LSVT BIG trains people with Parkinson disease (PD) to use their body more normally.  People living with PD or other neurological conditions often move differently, with gestures and actions that become smaller and slower. They may have trouble with getting around, getting dressed and with other activities of daily living. LSVT BIG effectively trains improved movements for any activity, whether “small motor” tasks like buttoning a shirt or “large motor” tasks like getting up from sofa or chair or maintaining balance while walking. The treatment improves walking, self-care and other tasks by helping people “recalibrate” how they perceive their movements with what others actually see. It also teaches them how and when to apply extra effort to produce bigger motions – more like the movements of everyone around them.

Because LSVT BIG treatment is customized to each person's specific needs and goals, it can help regardless of the stage or severity of your condition. That said, the treatment may be most effective in early or middle stages of your condition, when you can both improve function and potentially slow further symptom progression. Beginning your work with LSVT BIG before you've noticed significant problems with balance, mobility or posture will often lead to the best results, but it's never too late to start. LSVT BIG can produce significant improvements even for people facing considerable physical difficulties.

LSVT treatments are unique because the principles of LSVT are supported by research and the LSVT protocols have been scientifically studied over the past 25 years.

This research began in 1987 when Dr. Lorraine Ramig met Mrs. Lee Silverman (pictured right) and her family. “If only we could hear and understand her” was the expressed wish of Mrs. Silverman’s husband and her adult children. This motivated Dr. Ramig’s life-long work to develop an effective speech treatment for people with PD, scientifically document its effectiveness, and implement the treatment into real-word clinical practice. This speech treatment protocol, Lee Silverman Voice Treatment (LSVT LOUD), was later expanded to a physical or occupational therapy program called LSVT BIG.

The research on LSVT BIG is newer and less extensive than that on LSVT LOUD, but published results of a randomized, controlled trial (Ebersbach et al., 2010) document that LSVT BIG resulted in improvements in the Unified Parkinson’s Disease Rating Scale (the “gold-standard” scale which doctors use to measure the progression of PD) as well as other tests of motor functioning in people with PD. In contrast, other treatments examined in the study (Nordic walking and home exercises) did not.

Because of this research and the standardization of the treatments, positive outcomes of LSVT have been replicated around the globe when the therapy is delivered the same way as in the research studies. This reliable consistency provides people with Parkinson’s increased confidence that they may achieve the outcomes they want and expect!

With exercises involving the whole-body — personalized for each person but all built around “Think BIG!” as a guiding principle — LSVT BIG reteaches you how normal movement should feel. Often these movements seem strange at first — too big, even though they’re comparable to those of people all around you. Over time, you learn to recognize these larger movements as normal.

Specifically, research shows that LSVT BIG treatment can lead to faster walking with bigger steps and arm swings, better balance and more ability to twist at the waist. Clinicians also report that LSVT BIG often helps people with buttoning their clothes, writing and other smaller-movement (“small motor”) tasks, as well large (“large motor”) movements like dressing, getting up from a seat and getting into bed.

Because PD makes it harder to remember to use these bigger movements consistently, treatment includes a lot of repetition and progressive challenges, as well as daily home practice and assignments for using bigger movements in everyday life.

Ultimately, LSVT BIG helps improve the mismatch between what you feel you're doing and what you're actually doing, making you more confident, comfortable and empowered. With one month of hard work, LSVT BIG can open doors to a more active and independent life.

The standard LSVT BIG treatment spans a minimum of one month, including daily practice and carryover exercises. Once that initial treatment is over, you'll continue to practice at least once a day for 10–15 minutes, which readies you to use your new movement skills all day at home or work and in your community!

However, it's important to know that LSVT BIG is a life-long journey! A few things that can help you on that journey are:

• LSVT BIG Homework Helper Videos - Follow along with one of our LSVT BIG instructors to practice your daily exercises; purchase or rent today.
• Tune-up Sessions - When you finish the four week LSVT BIG program, you and your therapist will decide when to return for a reassessment. Periodic “tune-up” sessions are recommended to provide you with motivation and feedback to help you maintain the benefits of your hard work.
• BIG for LIFE ^® - Community-based exercise groups for people who have completed LSVT BIG treatment, created to help you stay fit and have fun exercising with others. BIG for LIFE classes are intended to be fun, challenging, engaging and will provide participants with opportunities for social interaction while they exercise! Find a BIG for LIFE Provider Near You or sign up for a Virtual BIG for LIFE membership and join our weekly online classes!