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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How to Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

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