Empowering Voices and Movements for people with Parkinson’s
Courtney Carter
/ Categories: WELLNESS, 2024

Empowering Voices and Movements for people with Parkinson’s

People with Parkinson ’s disease and similar neurological conditions often experience changes in the brain that can prevent them from recognizing changes in their movement or the ability to maintain clarity and volume in their speech. As a result, even simple tasks, such as getting in and out of a car or carrying on a conversation, can become challenging and time consuming.

But thanks to treatment options including LSVT LOUD and LSVT BIG, people can retrain their brains to reclaim some ability.

As SVMC physical therapist Noelle De Geus, DPT, explains, “While both the LOUD and BIG treatments are based on Lee Silverman Voice Treatment (LSVT), they’re distinctly different treatments that offer different benefits.”

She adds, “LSVT BIG focuses on mobility and large movements, LSVT LOUD targets speech. By intensively practicing louder speech or bigger movements, patients can essentially retrain their brains and bodies. Both treatments are offered at SVMC with LSVT BIG treatment provided by a physical therapist and physical therapist assistant, and LSVT LOUD conducted by a speech-language pathologist.”

 

Here’s a look at what’s involved in each treatment option:
LSVT BIG

The goal of LSVT BIG is to help patients recalibrate their perceptions of their movements, to counteract the tendency towards smaller, slower movements in Parkinson's disease.

It involves challenging, high-intensity, one-on-one clinical treatment delivered over one month’s time by a certified clinician. LSVT BIG consists of one-hour sessions, four sessions per week, with daily homework exercises. 

While LSVT BIG treatment can help people in all stages of Parkinson ’s disease, it’s ideal

to begin treatment before significant changes in movement and function have occurred.   

LSVT LOUD

Despite its name, there’s more to LSVT LOUD than helping people improve their vocal volume. Like LSVT BIG, LOUD is provided by a certified clinician over a period of one month.  Treatment consists of one-hour sessions, four sessions per week, with daily homework exercises. Over the course of treatment, patients improve their ability to perceive how loud they are speaking. This allows them to speak at a more normal volume and be better understood.  The effects can last two years or longer post-treatment.

While LSVT LOUD and LSVT BIG were originally developed for Parkinson's disease, there is early research to suggest that these programs can help people with other neurological conditions including stroke, multiple sclerosis, and ataxia. 

If you have Parkinson ’s disease or another neurological condition, consider asking your family and friends if they have noticed changes in your movements and/or voice.

 

To determine if you’re a candidate for either options or for more information, contact our therapists at 802-447-5140:

LSVT BIG: Noelle De Geus, DPT

LSVT LOUD: Kate O’Neill MS, CCC-SLP

 

To learn more about either treatment click below:

LSVT BIG

LSVT LOUD

Kate O'Neill, MS, CCC-SLP, Noelle De Geus, PT, DPT, and Nina Nunes, PTA are all members of SVMC Outpatient Rehabilitation, part of Southwestern Vermont Medical Center.

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Home Office How To

Did you know that many sources of chronic pain start in a poorly arranged office? Carpal tunnel, pinched nerves, overuse injuries can often be traced to chairs being positioned improperly or important tools being positioned outside easy reach. While reaching or straining once or twice wouldn't hurt us at all, doing so repeatedly day after day can cause painful and lasting injuries.

As an occupational health physician at Southwestern Vermont Medical Center, one of my responsibilities is to help employees of SVMC and other companies who have workplace injuries and recommend the adjustments they should make.

During a spike in work-from-home arrangements, I have heard about friends’ and family members' work-from-home set-ups. Some are working from laptops on their couches. Others are set up at kitchen tables. We know that their cats walk across their keyboards and their kids interrupt. Especially since Governor Scott has just indicated that remote workers will likely be the last to return to the traditional workplace, it's time to get our home office arrangements figured out.

That's why I would like to share the important details you need to arrange a healthful workspace and encourage all to invest the time (and sometimes a little bit of money) needed to implement them. Learning these points is key to avoiding injuries, as continued work-from-home policies, where feasible, will help maintain appropriate distancing needed to decrease the spread of COVID-19.

An adjustable chair is the first and most important component of an office set-up. Office chairs include crucial lumbar support and encourage good posture. When your forearms are resting on your desk or table, adjust the chair height up or down until your arms form a right angle. This is an important step in avoiding wrist pain and carpal tunnel, two of the most common office injuries. If, when your arms are in the correct position, your feet are not touching the floor, employ a footstool.

Position your monitor an arm’s length away. (If you can't see the screen from this distance, better go get an eye exam!) And raise the screen so that the top of the screen is eye level. This, too, will encourage good posture.

If you use two monitors, positioning them properly depends on how you use them. If you use them equally, the dividing line between them should be right in front of you. If you use one primarily and the other secondarily, position the more dominant screen directly in front of you. If you use a laptop, consider investing in a riser and an additional keyboard needed to raise the screen to eye level.

Put all of your other tools, including your mouse and phone, within easy reach. If you use the phone a lot, consider investing in a headset.

The only other recommendation I make is to stretch every 15 – 20 minutes. A list of helpful office-oriented stretches is available here. And every hour, be sure to get up and take a short walk or standing stretch.

If you follow these recommendations at home, you will be much more comfortable and are likely to be more productive, too, all while maintaining the social distance we need to keep COVID-19 infections low throughout this next phase of the pandemic. Most importantly, you will save yourself the pain and discomfort of office injury no matter where you're working.

Mark Zimpfer, MD, is a physician at Southwestern Vermont Medical Center's Occupational Health practice. 

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