Jenna Fratterelli, PT, DPT, demonstrates the exaggerated movements that help Parkinson’s Disease patients recalibrate perception of how normal movements should feel.

“Parkinson’s Disease is a neurodegenerative movement disorder that occurs when there is a decrease in dopamine, a neurotransmitter that helps regulate movement,” says Jenna Fratterelli, PT, DPT.  “As a result, both cognitive and automatic components of motor skill performance as well as procedural motor learning are affected.”



“LSVT BIG Therapy is a standardized treatment protocol that uses high intensity repetitive exercises.  It promotes learning and neuroplasticity (the brain’s ability to change) by having patients increase their amplitude with movement by “Thinking BIG!”  in order to override the symptoms of Parkinson’s Disease. LSVT BIG differs from conventional therapy as it focuses on increasing amplitude across all motor systems. It teaches a patient how to use increased effort to produce larger motions, much like everyone around them, by ‘recalibrating’ the patient’s perception of how normal amplitude of movements should feel.”



“Each session begins with the patient completing the LSVT exercises. This allows the clinician to make adjustments and progress the program accordingly. It is also expected that the patient will complete the exercises once a day for 15-20 minutes on treatment days and twice a day for 15-20 minutes on non-therapy days. The patient is also provided with a carry-over homework assignment at the end of each session.”


The Goal of LSVT BIG



“The goal of LSVT BIG therapy is to have a patient use their bigger movements ‘automatically’ in his or her daily living and to be able to maintain these bigger movements over time.”




“I have had a great experience working with the PD population especially by using the LSVT BIG program. I have seen firsthand how this program allows my patients to make improvements in overall movement and mobility. More importantly, I have noticed how empowered the patients have become when able to do activities that they enjoy with increased ease and confidence. This program has also impacted my daily clinical practice immensely as I frequently apply the training methods from this program to other neurological populations as well.”



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