The effects of standard and modified LSVT BIG therapy protocols on balance and gait in Parkinson's disease: A randomized controlled trial

Sefa Eldemir; Kader Eldemir; Fettah Saygili; Cagla Ozkul; Rezzak Yilmaz; Muhittin Cenk Akbostancı; Arzu Guclu-Gunduz

doi:10.1002/brb3.3458

The effects of standard and modified LSVT BIG therapy protocols on balance and gait in Parkinson's disease: A randomized controlled trial

Brain Behav. 2024 Mar;14(3):e3458. doi: 10.1002/brb3.3458.

Authors

Sefa Eldemir¹, Kader Eldemir², Fettah Saygili³, Cagla Ozkul⁴, Rezzak Yilmaz⁵, Muhittin Cenk Akbostancı⁵, Arzu Guclu-Gunduz⁴

Affiliations

¹ Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Türkiye.
² Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ordu University, Ordu, Türkiye.
³ Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Türkiye.
⁴ Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Türkiye.
⁵ Department of Neurology and Ankara University Brain Research Center, Ankara University, School of Medicine, Ankara, Türkiye.

Abstract

Background: Lee Silverman voice treatment (LSVT) BIG is an exercise program developed for patients with Parkinson's disease (PwPD), consisting of sets of exercises performed for 4 consecutive days a week for 4 weeks. However, the standard protocol suggests a treatment frequency difficult to follow for most patients who have difficulties reaching rehabilitation clinics. Our aim was to compare the standard LSVT BIG protocol with a modified LSVT (m-LSVT) BIG protocol (twice a week in the clinic for 4 weeks and twice a week at home for 4 weeks).

Methods: In this randomized controlled trial, 16 PwPD (aged 18-80 years, Hoehn and Yahr stages I-III) were recruited into two groups. The LSVT group received standard LSVT BIG training (four times per week for 4 weeks at the clinic). The other group was given m-LSVT BIG exercises, but unlike the LSVT group, the m-LSVT group exercised twice a week at the clinic and twice a week at home for 4 weeks. The Berg Balance Scale was used to assess functional balance. Biodex Balance System was used to assess laboratory balance measures. Timed Up and Go test and G-Walk sensor system were used to assess functional mobility and spatiotemporal gait analysis.

Results: Significant group-by-time interactions on the eyes open-firm surface score of the modified clinical test of sensory integration of balance (F = 10.138, p = .007) and gait cycle symmetry index (F = 10.470, p = .010) were found to be in favor of the LSVT group. Additionally, post hoc analyses revealed that both groups significantly improved postural stability, gait speed, motor symptoms, and functional mobility (p < .05).

Conclusion: The results revealed the beneficial effects of the modified protocol on balance and gait in PwPD, as well as the superiority of the standard LSVT BIG protocol. The m-LSVT BIG protocol may be an effective intervention method, especially for PwPD who have difficulty adapting to the treatment frequency of the standard protocol.

Keywords: LSVT BIG; Parkinson's disease; balance; physiotherapy.

Publication types

Randomized Controlled Trial

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Exercise Therapy
Gait
Humans
Middle Aged
Parkinson Disease* / complications
Parkinson Disease* / drug therapy
Postural Balance
Time and Motion Studies
Young Adult

Grants and funding

This research was supported by Türkiye Bilimsel ve Teknolojik Araştırma Kurumu (TUBITAK, Scientific and Technical Research Council of Turkey) for open access.