Parkinson's Disease

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Parkinson's Disease

Did you know that approximately 60,000 Americans are diagnosed with Parkinson’s Disease (PD) each year? But most people don’t really understand what PD really is.

PD is a progressive disease that affects the central nervous system and the ability to coordinate movement in the body. The disease typically affects one’s ability to walk, develops tremors in the hands, and causes muscles to become rigid, making any kind of motion extremely difficult. PD can also affect speech, swallowing, balance and activities of daily living.

Physical and speech therapy are key to help you improve your voice, range of motion, strength, stamina, and posture, so you can remain mobile and reclaim some independence in your life. With our LSVT LOUD, LSVT BIG, and Rock Steady Boxing programs, adapted for your individual needs, our therapists can help any patient in any stage of PD grow in mobility, strength, speech, and independence.


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 BIG treatment is delivered one-on-one and is tailored to each person’s own abilities and goals so that they work towards what's meaningful to them.

It requires (and can only be given by) an LSVT BIG Certified Clinician as part of prescribed physical or occupational therapy. Its holistic approach addresses not only movement issues but also takes into account non-motor symptoms including emotional changes and cognitive changes. It helps people "recalibrate" to recognize when their movements are smaller or slower than they think. Its sessions are based on the most effective, evidence-based strategies for learning and neuroplasticity (the brain's ability to change). It's designed to help people apply what they learn in treatment sessions to more comfortable, confident movements in everyday life beyond treatment sessions.

What LSVT BIG Improves

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.

After LSVT BIG Treatment

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


LSVT LOUD is an effective speech treatment for people with Parkinson's disease (PD) and other neurological conditions.  Named for Mrs. Lee Silverman (Lee Silverman Voice Treatment), a woman living with PD, it was developed by Dr. Lorraine Ramig and has been scientifically studied for over 25 years with support from the National Institute for Deafness and other Communication Disorders within the National Institutes of Health (NIH) and other funding organizations. LSVT LOUD trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people "recalibrate" their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.

While LSVT LOUD treatment has helped people in all stages of PD, the majority of research has been on those in moderate stages of the disease. LSVT LOUD has also helped people with atypical parkinsonisms, such as progressive supranuclear palsy (PSP), and has recently shown promise for adults with speech issues arising from stroke or multiple sclerosis and children with cerebral palsy or Down syndrome. Beginning your work with LSVT LOUD before you've noticed significant problems with voice, speech and communication will often lead to the best results, but it's never too late to start. LSVT LOUD has the potential to produce significant improvements even for people facing considerable communication difficulties.

What LSVT LOUD Improves

LSVT LOUD improves communication by helping you speak with a voice and volume that's easy for others to hear and understand. The treatment is built on tailored exercises that strengthen the voice box (larynx) and speech system.

The main focus of the treatment is to “speak LOUD!” However, it doesn't teach you to shout. Instead, LSVT LOUD retrains the feedback mismatch that PD often causes, helping you develop and become comfortable with a voice that you can use without strain at a loudness you'll know sounds normal to friends and family.

Another key is working with an LSVT LOUD Certified speech-language pathologist whose professional skills and training will ensure that you improve your voice in a healthy way.

While LSVT LOUD focuses on vocal loudness, research shows the treatment can also help with other qualities that improve communication, including articulation and intonation and even facial expression.

After LSVT LOUD Treatment

The standard LSVT LOUD treatment program spans four weeks of individual clinical sessions (four times per week) plus daily homework and carryover exercises. Once that initial treatment is over, you'll continue to practice at least once a day for 10–15 minutes.

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

  • LOUD for LIFE® — Community-based exercise class which offers the opportunity for people who have completed LSVT LOUD to practice their exercises and louder voices, not just at home by themselves, but also in a group setting with other LSVT LOUD graduates. LOUD for LIFE classes are intended to be fun, challenging, engaging and will provide participants with opportunities for social interaction while they exercise! Search for LOUD for LIFE Clinicians.
  • Tune-up Sessions — Staying in touch with your clinician with regular check-ups and short bouts of therapy to keep your voice strong, you and your clinician will continue to work together to maintain the benefits of your hard work.
  • LSVT Companion®, Client Edition — FDA-cleared medical device, this speech exercise computer program leads you through LSVT LOUD exercises, measures results and provides instant feedback via a virtual coach! This is for use during or after treatment. Learn more about LSVT Companion, Client Edition.
  • LSVT LOUD Homework Helper Videos — Follow along with one of our expert instructors to motivate your LSVT LOUD practice during and after your initial one-month treatment. View Clips and Learn more.

Our main focus at FYZICAL in Cordele is to help you maintain and improve all levels of physical function, so you can reclaim and improve your independence.