Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2018


Laura Frey Law


Background: Parkinson’s disease is a progressive, neurodegenerative disorder of the central nervous system and is the most commonly diagnosed movement disorder. It can affect an individual’s gait, balance, and quality of life. The purpose of this case report is to outline a multidisciplinary approach to rehabilitation, that incorporates Lee Silverman Voice Treatment (LSVT) BIG, for an individual with Parkinson’s disease to address strength, range of motion, fine motor, gait and balance deficits. Case Description: The patient is a 61-year-old male, who was diagnosed with Parkinson’s disease at the age of 56. Secondary to Parkinson’s disease, the patient has gross and fine motor impairments that negatively impact his quality of life and independence with activities of daily living (ADL’s). Intervention: Interventions were implemented by an occupational therapist and a physical therapist, both certified in LSVT BIG. The patient attended six, 60-minute treatment sessions with each therapist, for a total of twelve treatment sessions. Each therapist led the patient through the LSVT BIG protocol, and then implemented additional interventions for the remainder of their session based on patient goals and examination findings. Additional interventions included gait, balance, and stair training, sit-tostands, and specific fine motor tasks which included cutting food, practicing handwriting, donning/doffing clothing, etc. Outcome Measures: Primary outcome measures utilized by the physical therapist included lower extremity manual muscle testing, cervical range of motion, the Berg Balance Scale, and the Activities-Specific Balance Confidence (ABC) Scale. The occupational therapist utilized grip and pinch strength, the Box and Block Test, and the Nine-Hole Peg Test as primary outcome measures for their treatment interventions. Discussion: After 12 sessions, the patient demonstrated improvements in balance, gait, strength, range of motion, and finger dexterity. This case report demonstrates how a multidisciplinary treatment approach for individuals with Parkinson’s disease can address multiple facets of the disease, with meaningful improvements in both gross and fine motor function observed.


Parkinson’s Disease; neurology; gait training; physical therapy; rehabilitation


15 pages


Copyright © 2018 Paige Kelly