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PT for Parkinson’s helps Social, Physical, and Cognitive Symptoms.

By: Kathy Hubbard

Physical therapist Cher Cassidy starts the session by saying, “Be big! Big posture! Big hands!” with the biggest smile that totally lights up the room. I’m at BGH’s Performance Therapy Services with Marilyn Barnes, 83, who seven years ago was diagnosed with Parkinson’s disease (PD) and is now taking the LSVT Big/Loud classes.

LSVT stands for Lee Silverman Voice Treatment and was developed by Dr. Lorraine Ramig for a woman named, you guessed it, Lee Silverman, who had PD. LSVT Loud is speech therapy that improves communication in daily living, and LSVT Big trains to improve mobility and movement used in daily life.

PD is a progressive brain disorder that affects the nervous system and parts of the body controlled by nerves. At first it may present as just a slight tremor in one hand. Then your face may show little expression, your arms don’t swing while you’re walking, your family members complain that you’re mumbling, or your handwriting gets smaller and smaller.

To understand how LSVT Big/Loud therapy works, imagine for a minute that you want to walk across the room. Your brain tells your muscles to do that, and you walk across the room automatically. You don’t have to think, put your right foot forward, put weight on your foot, lift your left foot, etc. But, with PD that’s often the case. So, the exercises Barnes was working on in the session I attended were geared toward rewiring her brain to do the functions and to do them in a big way, automatically.

“We’re working on amplitude of movement,” Cassidy explained. That’s making the movement as big as possible. Cassidy started by having Barnes march while lifting her knees and counting.

“Count louder; I can’t hear you over the intercom,” Cassidy said. Barnes complied with a great big grin on her face. Exercises continued with her walking forward and backward, writing in large letters on the window, walking and stopping when told, and walking over and back across an obstacle course of oddly shaped objects.

Barnes’ daughter is Shannon Barnes, BGH’s Chief Human Resources Officer. She said she hadn’t sat in on a class for a long time and was astounded at the progress her mother had made. I even noticed a difference in Marilyn Barnes’ demeanor from when we started to when the therapy session ended an hour later.

LSVT Big/Loud therapy is intensive. It’s a four-week class, four times a week, for an hour each. Plus, there’s homework. Participants are given exercise assignments that are modified from the ones overseen by a physical therapist for safety reasons.

Next week, when she’s completed the LSVT Big/Loud therapy, Barnes will move on to Rock Steady Boxing. What’s that? I’ll tell you. I went directly there after I left Barnes.

Rock Steady Boxing was founded by Scott C. Newman, who worked with a former boxer, Vince Perez, to develop a training system that would help him live more independently after he was diagnosed with PD at age 40.

I got to Performance Therapy Services’ Ridley Village location about a half hour into the one-and-a-half-hour session led by coach Kristy Winter and Kris Gonzales-Rahrig, PT, DPT, CLT (physical therapist, Doctor of Physical Therapy, certified lymphedema therapist). There were six participants, four of whom had PD and the other two were spouses. The whiteboard on the wall had the day’s schedule of exercises, which included a warmup, stretching, and three rounds of balance and cognitive actions.  

After the exercises, the boxing gloves and counterbalanced, free-standing punching bags, including one that actually had a rubber head on it, were out. Tape on several of them had numbers. Coach Kristy had an app on her phone that called out instructions, including specific numbers and moves. It was very physical, and, of course, I could only think how therapeutic it is to punch out any frustrations one might have.

One participant told me that one of the best parts of taking this class is the camaraderie they all feel for each other. The whiteboard said it best. “We’re all in this fight. Working out together gives us light. By training together, we increase our might. Friendship together keeps hope in sight. Go Rock Steady!”

Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee on April 10, 2024.

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