Cynthia M. Fox, PhD, CCC-SLP
Cynthia Fox, PhD, CCC-SLP, received her doctorate degree in speech and hearing sciences from the University of Arizona, Tucson. Her training focused in the areas of neuroscience and motor control. She is an expert on rehabilitation, neuroplasticity, and the role of exercise in the improvement of function consequent to neural injury and disease. She has…Read full bio
Laura Gusé, MPT
Ms. Guse received her master's in physical therapy from the University of North Dakota. She has more than 15 years of experience working with adults with neurological disorders, with a special focus on Parkinson's disease and multiple sclerosis. She was LSVT BIG certified in 2009 and now serves as chief clinical officer of LSVT BIG.…Read full bio
Erica Vitek, MOT, OTR, BCB-PMD, PRPC
Erica graduated with her master's degree in occupational therapy from Concordia University Wisconsin in 2002. Erica works for Aurora Health Care at Aurora Sinai Medical Center in downtown Milwaukee, Wisconsin. She has attended extensive postgraduate rehabilitation education in the area of Parkinson's disease and exercise, including the Parkinson's Foundations Allied Team Training for Parkinson's. She…Read full bio
1. The Growing Need for Coordinated Interprofessional Care for People With Parkinson's Disease (PD)
The prevalence of Parkinson’s disease, a complex neurodegenerative disorder, is growing rapidly. This necessitates a greater number of therapists who have expertise in providing patient-centered care as part of a highly collaborative interdisciplinary team.
2. Amplitude: A Common Target
Hypokinesia is a primary motor symptom of PD that has broad effects across the speech and limb motor systems. Because of this, amplitude is an ideal common singular target for the allied health team as they work to improve patients’ mobility, activities of daily living, and speech. LSVT BIG and LSVT LOUD are examples of amplitude-focused therapies that show evidence of cross-system treatment effects extending beyond amplitude.
3. Training Amplitude: How Does It Work?
LSVT BIG and LSVT LOUD are parallel treatment protocols that are amplitude-focused and drive activity-dependent neuroplasticity. At the same time, they address multiple nonmotor symptoms that can be barriers to generalization of improved mobility, function with ADLs, and communication in everyday life.
4. Training Amplitude: Why Does it Work?
More than 30 years of published research, including multiple randomized controlled trials and numerous other treatment studies, provide evidence that LSVT BIG and LSVT LOUD are effective in eliciting positive treatment outcomes in people with PD and other neurological conditions. With a singular treatment focus of amplitude, patients are offered a comprehensive, unified, and practical way to approach management of their symptoms.
5. Interprofessional Implementation of LSVT LOUD and LSVT BIG Across Speech, Physical, and Occupational Therapies
Ongoing and close collaboration between physical, occupational, and speech therapy is important for efficient and effective care in people with chronic neurological conditions like PD. Partnership with other medical providers and community-based professionals who serve people with PD is also important in providing optimal, patient-centered care.
6. Starting Small But Thinking BIG! How Can You Begin to Improve Care for People With PD?
Through a case example of a person who received LSVT BIG physical and occupational therapy and LSVT LOUD speech therapy, you will see how discipline-specific goals can be functional and salient and can carry a common theme of amplitude.
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