LSVT Big for Parkinson’s Disease

LSVT Big is a physical therapy treatment program for Parkinson’s Disease that has been thoroughly researched and has repeatedly been shown to increase balance, walking, speed of walking, posture and ability to perform activities of daily living with greater ease.  What’s even more exciting is that not only does this treatment program provide fantastic outcomes in participants who work hard—-there are long-lasting effects.

Before diving into the nitty-gritty of what LSVTBig program is and what it entails, here is a video showing a patient’s performance in walking, balance and daily activities before and after LSVTBig treatment (before=gray T-shirt; after=black T-shirt):

Pretty good, right?

LSVT stands for Lee Silverman Voice Training.  That’s right —VOICE training.  Mrs. Lee Silverman was a patient of Dr. Lorraine Ramig who began the research and development  in 1987 of what would become the original LSVT program.  The original program, which is now called  LSVT LOUD, focused on activation of muscles associated with producing loud and clear speech in Parkinson’s patients.  This program uniquely focused on amplitude in retraining the vocal muscles.  The effectiveness of this program lead to the subsequent development of LSVT Big, which also focuses on amplitude, but treats the whole body.  LSVTBig improves muscle activation and increases the size of movements, therefore improving the ability to walk, maintain balance, get in and out of a chair, reach for objects, button up a shirt—-just all around more efficiently carry out activities of daily living.  In short, LSVTBig recalibrates a person’s ability to initiate and produce normal size movements which become slow and of small amplitude in Parkinson’s Disease.

Is LSVT Big helpful for patients at all stages of Parkinson’s Disease?

LSVTBig can improve movement in ALL persons affected by Parkinson’s Disease –regardless of stage of severity. Although, LSVTBig is most effective for early or middle stage Parkinson’s Disease, those affected by late stage Parkinson’s Disease can still make substantial improvements because your physical therapist will tailor the program to best suit your needs.

What does the LSVT Big program consist of?

LSVTBig is provided by your physical therapist in a total of 16, one hour sessions over the course of 4 weeks.  Your physical therapist will work one-on-one with you for 1 hour, 4 days per week completing exercises that emphasize big movements that recalibrate your sense of what it is to move with normal size movements.  See an example of exercises in the video below:

Your physical therapist will also tailor the program to work on tasks that you are especially struggling with so that you can perform them with larger movements and with greater ease and efficiency.  Common examples of tasks that people have had success in improving are large movements such as walking and getting dressed as well as small movements such as writing or buttoning a shirt (see within session improvement in shirt buttoning skills in the video below!).

LSVT Big is life changing….but is a lot of work….are you ready to commit?

Here is a summary of this intensive program:

1.     You will complete an initial evaluation with your physical therapist 60-90 minutes so that you can get to know one another, what your goals are and what your current physical function level is.  For this, you schedule a “New Patient Evaluation” here:

Schedule Appointment

2.     You will establish 16 follow up visits with your therapist.  Each visit is 1 hour long.  You will schedule 4 visits per week for 4 consecutive weeks.  It is VERY IMPORTANT that you don’t have interruption in these 4 weeks or the program overall is less effective.  You and your therapist will schedule these at times that work for you during your initial evaluation.

3.     On the days that you will see your physical therapist, you will also complete exercises for homework outside of therapy.  On days of the week when you don’t see your physical therapist you will do your homework 2 times per day!  This is to ensure that you get the intensive exposure to the exercises that you need to improve which has been shown by research.

For questions about any aspect of the program, please get in touch with Carolyn Weber here.  I look forward to helping you on your journey to better movement ….. and LIFE!


What do you do after you have finished LSVT BIG treatment?  How do you maintain the gains that you have made?

**Do your LSVT BIG exercises daily

**engage in group exercise programs (see Parkinson’s Disease Resources)

**if you would like a specialized personal training program that keeps you challenged with your LSVT BIG exercises, consider enrolling in BIG for Life which is offered through Weber Physical Therapy and Wellness.  BIG for LIFE can also be offered in group settings.  For more information on BIG for Life, click here.

**It is recommended that you have “tune-ups” in physical therapy every 3-12 months depending on your motor symptoms.