Parkinson's Disease Treatment Program
Parkinson Wellness Recovery (PWR) & LSVT Big
What is Parkinson's Disease?
Parkinson’s Disease is the second most common neurodegenerative disease, after Alzheimer‘s. Approximately 1 million Americans live with Parkinson’s Disease and that number is expected to double by 2030. This chronic, progressive disease usually presents in people over the age of 60, but it can present earlier in life as well.
Parkinson's Disease results from a loss of dopaminergic neurons in the substantia nigra with approximately 50-60% of cell death at diagnosis. Causes of Parkinson's Disease remain unknown, however most cases are thought to be a result of interplay between genetics and environment.
Often, the first symptom of Parkinson's disease is tremor (trembling or shaking) of a limb, especially when the body is at rest. The tremor commonly begins on one side of the body, most frequently in one hand. Other common symptoms include slow movement (bradykinesia), an inability to move (akinesia), rigid limbs, a shuffling gait, and a stooped posture. People with Parkinson's disease often show reduced facial expressions and speak in a soft voice.
Since Parkinson's Disease symptoms exacerbate over time, patient's can begin to have trouble with simple tasks such as getting in and out of bed or the bath, walking or talking. People with Parkinson's Disease may also experience “freezing,” where they have extreme difficulty starting to walk again after having stopped, or difficulty stopping walking once started. This may lead to falls in the home and when out in the community.
Other Parkinson's Disease symptoms may include anxiety, depression, sleep disorders, constipation, sensory changes and dementia. There is also a significant impact of Parkinson's Disease on families and caregivers, since the need for constant care increases as the disease progresses.
While there is no cure for Parkinson's Disease, medications and other interventions such as Deep Brain Stimulation have been found to provide dramatic relief from symptoms. Physiotherapy is another effective method of conservatively managing the symptoms of Parkinson's Disease and improving quality of life.
Benefits of Exercise for Parkinson’s Disease
Research shows that specialized exercise and rehabilitation are essential to limiting the impact of Parkinson’s disease and other movement disorders. Specialized exercise as prescribed by your St. Catharine’s Physiotherapist at LV Physiotherapy helps to maintain and improve flexibility, strength, endurance, posture and balance. Rehabilitation will help the individual with Parkinson’s Disease or other movement disorder to re-learn how to move and function more normally in order to minimize the challenges of Parkinson’s Disease on daily life.
Newly Diagnosed with Parkinson’s Disease? LV Physiotherapy can help you to stay mobile and fit.
Have you had Parkinson’s Disease for some time? LV Physiotherapy can help you improve your mobility, function, and fitness level regardless of your current level of ability.
What is LSVT Big for Parkinson's Disease?
LSVT BIG is a an intensive, amplitude focused physical and occupational therapy approach
developed from principles of the effective Parkinson’s specific speech treatment LSVT LOUD®.
LSVT programs have been developed and scientifically researched over the past 25 years with funding from the National Institutes of Health.
Research on LSVT BIG has documented improved ratings on tests of motor functioning in people
with Parkinson disease following treatment including:
- Faster walking with bigger steps
- Improved balance
- Increased trunk rotation
- Improvements in activities of daily living such as bed mobility
- Improved UPDRS Motor Score
LSVT BIG is a standardized treatment protocol, which is customized to the unique goals of each
patient including both gross and fine motor skills. LSVT BIG can be adapted or progressed in order
to meet each patient’s needs across a range of disease severity and presenting impairments.
LSVT BIG treatment consists of:
1) 16 sessions: 4 consecutive days a week for 4 weeks
2) Individual 1 hour sessions
3) Daily homework practice (all 30 days of the month)
4) Daily carryover exercises (all 30 days of the month)
LSVT BIG is being delivered by over 10,000 certified LSVT clinicians in 38 countries.
View LSVT Big Fact Sheet>>
What is PWR for Parkinson’s Disease?
PWR!Moves® is a Parkinson’s Disease-specific skill training program aimed at slowing and stopping the progression of Parkinson’s Disease. LV Physiotherapy utilizes the PWR!Moves® program at our clinic to help meet the goals of our clients by maintaining or restoring skills that help them to live life optimally.
PWR!Moves® is an evidence-based program developed by Dr. Becky Farley, PhD, MS, PT, as the Evolution of her original LSVT BIG® exercise program. It focuses on functional skill training that is most affected by bradykinesia. The program also incorporated various exercises to target symptoms of rigidity, incoordination and decreased balance to help improve postural stability and reduce the risk of falls.
Research shows that exercise slows the progression of Parkinson’s Disease. The exercises completed in this program mimic everyday movements such as dressing, walking, getting out of bed and standing up. PWR!Moves® trains function as “Big” and as “Fast” as possible to allow the recruitment of the basal ganglia circuits in the brain.
The motor cortex is more affected in people with Parkinson’s Disease, so they rely more on their executive function to move and walk around. This leaves little to spare in their cognitive reserve when it comes to multi-tasking, which can be exhausting for someone in a busy environment or performing simple tasks like “walking and talking”.
This program allows us to reinforce the basal ganglia circuits to allow individuals to move more freely and to have more cognitive function left over when doing so, thereby improving overall quality of life.
PWR!Moves® - The BASIC4 are performed with large amplitude, high effort and attention to action in multiple postures (floor, all 4’s, sitting, and standing). They specifically target 4 skills shown by research to interfere with mobility in people with Parkinson’s Disease (Antigravity extension, weight shifting, axial mobility and transitional movements).
This Parkinson’s exercise program is suitable for all individuals with Parkinson’s Disease and allows individuals to improve their overall function by incorporating dual-task and cognitive exercises to allow individuals to be more confident with multi-tasking in the real world.
PWR!Moves® can be combined and progressed into a stand-alone group exercise program or integrated into ANY exercise program, ANY activity (functional activity, activity of daily living, recreation, sports and hobbies), in ANY setting (community group or rehab 1:1) and is run by our Physiotherapists at LV Physiotherapy.
How are PWR & LSVT Big Different from other Physiotherapy for Parkinson's Disease?
Traditional Physiotherapy includes general conditioning exercises, functional training, gait and balance training, with the use of external cues to reduce the “shuffling” pattern of walking and improve the quality of movements – devices such as metronomes, laser lights, taped markers on the floor, mirrors and simplifying tasks are ways to do this. These methods of treatment have had varying degrees of success based on the severity of the Parkinson’s Disease symptoms in each patient.
This traditional approach breaks down each action but requires patients to remember multiple instructions for each movement goal. In LSVT Big, patients simply focus on one goal, to think BIG!
More Information and Resources on LSVT Big
For more information on LSVT Global or to find a Certified LSVT Therapist in your area visit: www.lsvtglobal.com
To access Free Webinars visit: http://www.lsvtglobal.com/patient-resources/free-webinars
LSVT Big Videos
Treatment for Parkinson's Disease in Niagara
LV Physiotherapy offers Parkinson Wellness Recovery (PWR) & LSVT Big treatment for Parkinson's Disease