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Washington Health System Offers Evidence-Based, Proven Therapies to Help People with Parkinson’s
By Daniel Casciato

The Lee Silverman Voice Treatment (LSVT) LOUD has been changing lives with proven therapies that work. LSVT LOUD is an evidence-based, intensive speech and voice treatment technique for adults with speaking difficulties arising from a neurological condition, with a special focus on Parkinson’s disease. This treatment focuses on increasing vocal loudness and is delivered by a speech-language pathologist in sixteen one-hour sessions spread over four weeks.

An LSVT LOUD certification is necessary to provide the most accurate treatment possible to patients according to the best available research, notes Scott Gilbert, M.A. CCC-SLP, speech-language pathologist with Washington Health System.

“A key feature of Parkinson’s disease is deficiency in movement,” says Gilbert. “Common features may include muscle rigidity and stiffness, tremor, and slowness of movements.”

Those with Parkinson’s disease often have a low speaking volume, poor voice quality which often includes vocal hoarseness, reduced accuracy of pronunciation, and monotone speech and loudness. These voice and speech deficiencies ultimately affect how well the speaker is understood, which is a measure called speech intelligibility.

“LSVT LOUD has been a well-researched treatment protocol for the past 25 years with funding from the National Institutes of Health,” says Gilbert. “It is an established program that follows a specific treatment protocol that has the best outcomes when taught specifically by a certified clinician.”

LSVT LOUD treatment consists of:

  • 16 treatment sessions with the speech-language pathologist: 4 consecutive days a week for 4 weeks
  • Individual 1 hour sessions
  • Daily homework practice
  • Daily carryover tasks to promote better learning

According to Gilbert, the ultimate goal of treatment, which has been shown to be effective time and time again in multiple independent research studies, is to improve the speech intelligibility of participants in the following ways:

  • Increased vocal loudness
  • Improved articulation or pronunciation
  • Improved intonation and character of voice
  • Improvements in facial expression necessary for engaging conversation
  • Positive changes in neural functioning related to voice and speech

“If an individual with Parkinson’s disease or a loved one notices a slow but gradual loss of vocal loudness or difficulty understanding speech, it would benefit them to undergo a motor speech evaluation by a licensed Speech-Language Pathologist,” adds Gilbert. “The Speech-Language Pathologist will be able to recommend the best treatment protocol to improve speech skills which may be with the LSVT LOUD treatment program.”

A derivative of this treatment, known as LSVT BIG, is used in treating movement aspects of Parkinson's disease.

“LSVT Big certification is a specialized certification that a Physical Therapist or Occupational Therapist can receive through a comprehensive online or live course that addresses a specific treatment plan for a patient who has Parkinson’s disease,” says Jenny Szuminsky, a physical therapist with Washington Health System’s Outpatient Rehabilitation Services, who has a LSVT Big certification.

Szuminsky says that the LSVT Big certification is important because it is required to carry out the LSVT program. A therapist is not allowed to administer the LSVT Big treatment without completing the certification course.

“The mission of the program is to empower people with Parkinson’s disease to restore and maintain their highest levels of functional communication, mobility and independence in daily life through scientifically supported therapy programs,” she says.

The LSVT BIG program is administered four consecutive days a week for four weeks (16 treatment sessions). 

“Each treatment is one hour long and is provided in a one-on-one setting,” says Szuminsky. “Patients will be evaluated prior to the treatment by their therapist to analyze the patient's mobility and create customized goals for each patient.”

The goals will be customized to each patient and what he or she would like to achieve through the program. 

“Whether it be getting out of the car more efficiently, arising out your favorite chair, or sitting onto the floor to play with your grandchildren, we will design the goals specifically for you,” she adds. “Our ultimate goal is to improve your quality of life, improve your safety, and to move BIG!”

Szuminsky encourages patients and their loves ones to talk with their neurologist or primary care doctor about treatment options available for their diagnosis of Parkinson's disease. 

“You will need a referral from your doctor specifically for the LSVT BIG/LOUD program to get started,” she says. “If you or your loved one is noticing that your mobility has changed since your diagnosis with Parkinson's this program might be right for you.”

Gilbert adds that for individuals with Parkinson’s disease who are prescribed both physical and speech therapy, it is possible to have LSVT LOUD and BIG treatment sessions back-to-back over the course of the treatment protocol.

“This means the client can simultaneously complete both speech and physical therapy treatments in four weeks,” he says.

For more information, visit whs.org.

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