What is LSVT BIG?

LSVT BIG is an exercise program developed from LSVT (Lee Silverman’s Voice Treatment) LOUD, a treatment used to improve speech in people with Parkinson’s disease. Its principle is to use body movements of great amplitude, with great effort and high intensity, in order to stimulate the brain to form new, more efficient motor circuits that allow these people to move better.

How can LSVT BIG help people with Parkinson’s?

Parkinson’s disease is a neurodegenerative disease characterized by tremors, rigidity, bradykinesia and postural instability. It is caused in particular by a loss of neurons in the brain, which is responsible for the production of a neurotransmitter, dopamine. Not only does it play an important role in movement control, but it is also responsible for executive function, cognitive function, emotions, motivation and the reward system. So impairments such as a lack of motivation, diminished abilities to learn, think, and plan for movement, as well as compromised proprioception (i.e. the perception of movement in space) can also affect the quality of movements. For example, a person with Parkinson’s disease often has a gait characterized by shorter stride lengths. But, since he does not perceive the decrease in the amplitude of his steps, he will continue to walk slowly with small steps.

In general, exercise helps slow the progression of the disease in people with Parkinson’s. This is possible thanks to neuroplasticity, which is the ability of the brain to adapt and form new circuits under adequate stimulation. The LSVT BIG approach was developed based on the principles of neuroplasticity: repetition, intensity, complexity and motivation. In other words, the exercises of BIG are repeated in an intense way, in an enriching context, and with motivating tasks for the person. In addition, this approach targets bradykinesia by helping people recognize the range of motion required to produce optimal movement, allowing them to generalize what is learned from the clinic to everyday life.

What does the LSVT BIG protocol look like?

The LSVT BIG is an individual treatment guided by a physiotherapist or occupational therapist certified in this approach. Each session is adapted to the person’s objectives and functional capacity. A one-month program consists of 4 treatments per week, for 4 weeks in a row, with daily exercises at home. This frequency and intensity of treatment demonstrated improvements in balance, gait, functional ability in activities of daily living, and quality of life.