A BIG Step in Therapy for Parkinson’s Disease

By John Russell
MUSC Health Florence Medical Center

Walking and chewing gum is something most people take for granted. If you have been diagnosed with Parkinson's Disease (PD) you certainly won't take it for granted. Parkinson's Disease and other neurological conditions can make seemingly simple things, like walking or other daily living activities, a challenge. Many PD patients often fall due to a sudden lost sense of balance. A new therapy program now available at MUSC Health – Outpatient Rehabilitation Center can give hope and help to PD patients.

The LSVT BIG treatment program is tailored to help PD patients re-train the brain to improve movements. The Lee Silverman Voice Treatment (LSVT LOUD) started as a speech treatment program and has since expanded to a physical or occupational therapy called LSVT BIG for people with Parkinson's Disease.

The therapy helps improve small motor tasks, like buttoning a shirt or tying your shoes, and larger motor tasks, like getting up from a chair or keeping your balance while walking.

Gwendolyn Strickland, age 66, was diagnosed with PD a little more than two years ago. She saw two different neurologists until one of them suggested she could benefit from therapy specifically geared toward Parkinson's patients.

"My life had changed tremendously [since being diagnosed with PD]," Strickland said. "I was having difficulty doing things, and I would fall a lot. I was afraid to go shopping because I might fall while turning or walking backward."

Her doctor referred her for therapy, where she met Nick Everetts, an MUSC Health Florence Medical Center physical therapist. Before coming to Florence, Everetts worked with a therapist who had a passion for helping people with PD. It inspired him enough to get certified and start helping patients in and around Florence.

"LSVT BIG focuses on doing big movements in everything we do," Everetts said. "Whether it's brushing your teeth, rotating the trunk of your body, sitting or putting on a shirt, everything needs to be big."

Everetts said PD causes patients to be more rigid, some have tremors, and general movements of the body are smaller, i.e. shuffling feet, or not swinging your arms when walking. When Strickland first met Everetts, she said she was nervous, didn't quite know what to expect, but was hopeful he could help her. LSVT BIG is an intensive four-week, 16 session program emphasizing dual-task situations. Before long, Everetts said Strickland was walking up and down stairs without using the handrail while holding a cup of water without spilling it.

"Right from the get-go, I emphasized how important it is to do exercises at home every day. It's a lifelong learning thing, and Parkinson's is a lifelong thing to deal with," Everetts said. "I knew the biggest thing for her (Strickland) was going to be turning. She shuffled her feet a lot, was a high fall risk, and we worked a lot on balance. With PD, you can focus on something and accomplish a task. We try to train the brain to do tasks as you want to perform them in your daily life."

Strickland said the homework she did at home was actually fun. "Nick made it that way. I couldn't wait to go home and show my daughters what I learned and working on getting better at it," she said. "Practice makes perfect, and I've been practicing every day since. I knew I was getting better. I’m not saying everything with my PD has been cured, but it certainly has helped. I can walk and turn a lot better now. Everything I do now, I think of doing it big."

Since participating in the program, Strickland said she hasn't fallen one time. Now, she enjoys going outside to play with her grandchildren. "My granddaughter has a jungle gym in the back yard, and I love to climb the ladder and go down the slide with her. Before, I couldn't do that," she said.

The difference-maker for Strickland was that she worked hard to improve. Everetts said the best results come from patients who are motivated to work hard and get better.

"I think it's a great population to work with because you do see huge improvements in a month. To me, it's a lot of fun and seeing people get better is extremely rewarding. To hear she hasn't fallen at all is a success. To me, it's great to hear patients are doing better," Everetts said.

To find out more information about the LSVT BIG program and other services at the MUSC Health Outpatient Rehabilitation Center, visit our site or give us a call.