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Contributions by Olivia Lizak and Debbie Struiksma, PT, NCS

What is LSVT BIG & LOUD Therapy?

Parkinson's Disease

Parkinson's disease is a brain disorder that causes uncontrollable shaking, stiffness, and difficulty with balance and coordination. It usually begins gradually and worsens over time. As the disease progresses, people may have difficulty walking and talking.

About 10 million people worldwide have Parkinson's disease. It causes many problems with movement and motor control, making it hard for people to do their basic daily activities. LSVT-BIG & LOUD is a program that was developed to treat the speech and swallowing symptoms associated with Parkinson's disease and the functional difficulties associated. The "BIG" component uses large amplitude movements to increase a client's ability to move with high intensity. The "LOUD" component was developed to improve vocal quality and breathing. The high intensity of these two components carries over into the daily functional activities clients do by improving voice quality, range of motion, strength, and motor planning. These specific exercises that include large, loud, exaggerated movement patterns result in smoother, larger movements and can improve quality of life.

The Benefits of LSVT BIG & LOUD Therapy

  • Improved Movement
  • Improved Balance
  • Improved Quality of Life
  • Improved Voice Quality

How Does LSVT BIG & LOUD Therapy Work?


LSVT BIG & LOUD is a standardized, research-based therapy protocol. It is delivered by LSVT BIG & LOUD-certified physical therapists. It differs from other forms of therapy in that it focuses entirely on the amplitude of movement (big movements) to recalibrate the body to what "normal" movements should feel like. LSVT BIG & LOUD is an intensive program that is administered in 16 sessions over a single month to address the unique movement and voice impairments of people with Parkinson's disease with specific exercises focused on core movements used in daily living. The outcomes include reduced fall risk, improved movement amplitude, ability to walk, improved voice quality, and quality of life.

After LSVT BIG Treatment

Periodic "Tune-Up" Sessions – To maintain your progress and maximize the benefits of your physical therapy, we recommend that you schedule tune-up sessions.
Join Exercise and Speech Groups – Patients who participate in LSVT are encouraged to join community-based exercise groups to be active with other people who have completed the program.
Homework videos – Gives patients the opportunity to practice their home exercises daily.

Find a clinic near you here and learn how you can manage your Parkinson's symptoms and slow the progression of the disease. Moving matters, as does a positive outlook on life.

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