In Parkinson's Disease

Individuals living with Parkinson’s disease and other neurological conditions often present with smaller, slower movements and lower volume of speech. The Lee Silverman Voice Treatment, also known as LSVT, is an evidence-based treatment protocol designed to target these areas of concern. LSVT BIG® and LSVT LOUD® were developed to target the symptoms associated with Parkinson’s disease through restorative training. The LSVT BIG® program is an intensive amplitude-based exercise program for bigger motor movements. The LSVT LOUD® program focuses on amplitude-based training for the voice. Research shows that exercise prescriptions designed for individuals with Parkinson’s disease can slow the rate of progression of the disease.

Types of Parkinsonian Disorders

Idiopathic Parkinson’s:

  • Accounts for 85% of individuals diagnosed with Parkinson’s
  • Individual’s present with tremor, postural instability, and deficits in walking
  • LSVT research based on this type of Parkinson’s

Secondary Parkinsonism:

  • Can result from drug-induced, metabolic, toxins, trauma, post-encephalitic slow virus, brain tumors, or vascular issues

Atypical Parkinson’s:

  • Can occur with dementia, ALS, and Basal Ganglia CVA

LSVT BIG® and LSVT Loud® Protocol

LSVT BIG® and LSVT LOUD® treatment includes 16 individual one-hour sessions, four consecutive days, for a total of four weeks. Individuals are required to perform daily homework and carryover exercises in order to maximize the full potential of the program. The treatment includes a lot of repetition and progressive challenges. Sage Outpatient Services also offers an LSVT Wellness class every Friday from 12-1 for individuals who have previously completed the LSVT BIG® and/or LSVT LOUD® programs. Certified physical, occupational, and speech therapists begin each class with the LSVT BIG® and LSVT LOUD® exercises followed by a fun, themed based activity to carry over the principles in everyday life situations.

What are the LSVT BIG® and LSVT Loud® exercises?

LSVT LOUD® Exercise:

  • Daily tasks (30 minutes)CORE exercises
    • Sustained “ah” (minimum 15 reps)
    • High/Low “ah” (minimum 15 reps)
    • Functional phrases (minimum 50 reps)
  • Hierarchical speech tasks (30 minutes)Train amplitude from CORE exercises into in context-specific and variable speaking activities

LSVT BIG® Exercises:

  • Maximal daily exercises
    • Set of 7 researched based exercises
  • Functional Component Tasks
    • Everyday tasks (Examples: Sit-to-Stand, Pulling keys out of pocket, buttoning shirt, handwriting)
  • Hierarchical Tasks
    • Patient-identified tasks (Examples: Getting out of bed, Playing golf, Getting in and out of a car)
  • BIG Walking


In closing, the LSVT BIG® and LSVT LOUD® programs have shown to greatly improve the overall functioning of individuals with Parkinson’s disease and other neurological conditions. With the completion of the LSVT LOUD® program, individuals have noted that they automatically take deeper breaths, improve their pitch range, open their mouth wider, increase intelligibility, and improve vocal quality and amplitude. LSVT BIG® participants have been able to walk faster with larger steps, improve their balance, improve posture, prevent falling, and improve trunk rotation. For more information on how to get started with the LSVT BIG® and LSVT LOUD® programs at Sage Outpatient Services, give us a call at 225-906-4097.

Recent Posts
outpatient gym