimum 30-day period.

This means that the learning needed to successfully adapt to the principles of the LSVT programs is intensive and requires continued practice and self-monitoring, along with reinforcement from others to effect lasting change.

Patients enrolled in a LVST program will undergo:

  • a 60-minute session each day, over four consecutive days a week, for four continuous weeks.
  • Daily homework practice for 10-20 minutes each day for the whole 30 days
  • Daily carryover assignments for all 30 days.

Each session is administered on a 1:1 basis using high-effort treatment that is tailored to a patient’s individual interests, needs and goals. Some patients may need additional treatment sessions, but never less than the standard 30-day dosage schedule. 

In the event of illness or any other unexpected disruption to the treatment process, our LSVT certified clinicians are specifically trained to adapt therapy accordingly.

The benefits of LSVT BIG® and LSVT LOUD® are:

  • Faster walking with bigger steps
  • Increased functionality
  • Better balance and mobility
  • Clearer, louder communication
  • Improved articulation and intonation
  • Increased self-confidence
  • Enhanced socialisation
  • Better ability to enjoy life.

What happens at the conclusion of the LSVT programs?

Patients can continue to enhance what they have learned by partaking in a number of group therapy programs that aim to support and maintain the progress and improvements they have made to their lives through the LSVT programs. 

BIG FOR LIFE® and LOUD FOR LIFE® continue to build on the foundations of the intensive four-week programs but require less of a commitment overall. These maintenance programs enable patients to continue practising with the professional support and guidance of our specialists who are committed to walking alongside them on their Parkinson’s journey.

While consistent, ongoing attendance is not a requirement of the LSVT BIG FOR LIFE® and LSVT LOUD FOR LIFE® programs, patients must have completed LSVT BIG® and/or LSVT LOUD® to be eligible for the extension program. Bookings are also required and can be made by calling 03 9788 3333.