Parkinson's Patients Take BIG Steps

The Messenger - Fall 2010 Issue. Comments by Brian Cooper, OTR, Residential Home Health, Member, MPF Professional Advisory Board.

Preliminary studies show that patients with Parkinson's disease who regularly do certain exaggerated movement exercises are seeing reductions in their symptoms. In an article published in MedPage Today, www.medpagetoday.com/MeetingCoverage/AAN/19593, the senior editor reported on a study of 20 patients who underwent a supervised program called LSVT BIG for eight weeks and then worked with the Nintendo Wii video gaming system in the final four weeks.

The patients participated in a supervised open-floor series of exercises, which stresses large extensions and movements of the arms and legs. The Wii activities encouraged patients to swing their arms and move vigorously. At the end of the study, all patients showed measurable improvements.

Locally, Brian Cooper, an occupational therapist with Residential Home Health, explained that BIG is based on a successful speech therapy program for PD patients, called LSVT (Lee Silverman Voice Treatment). That therapy helps participants enhance sound and articulation by speaking at an exaggerated volume.

"LSVT BIG teaches patients how to move better, focusing on high amplitude movements to overcome perceptual deficits," said Cooper. "It shows patients, through modeling, how to make bigger movements, then reinforces through practice how to perform high intensity, high amplitude exercises."

Cooper said that patients are taught to take "great big" steps with arms extended and swinging forcefully. They are encouraged to overcome the typical shuffling steps of PD. The concept behind the program is to increase awareness of how movements are made and, by exaggerating the way they are performed, learn more effective techniques. In addition to improving walking, BIG therapy sessions can help patients work on other daily functions such as dressing.

In Michigan, certain physical and occupational therapists have been trained in BIG therapy. Typically, the therapy is conducted in one-hour sessions four times a week on an outpa¬tient basis and is customized when appropriate. After about three or four weeks, patients can practice on their own. Contact your physician for a referral. For more information, call your physician, or (866)902-4000.