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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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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