THINK “BIG” – Parkinson’s Disease strategy
Physiotherapy technique showing improved motor function in patients suffering with Parkinson’s disease.
Bradykinesia – a common symptom displayed in Parkinson’s disease meaning slowness of movement whereby physical movements are much slower than normal. This makes activities of daily living difficult and can result in distinctive slow, shuffling walk with very small steps, often leading to an inability to initiate movement ‘freezing’ in a certain position.
Physiotherapy and exercise prescription has proven to provide symptom management showing improvements in balance, gait, flexibility, strength and co-ordination. Evidence supports physical exercise in Parkinson disease patients promoting brain health and optimising brain function via activity dependent neuroplasticity mechanisms. These mechanisms help restore damaged pathways and improve the efficiency of undamaged pathways.
There are many treatment techniques focused at improving Parkinson’s disease symptoms including Tai chi, Pilates, Stretching, gait re-education, cardio vascular based exercises, personalised home exercise programme to name a few.
LSVT BIG is another treatment technique aimed at achieving a single goal of THINKING BIG! LSVT BIG targets bradykinesia by training a patient to use a bigger effort in all aspects of daily living with repetitive practice to teach the patient to produce and perceive the action of normal movement. The LSVT exercise protocol is delivered in 1:1 sessions by a Physiotherapist. Patients are treated for an hour4 days per week for 4 weeks and during the therapy sessions are taught to make a big effort through big steps and big gestures. Also, through intensive motivation and feedback on performance, patients complete goal orientated activities of daily living using high amplitude movements which are transferable to life after the sessions are complete. The aim is to achieve maximal neuroplasticity within the brain to improve Parkinson symptoms through high effort and intensive repetitive practice within the LSVT BIG programme.
Examples of BIG exercises include:
• Floor to ceiling stretch in sitting.
• Side to side stretching in sitting.
• Stepping and reaching forwards/ sideways and backwards
• Rock and reach forwards/backwards/sideways
• BIG rolling
• BIG sit to stand with varying arm movements
• Walking and turning
• BIG activities of daily living (targeted to specific requirements of patient)