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Open up and say ‘ah’

BIG and LOUD programs help patients with Parkinson’s disease

Friday, July 19, 2019

If you or someone you love is dealing with Parkinson’s disease (PD) at any stage, it may be time to get BIG and LOUD.

NCH Speech-Language Pathologist Sarah May, left, works on pitch and volume with patient Gail Mathein while husband Bob offers support.

PD can impair a patient’s ability to speak and move. In particular, it can nearly silence speech to barely audible words, turn walking into a shuffling gait and limit the ability to perform normal functional tasks such as dressing, grooming and eating.

Two innovative and proven treatment programs at NCH – LSVT BIG and LSVT LOUD – can help combat these deficits and improve quality of life for patients with PD. LSVT stands for Lee Silverman Voice Treatment, named after the woman for whom the treatment was created.

“Our LSVT programs are designed to treat the bradykinesia and hypokinesia associated with PD, essentially, slowness and decreased movements that impact speech and ambulation,” says Sarah May, Speech-Language Pathologist at the NCH Outpatient and Day Rehabilitation Center at 3300 Kirchoff Road in Rolling Meadows.

“LSVT LOUD retrains the feedback mismatch that PD often causes, helping you develop and become comfortable with a voice you can use without strain, at a loudness level that sounds more audible to friends and family. And LSVT BIG reintroduces you to how normal movement should feel.”

LSVT BIG and LSVT LOUD are effective, evidence-based and empowering treatments for people in all stages of PD. The programs were developed and researched with funding from the National Institutes of Health.

“People can hear me now, even in a crowded restaurant,” says Rolling Meadows resident Gail Mathein, 69, a recent graduate of the LSVT LOUD program. “Even my mother, who is hard of hearing has said, ‘Oh, I can hear you so much better!’”

Whether a patient is participating in LSVT LOUD or LSVT BIG, the timeframe and intensity are the same: four one-hour sessions each week over four weeks for a total of 16 treatments. Patients are given personalized homework so that, whether they have a session or not, they practice their exercises twice a day, every day. The two programs can be taken consecutively, in any order or within the same month – although the exercises for both can be strenuous.

Gail's speech has improved after participating in the LSVT LOUD program at NCH.

“In the LSVT BIG therapy, patients practice larger-than-life movements like walking faster, taking bigger steps, rotating their body and swinging their arms front to back,” says NCH Occupational Therapist Lindsey Butkus. “This helps to retrain the brain to send out signals for a more typical size of movement patterns.”

While LSVT LOUD focuses on vocal loudness exercises, research shows the treatment also can help with other qualities that improve communication, including articulation, intonation, facial expressions and swallowing.

Clinicians report LSVT BIG helps patients with buttoning their clothes, writing and other small motor tasks, as well as large motor movements like dressing, getting up from a chair and getting into bed.

“What I love about the program,” Lindsey says, “is seeing patients with PD resume activities they thought they had lost, like being able to keep working or babysitting their grandchildren.”

Patient Gail Mathein’s husband Bob has been impressed with his wife’s progress in the LSVT LOUD program. “The program not only improved Gail’s speech but it’s opened her up in other ways,” Bob says. “She no longer gets shut out of conversations because people can’t hear her. I no longer need to talk for her. She can speak up for herself when she needs to.”

Now that Gail has graduated from LSVT LOUD, she plans to enroll in LSVT BIG in the fall.

LSVT LOUD and LSVT BIG are currently offered at the NCH Outpatient and Day Rehabilitation Center in Rolling Meadows. Call 847-618-3880 to schedule an appointment.

Additionally, LSVT BIG is available at the NCH Physical Rehab Services in Buffalo Grove. Call 847-459-6100 and select “Option 3.”

Note: Patients need a referral from their physician to enroll.

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