Parkinson's Program at Sibley
Sibley Hospital Rehabilitation Department offers the Lee Silverman Voice Treatment (LSVT®) BIG™ and LOUD™ Program for people with Parkinson's Disease and other neurological disorders.
LSVT BIG is a research-based exercise approach developed from LSVT LOUD program principles. LSVT BIG is a standardized treatment protocol that will teach you how to move to your full potential, help you to establish lifelong habits of BIG movement and empower you to improve your quality of life with everyday activities. The LSVT programs have been developed and scientifically researched over the past 20 years with funding from the National Institutes of Health. LSVT BIG research has documented improvements including faster walking with bigger steps, improved balance and increased trunk rotation for daily activities. Research suggests that you should not wait until you experience disability, impairment of function or loss of balance to start this program. The LSVT BIG program is a standardized treatment protocol and is provided by a LSVT certified OT or PT.
The LSVT BIG program consists of 16 sessions of 4 days a week for 4 weeks. Treatment sessions run for one hour and include assigned home program practice for carryover of skills. The program focuses on high amplitude and repetitive motions performed with maximal effort which helps produce bigger and more functional movements for everyday activities.
To participate in the LSVT BIG program please obtain a physician order with diagnosis and stating Occupational Therapy/Physical Therapy for LSVT BIG program. Schedule an evaluation appointment with one of the Sibley Rehab LSVT certified therapists at 202-364-7665. You can also learn more about the LSVT BIG program at www.LSVTGlobal.com.
LSVT LOUD is a clinically proven method for treating speech and voice impairments in patients with Parkinson's disease (PD). Often referred to simply as LOUD therapy, this 4 week intensive program helps individuals improve effectiveness as a communicator by focusing on one target, "Think LOUD!" As changes with Parkinson's disease take a toll gradually over the course of years, its effect on volume and intelligibility often goes unnoticed until an individual is having significant difficulty in being heard and understood.
Vocal Quality and Volume
The most prominent vocal symptom related to PD is a reduction in volume. Because this change occurs gradually over a period of years, the patient is often the last one to recognize it as a communication problem. If family and friends are often asking for a repetition, it may indicate the need to have a voice evaluation.
PD can also affect one's vocal quality. People often describe changes such as a raspy, hoarse, and breathy quality. These symptoms often clear quickly after the first couple of weeks of LOUD therapy.
PD is known to cause a stooped posture, thereby collapsing the chest and directing speech downward. With such changes in posture it can become difficult to fully expand the lungs or to fit a single sentence on one breath. This posture can direct already soft speech downward. In speech therapy, we emphasize the importance of posture for eye contact and successful communication.
Increasing breath support is another goal for improving communication. With reduced breath support it is difficult to convey all of one's thoughts and ideas. Often people compensate by speeding up to attempt to fit more words in on one breath, which results in reduced intelligibility. Some individuals make no effort to compensate and the last few words of a sentence are uttered at a volume too soft to be understood. Others find they are constantly taking a breath every few words. Communication shouldn't require so much effort. With training and respiration exercises the breath can once again support speech.
In Their Own Words
A few of Sibley's LOUD participants described their experience in the program in this way:
"In all the things I've done, [LOUD] has had the greatest impact." AMC, Bethesda
"I have completed the LOUD program at Sibley Hospital. I can attest to its value. Before I joined the program, I had trouble making myself heard at a meeting. Since taking the program, I had no such problem. I recommend this program with enthusiasm." Bob, Bethesda
Don't wait! It is most beneficial to start the LSVT programs early in the diagnosis period and before experiencing a communication problem.
The Speech Language Pathologists of Washington Hearing and Speech are LSVT trained and certified. Call with questions or to be scheduled for a LOUD evaluation as soon as you are considering the program, as there is often a waiting list.