What is the LSVT BIG program?

The LSVT BIG program is an intensive program designed to assist people with Parkinson’s disease (PD) in creating a “new normal” within the signaling system between the brain and the body in order to normalize their movement. People with PD tend to move differently, in a way that tends to be smaller and slower. Therefore, the program is focused on amplitude which is the amount of perceived effort required to perform movement. LSVT BIG seeks to “recalibrate” a person’s perception of how much effort is required to allow their perceived movements to match what others actually see.

How does LSVT BIG seek to “recalibrate” perceived motion?

The program assists patients in this “recalibration” process through lots of repetition and the “Think BIG!” concept that is used throughout the entire program. LSVT BIG reteaches how normal movement should feel. Most often, to people with PD, these movements feel too big, but the reality is, that “too big” feeling movement tends to be comparable with others normal movement patterns. Over time, this “too big” movement pattern becomes normal feeling and normalizes one’s movement pattern.

What kind of activities can this program help me improve?

LSVT BIG targets all kind of movements and activities! The program involves exercises that target specific deficits related to PD, as well as important functional activities, including walking, sit-to-stand transfers, balance, and more. This program is also designed to target specific activities that are a priority to each individual patient, that are single step activities like opening a door or a multi-step activity like going to a restaurant.

What does the program involve in terms of therapy and home exercise program (HEP)?

The program involves:

  • 16 sessions (4 days a week for 4 weeks)
  • Usually 1-hour sessions
  • Daily homework practice
  • Daily carryover exercises

Any modifications made must be discussed and determined with the therapist but are allowed. If modifications are made, outcomes do not tend to be as effective, and that factor must be taken into consideration. The program may also be extended if needed for benefits of full “recalibration”.

The program is designed to fit people with all levels of function. Each of the daily exercises can be modified to be performed in standing, sitting, or even laying down. Priorities of this program are based on the patient’s priorities for their functional goals.