It’s Parkinson’s Awareness Month: Learn More About LSVT BIG Treatment at Christian Health

Through the groundbreaking research and efforts of those in the health-care community, treatments and outcomes for those with Parkinson’s have improved considerably over the years. Among these therapies is LSVT BIG, a research-based physical and occupational therapy that addresses the symptoms of Parkinson’s and helps those affected by the disease to perform everyday tasks more effectively.

Parkinson’s disease is a brain-based movement disorder that negatively affects the ability to perform daily activities by causing body tremors, stiffness in the limbs and trunk, slowness of movement, and impaired balance and coordination. It also causes difficulty sleeping, anxiety, depression, fatigue, numbness, burning sensations, and chronic pain. The disease is unfortunately progressive and without a cure, with symptoms growing worse over time. However, treatment and therapy can help make the symptoms manageable and increase quality of life.

“People with Parkinson’s often move differently. Their gestures and actions become smaller and slower because that’s what feels normal to them,” says Erica LaGruth, DPT. Ms. LaGruth is a LSVT BIG–certified clinician at Christian Health. “LSVT BIG is an intensive one-on-one treatment that trains individuals to use their body more normally. It focuses on walking, balance, and activities of daily living. By learning how and when to use extra effort to produce bigger motions, their movements become more like those of everyone else around them.”

“LSVT BIG increases amplitude of motion. Not only does motion get big, but it gets faster and smoother and larger,” Ms. LaGruth says. “Essentially, we’re training individuals with Parkinson’s to use what others would consider exaggerated movements. If I tell you that I want you to move your arm from your side to over your head with the maximum amount of effort and speed that you can, you would fling your arm. If I ask a person with Parkinson’s to do that, the motion is slow because the reduced amount of dopamine in the brain doesn’t allow him or her to do something as fast or as large. Through LSVT, that individual learns how to create normal movements by using exaggerating movements.”

Prior to commencing the four-week program of four one-hour sessions per week, LSVT BIG candidates are evaluated and their goals are discussed. Although LSVT BIG can help at any stage or severity of Parkinson’s, studies have shown that it is most effective for individuals in the early to middle stages.

“The treatment plan comes directly from the patient: What are you having trouble doing? What do you want to make sure that you don’t have trouble doing? From that, we pick five simple daily movements and create a hierarchy – one-step movements that combine to make a whole activity,” says Ms. LaGruth. “One person’s hierarchy might be the ability to make breakfast. Someone else’s may be to walk down the front steps to the car.”

“It takes time to build up tolerance and endurance, learn appropriate technique and position, and understand what it feels like to make that big a movement,” Ms. LaGruth says. “Exercise is modeled, meaning that I’m across from the patient doing the exercise that I want him or her to do, such as reaching out, down, and up, and holding it.”

Exercises lead up to the individualized hierarchy with its one-step movements.

“If the hierarchy is to make breakfast, we look at all the steps involved: Go to the refrigerator. Open the door. Take out the juice. Put it on the counter. Reach for a glass. Pour the juice. Bring it to the table, and so on,” says Ms. LaGruth. “We then determine the portions that are the most difficult. Maybe the person lost balance when opening the refrigerator door. For the remainder of the session, we’ll focus on that movement. In subsequent sessions, we’ll make the hierarchy more difficult by adding a cognitive task, such as talking to someone while making breakfast.”

“LSVT BIG is phenomenal. Erica is enthusiastic and encouraging,” says outpatient Doris Minck, who was diagnosed with moderate Parkinson’s disease in 2012. “I could tell a difference shortly after I started the program. I have greater mobility, and my sense of well-being has improved. I’m very happy with Christian Health overall. There’s a caring spirit. And being picked up and dropped off by a Christian Health van is a tremendous help. The drivers are so courteous.”

Daily practice of the exercises at home is key to successful LSVT BIG therapy, both during the program and following discharge. A follow-up appointment is scheduled three to six months after the patient is discharged, depending on the individual’s stage of Parkinson’s. If needed additional sessions may be recommended.

“LSVT BIG has tremendous benefits, not only for an individual’s physical well-being but for mental well-being,” Ms. LaGruth says. “It can help a person be more confident and more empowered to reengage in life. Just remember to think BIG!”

For more information about LSVT BIG and other short-term rehab services, contact Erica LaGruth at (201) 848-5518 or elagruth@ChristianHealthNJ.org.