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LSVT BIG and LOUD

LSVT BIG and LOUD therapyProgressive neurological diseases such as Parkinson Disease (PD) impair speech, swallowing, limb function, walking, balance, and activities of daily living. Even with medical management (medication, surgery, etc.) these deficits may not be controlled satisfactorily in many individuals with PD, and have a negative effect on quality of life.

Common problems include:

  • Soft voice
  • Mumbled speech
  • Monotone speech
  • Hoarse voice
  • Small, shuffling steps
  • Loss of balance
  • Decreased activity level
  • Fear of going out in the community

The Lee Silverman Voice Treatment (LSVT™) programs for individuals with Parkinson disease have been developed and researched over the past 20 years, beginning with a focus on speech (LSVT LOUD) and later on movement (LSVT BIG). Licensed therapists in physical, occupational and speech therapy must be certified to perform this method of treatment.

The unique aspects of the LSVT programs include the combination of:

  • Increasing amplitude – loudness in speech, bigger movements in the limbs
  • Helping patients recognize that movements with increased amplitude are normal, even if they feel “too loud” or “too big”
  • Training – self-cueing and a home exercise program for long-term maintenance of treatment outcomes

This standardized treatment program consists of:

  • 16 sessions (4 days per week for 4 weeks)
  • Individual one-hour sessions
  • Daily home exercises

Outcomes of LSVT BIG and LSVT LOUD include:

  • Improved vocal loudness
  • Improved speech intelligibility
  • Faster walking with bigger steps
  • Improved balance and daily activities
  • Improved confidence and quality of life!

PWR! (Parkinson Wellness Recovery) certified therapists develop comprehensive exercise programs to address multiple systems and personalized goals for all levels of the disease severity.

PWR! teaches four exercises that target rigidity, bradykinesia (slow movements and reflexes), incoordination, and automaticity.

PWR! techniques use high physical effort, cognitive engagement, attention focus, and emotional engagement. The goal of PWR! is to delay and reduce symptoms of Parkinson’s disease, decrease fall risks, and improve the quality of life and real-world function.

Research suggests that patients should not wait until they begin to experience disability or impaired function to start therapy.


Covenant Therapy Centers accept most insurance and managed care plans. For questions or information about the clinic nearest you call (865) 541-4500.