Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019


Frey Law, Laura


Background: Parkinson's disease is the most prevalent progressive neurological disease with motor deficits. The hallmark symptoms include bradykinesia, tremor, rigidity, and postural instability. The primary focus of physical therapy is to address these symptoms. The purpose of this case study is to present the use of the Lee Silverman Voice Treatment (LSVT)-BIG as a Parkinson's disorder intervention, along with a critical review of the literature. Case Description: The patient is a 71-year-old man diagnosed with Parkinson’s disease during the summer of 2019. Before any noticeable symptoms, the patient reported being active and independent without any self-reported limitations. The patient became progressively limited with overall mobility over a period of a year. The patient's primary complaints included poor standing and walking balance with a history of falls as well as difficulty performing activities of daily living. Intervention: The patient participated in LSVT-BIG that included daily exercises, patient-identified functional activities, and gait training. The program was four weeks in duration and consisted of four consecutive one-hour sessions each week. LSVT-BIG is amplitude-based training with the cue for "big" as the sole focus. Outcome Measures: 10-Meter Walk Test, the Timed-Up and Go Test (with and without a cognitive task), the Functional Gait Assessment, and the Five Times Sit to Stand. Discussion: The patient made improvements in all outcome measures, demonstrating the potential benefits gained following the completion of LSVT-BIG. This case study provides additional research to the limited collection of evidence that currently exists for the support of LSVT-BIG. However, more high-quality randomized trials are needed to further assess the true efficacy of LSVT-BIG.


Physical Therapy; rehabilitation; LSVT-BIG; Parkinson's Disease; parkinsonism; amplitude-based; exercise


12 pages


Copyright © 2019 Reginald Hochstedler