b'GO BIG . GO LOUD .Experience Enhanced Quality of Life.F or those experiencing movement or speech problems due to Parkinsons disease, a specialized therapy program focusing on big movements and loud speaking may be the ticket to a signifi cant improvement in quality of life. LSVT BIG, LSVT LOUD, and SPEAK OUT! are three intensive therapy programs developed for people living with Parkinsons disease. The emphasis of these programs is on exaggerated activity done with purpose to compensate for Parkinsons movement and speech symptoms, says Betsy Cheney, Director of Rehabilitation Services at Beth Sholom.Betsy explains that for movement issues, patients are encouraged to move big in amplifi ed ways, whetherThe thinking behind LVST and Parkinson Voice Project is theyre walking, buttoning a shirt, pulling change fromthat by retraining sensory, motor and cognitive functions pockets, or drawing. BIG trains people to exaggerate theirthrough moderate to intensive exercise and patient physical movements so movements that seem too big toempowerment, patients can improve function and them are actually appropriate. potentially slow deterioration, says Betsy. Interventions For speech, the focus is on speaking with intent. Therapistsalso increase speech intelligibility and facial expression and target voice production defi cits such as softness andimproves confi dence.diculty forming sounds clearly. Therapy may includeAt Beth Sholom, LVST LOUD, BIG and Parkinson Voice practicing sustaining a vowel sound, as well as readingProject (PVP) programs like SPEAK OUT! are off ered on aloud and speaking activities that increase in length andan inpatient and outpatient basis. Both programs are complexity. administered with intensityfour times per week for four weeksand are tailored to each individual patient. The majority of participants Ive worked with fi nd LSVT to be extremely helpful and report improvements in overall quality of life, says Betsy. BIG patients typically notice improvements in walking, getting up and down, and rolling in bed as well as overall fl exibility, balance, strength and endurance. LOUD patients often notice improvements in speech volume and voice quality.The people who tend to benefi t the most from LSVT BIG, LSVT LOUD and PVP are early on in their diagnosis or have minimal to moderate functional loss. But, because the program is specifi c to individual patients and their needs, results are based on personal goals.9'