Date Presented 03/23/24
Evidence supports movement programs to lessen motor impairments in people with Parkinson’s disease; however, less is known about interventions that improve activities of daily living (ADL) task performance. This study reports increased speed in ADL performance after Lee Silverman Voice Treatment–BIG programming.
Primary Author and Speaker: Ingrid Anna Franc
Contributing Authors: Barbara M. Mollere Doucet, Mark Blanchard
Lee Silverman Voice Treatment (LSVT-BIG®) is a motor retraining program that emphasizes increased amplitude of movement in persons with Parkinson’s disease (PD). Recent studies suggest that LSVT-BIG can have positive effects on motor impairment areas such as timed walking, reaction time, step length, and reaching (McConnell et al., 2017; Fox et al., 2012); however, few studies provide objective outcomes for changes in bradykinesia (slowness of movement) during ADL task performance.
PURPOSE: To investigate changes in speed of movement during functional tasks following participation in LSVT-BIG.
DESIGN: Quasi-experimental, one-group pretest posttest design. Outpatients (N=60) diagnosed with PD from three clinics were assessed by treating clinicians using systematic task timing before and after participating in LSVT-BIG.
METHOD: Investigators standardized three functional tasks to use as outcome measures. Tasks were modified from currently existing assessments and included 1) donning/doffing a sock; 2) donning/doffing a coat; and 3) inserting a pillow into a pillowcase. Directions for set up, administration, and timing were provided to clinicians. Time to complete each task was recorded before and after LSVT BIG program; pre and post data were compared using paired t-tests or analogous nonparametric tests when indicated.
RESULTS: Average time to complete each task for patients after LSVT-BIG program was significantly lower than pre-intervention time: Sock- 73.8s pre vs. 59.3s post (p=0.02); Coat- 73.0s pre vs. 54.7s post (p=0.02) Pillow- 87.5s pre, 69.9s post (p<0.001).
CONCLUSION: Findings suggest that participation in LSVT-BIG could positively impact bradykinesia associated with PD. Impact statement: This investigation has meaningful implications for occupational therapy practice as these preliminary data support the use of LSVT-BIG to potentially decrease the extended time spent in activities of daily living (ADL) performance for many persons with PD.
References
McDonnell, M. N., Rischbieth, B., Schammer, T. T., Seaforth, C., Shaw, A. J., & Phillips, A. C. (2017). Lee Silverman voice treatment (LSVT)-BIG to improve motor function in people with Parkinson’s disease: a systematic review and meta-analysis. Clinical Rehabilitation, 32(5), 607–618. https://doi.org/10.1177/0269215517734385.
Fox,C., Ebersbach, G., Ramig, L., & Sapir, S. (2012). LSVT-LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson’s disease. Parkinson’s Disease, 391946, 1–12. https://doi.org/10.1155/2012/391946.
