A new physical therapy program at Wilson Memorial Hospital is helping patients with Parkinson’s disease to improve function and slow motor deterioration by retraining sensory, motor and cognitive functions through intensive exercise and patient empowerment.
The BIG therapy program is a standardized exercise approach developed from 20 years of research and has shown documented improvements in balance, trunk rotation, and faster walking with bigger steps. The program trains patients to make bigger movements and teaches the amount of effort required to produce normal movements in real world, everyday activities.
“Even patients with slight deficits show measurable improvements within the first 50 minutes of BIG therapy,” said Amy Bruggeman, MPT, one of seven Wilson Memorial therapists certified in the program.
Neta McCorkle, 88-year old Fort Loramie resident, was referred to Wilson Memorial’s PT services by her family medicine physician, Dr. Eric Prenger, back in January of this year. Through collaboration with McCorkle’s neurologist, Dr. Rabindra Kitchener, she was referred to Wilson Memorial’s PT services and completed the BIG therapy program which consisted of one-hour of individual therapy four days a week for four weeks. Homework consists of intensive practice outside the clinical setting two times each day.
“We have seen dramatic improvements in Neta from an overall physical standpoint,” said Dr. Prenger. “Prior to receiving BIG therapy she was hardly moving and now we are seeing a complete transformation on this patient as a result of the BIG therapy program at Wilson Memorial.”
Becky Jelley, daughter of McCorkle is amazed by her mother’s improvements. “I was to the point where I physically could not take care of my mother. She was so sedentary and not moving at all that I was concerned that I couldn’t provide the proper care she needed,” said Jelley. “After completing the BIG therapy session, I feel like I have my mother back with me again. She walks and talks better than ever since she was diagnosed with Parkinson’s disease back in 2011.
Dr. Rabindra Kitchener, McCorkle’s neurologist, shares his insight. “I am pleased with Neta’s improvements from a neurological standpoint. Exercise is essential for people with Parkinson’s disease, not only for physical well-being, but for mental stimulation which is just as important for Parkinson patients.”
The BIG program is an adaptation for muscular disorders of the clinically proven Lee Silverman Voice Training (LSVT) LOUD method, which was developed in 1987 to improve voice and speech in individuals with Parkinson’s disease. Those principles that made LSVT LOUD an effective treatment for the speech motor system have now been successfully applied to the limb motor system. The BIG program applies the principles and approach of LSVT® LOUD to improve major motor skills such as walking, moving of the arms and legs, and balance. BIG training increases the size of limb and body movement (“bigness”) in people with Parkinson’s disease, which leads to improvements in the quality and speed of movement, balance, and quality of life. The program utilizes many repetitions of movements that are used in daily living with varying complexity and intensity to improve carryover once patients complete the program.
“BIG therapy includes repetitive, exaggerated movements to increase dopamine production in the brain and recalibrate muscle function,” said Dr. Kitchener. “Therapists model the structured movements while giving simple commands such as “do what I do” or “move bigger.” This creates an automatic response in the patient’s brain that results in larger, more normalized movements by the patient.”
Along with the BIG therapy program, the LOUD program is offered by speech-language pathologists at Wilson. Because it is common that individuals with Parkinson’s disease have difficulty being loud enough for people to hear, run out of air when talking, and avoid groups of people/conversations because of their voice, the LOUD program strives to increase patient’s success with communication by improving the patient’s voice and speech function. The LOUD program is designed to increase the loudness of one’s voice and improve speech clarity through repetitive tasks with varying complexity that lead to carryover in all daily tasks upon completion of this program.
“How remarkable to see these individuals communicate effectively once again,” remarks Beth Mathewson, MS/CCC-SLP, one of the speech-language pathologists certified in the LOUD program at Wilson Memorial Hospital.
The LOUD Program, like the BIG Program, consists of one-hour individual therapy sessions, four days a week for four weeks. Again, homework consists of intensive practice outside of the clinical setting two times each day.
The BIG and LOUD therapy programs are offered through the PT and Speech services at Wilson Memorial Hospital. Call your doctor for a referral if you think you or a family member may benefit from these programs. To learn more, call the Wilson Memorial Physical Therapy department at (937) 498-5332.