Dynamic balance and gait speed improve in persons with Parkinson´s disease after Lee Silverman Voice Treatment (LSVT)-BIG training: a single subject experimental design study

Abstract

Background: Parkinson ́s disease (PD) is characterised by small, slow movements affecting balance and gait. Lee-Silverman-Voice-Treatment-(LSVT)-BIG is an intensive intervention aiming to restore normal amplitudes of movements. This study aimed to examine whether LSVT-BIG influences dynamic balance and gait in persons with PD.

Methods: We used a Single-Subject-Experimental-Design with three phases; phase A (2 weeks) with no treatment, phase B (4 weeks) with LSVT-BIG-treatment and LSVT-BIG-home-training, and phase C (7–8 weeks) with LSVT-BIG-home-training. Two persons with PD participated. Outcome measures included the Mini-Balance-Evaluation-Systems-Test (Mini-BESTest) with its four subcomponents (‘anticipatory postural adjustments’, ‘postural responses’, ‘sensory orientation’, ‘balance during gait’), the Step-Test (ST) and 10-Meter-Walk-Test-fast (10MWT-fast). The participants were assessed 6, 4 and 8 times during phase A, B and C, respectively. During phase B, they received 16 individual 1-hour LSVT-BIG-treatment sessions and completed between 28 and 39 1-hour sessions LSVT-BIG-home-training. During phase C, they were encouraged to complete one session of home-training every day.

Results: The Mini-BESTest-total-score, ‘balance during gait’, ST and 10MWT-fast improved significantly in both participants. One participant demonstrated improved ‘postural responses’. Two of the Mini-BESTest subcomponents were not sensitive to possible improvements.

Conclusion: LSVT-BIG may have a positive effect on dynamic balance and gait-speed in persons with PD.

Keywords:

• Intensive exercise therapy
• motor training
• physiotherapy
• rehabilitation
• therapeutic exercise
• walking

Aknowledgments

We thank the two persons with PD and physiotherapist Veslem⊘y Heyn for their participation in the study and physiotherapist Lynn Mendicino for valuable feedback on the manuscript.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This study was funded by the Norwegian Fund for Post-Graduate Training in Physiotherapy.