Medical Reviewers: Physical Therapist Lisa Ebb, PT, MS, NCS, and Speech Language Pathologist Karen Edick, PT, MS
“Because You Asked” focuses on topics suggested by our readers. If you want to suggest a topic for future issues of this newsletter, please email them to email@example.com.
BIG: Own Your Motion
Parkinson’s disease is a chronic, progressive neurodegenerative movement disorder.
Characteristic primary symptoms of Parkinson’s include tremors, rigidity, slow movement (bradykinesia) and poor balance. Additionally, many people suffer with difficulty walking (referred to as “parkinsonian gait”) as well as reduced vocal loudness. But there is hope.
According to Johanna Murphy, PT, MS, director of MedStar Georgetown’s Physical Medicine and Rehabilitation, “The key to living well with Parkinson’s is getting the right medical care and treatment. That regimen should include physical rehabilitation and speech therapy, which can help patients improve their quality of life.”
One such offering at MedStar Georgetown is the Lee Silverman Voice Treatment® (LSVT) BIG and LOUD program, which is designed to counter the physical as well as vocal symptoms of Parkinson’s disease. A two-part program, it consists of intensive, hourlong, one-on-one sessions that occur four days a week for a month. As part of the regimen, patients perform at-home exercises daily.
Only specially certified therapists, such as those found at MedStar Georgetown, may offer the BIG and LOUD program.
“Parkinson’s disease affects the center of your brain which controls automatic movement,” says physical therapist Lisa Ebb, PT, MS, NCS, a board certified neurologic clinical specialist. “That’s why so many people with the disease walk with short, shuffling steps and barely swing their arms.”
Through BIG, Lisa helps patients improve their ability to rise out of a chair, write more legibly and avoid falls by working on balance and walking techniques. It takes dedication, commitment and daily practice—such as repeatedly shifting your standing weight from right to left, front and back—to see results.
“You have to consciously think about what you’re going to do, and make forceful, purposeful movements,” Lisa says.
With intense and repetitive practice, many people can regularly achieve the movements they want. Patients who start therapy soon after diagnosis have the most success.
LOUD: Can You Hear Me Now?
LOUD can help the approximately 60 to 70 percent of Parkinson’s patients whose voices are hard to hear by increasing their overall speaking volume. Other benefits include improved speech clarity, swallowing and facial expressions, which can also be hampered by the disease.
“LOUD uses a series of specially designed exercises—in therapy and at home—to strengthen and tone the vocal cords, such as saying ‘ah’ for as long and loudly as you can,” says speech language pathologist and board-certified neurologic clinical specialist Karen Edick, PT, MS. “It also improves breath support, which is important for voice projection.”
By the end of the program, most people’s loudness increases by 10 percent or more. That’s enough, says Karen, to help many patients regain confidence in their ability to communicate.
“It’s very frustrating not to be able to make yourself heard and understood, especially by loved ones,” she says. “After LOUD, most people are happy with the results and become much more sociable again.”
As a National Parkinson Foundation’s “Center of Excellence”—one of only 43 worldwide and the only one in the metropolitan area — MedStar Georgetown’s experienced and interdisciplinary team provides comprehensive and patient-centered care. That type of approach includes treatments that are tailored to each person’s unique needs and nearly always includes rehabilitation therapy.
Should I try BIG and LOUD?
All physical and speech therapies require a referral by your doctor. With this referral, a MedStar Georgetown therapist will carefully assess you and determine the best treatment plan for you. MedStar Georgetown also offers a group exercise program and a communication support group, both of which are free and open to community members who have Parkinson’s disease.