# What are the Effects of LSVT BIG Treatment on Quality of Life Outcomes in Parkinson’s Disease Patients?

> A review of the effectiveness of LSVT BIG therapeutic techniques on quality of life outcomes for patients with Parkinson’s disease.

## Background
Evidence-Based Physical Therapy (EBP) integrates research evidence, clinical expertise, and user preferences to provide effective care. In 2025, an international course in A Coruña, Spain, brought together over 30 physiotherapy students and 9 teachers from six universities—Savonia University of Applied Sciences (Finland), Universidade da Coruña (Spain), Charles University (Czech Republic), CERRFF and École D´Assas (France), and Escola de Santa María de O Porto (Portugal)—to collaborate on evidence-based research topics. This article presents the findings of the neurological group regarding Lee Silverman Voice Treatment (LSVT) BIG.

## LSVT BIG in Parkinson’s Disease
LSVT BIG is a therapeutic technique for Parkinson’s disease involving progressive, high-effort, high-amplitude movement patterns. These include held seated reaching, repetitive step and reach patterns, functional movements like sit-to-standing, and "BIG" walking. The goal is to counteract the bradykinetic and hypokinetic movement stereotypes associated with the disease. While motor outcome evidence is robust, this review explores the impact of LSVT BIG on quality of life (QoL).

## Methodology
The research team defined a PICO question focusing on:
*   **Population:** Patients with Parkinson’s disease.
*   **Intervention:** LSVT-BIG treatment program.
*   **Control:** Standard physical therapy or usual care.
*   **Outcome:** Quality of life.
*   **Study type:** Randomized controlled trials (RCTs).

Searches were conducted in PubMed, PEDro, and SpringerLink. Five articles were identified, with three selected for detailed review based on relevance and quality assessment using the PEDro scale.

## Review of Selected Studies

### Schaible et al. (2021)
*   **Participants:** 44 patients.
*   **Method:** Randomized into LSVT-BIG (n=14), intensive personalized physiotherapy (n=15), and conventional physiotherapy (n=12).
*   **Findings:** All groups showed improvements in QoL (PDQ-39), but no significant differences were found between the groups.
*   **PEDro Score:** 7/10 (Limitations: lack of blinding and allocation concealment).

### Aytutuldu et al. (2024)
*   **Participants:** 32 patients.
*   **Method:** Compared LSVT BIG to Progressive Structured Mobility Training (PSMT).
*   **Findings:** LSVT BIG showed significant improvements in balance confidence and functional activity, but no significant difference in overall QoL between groups.
*   **PEDro Score:** 7/10 (Limitations: lack of blinding and absence of long-term results).

### YoungSeok and DeokJu (2022)
*   **Participants:** 14 patients.
*   **Method:** Intervention group (LSVT BIG + occupational therapy) vs. control group (occupational therapy + relaxation/stretching).
*   **Findings:** The intervention group showed significant improvement across all QoL domains.
*   **PEDro Score:** 6/10 (Limitations: lack of blinding).

## Conclusion
The current evidence suggests that the effect of LSVT BIG on quality of life in Parkinson’s disease patients is not definitively significant. Limitations in existing research—such as small sample sizes, lack of blinding, and short intervention periods—hinder conclusive results. Further high-quality studies with long-term follow-ups are recommended.

## Authors
*   **Aapo Kuokkanen**, physiotherapy student, Savonia, University of Applied Sciences, Kuopio, Finland
*   **Eliška Coufalová**, physiotherapy student, Charles University, Czech Republic
*   **Vincent Leone-Ganado**, physiotherapy student, Charles University, Czech Republic
*   **Dagmar Pavlu**, PT. Assoc. Prof. Charles University, Czech Republic.
*   **Ivana Vláčilová**, PhD., PT. Charles University, Czech Republic.
*   **Marja Äijö**, PT, PhD Principal Lecturer of gerontology and rehabilitation, Savonia, University of Applied Sciences, Kuopio, Finland.
*   **Veronica Robles García**, PhD. PT. OT. Associate Professor, University of A Coruña, A Coruña, Spain.
*   **Zeltia Naia Entonado**, PhD. PT. University of A Coruña, A Coruña, Spain.
*   **María Vilanova Pereira**, PhD., PT. University of A Coruña, A Coruña, Spain.
*   **Adrien Pallot**, PT, MSc, Lecturer at École D´Assas, France.
*   **Aurel Bellaïche**, PT, Lecturer at CEERRF, France.

## References
*   Choi, Y., & Kim, D. (2022). Effects of Task-Based LSVT-BIG Intervention on Hand Function, Activity of Daily Living, Psychological Function, and Quality of Life in Parkinson’s Disease: A Randomized Control Trial. Occupational therapy international, 2022, 1700306. https://doi.org/10.1155/2022/1700306
*   Ernst, M., Folkerts, A. K., Gollan, R., Lieker, E., Caro-Valenzuela, J., Adams, A., Cryns, N., Monsef, I., Dresen, A., Roheger, M., Eggers, C., Skoetz, N., & Kalbe, E. (2024). Physical exercise for people with Parkinson’s disease: a systematic review and network meta-analysis. The Cochrane database of systematic reviews, 4(4), CD013856. https://doi.org/10.1002/14651858.CD013856.pub3
*   Kaya Aytutuldu, G., Ersoz Huseyinsinoglu, B., Karagoz Sakalli, N., Sen, A., & Yeldan, I. (2024). LSVT® BIG versus progressive structured mobility training through synchronous telerehabilitation in Parkinson’s disease: A randomized controlled trial. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 45(7), 3163–3172. https://doi.org/10.1007/s10072-024-07322-0
*   Rodriguez-Blazquez, C., Forjaz, M. J., Lizcano, E., Martínez-Martín, P., & the International Parkinson and Movement Disorder Society Non-Motor Study Group. (2020). Symptom burden among individuals with Parkinson disease: A national survey. Neurology and Therapy, 9(1), 135–148. https://doi.org/10.1007/s40120-020-00193-1
*   Schaible, F., Maier, F., Buchwitz, T. M., Schwartz, F., Hoock, M., Schönau, E., Libuda, M., Hordt, A., van Eimeren, T., Timmermann, L., & Eggers, C. (2021). Effects of Lee Silverman Voice Treatment BIG and conventional physiotherapy on non-motor and motor symptoms in Parkinson’s disease: a randomized controlled study comparing three exercise models. Therapeutic advances in neurological disorders, 14, 1756286420986744. https://doi.org/10.1177/1756286420986744