Be BIG! Get LOUD! Therapies for people with Parkinson’s

By on March 16, 2019

Occupational Therapist Angela Goetchsch (right), works with Mindy Thompson to improve movement. Thompson is the first patient to complete the LSVT BIG program at TOBH.

Parkinson’s disease, or simply Parkinson’s, is the most common of a group of motor system disorders. It is a degenerative disease that impairs swallowing, limb function, gait, balance, and activities of daily living. It is usually associated with the following symptoms:

• Tremors or trembling of the arms, jaw, legs, and face
• Stiffness or rigidity of the limbs and trunk
• Slowness of movement
• Impaired balance and coordination
• Soft, mumbled, monotone, or hoarse voice

The cause of Parkinson’s is unknown. Medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Although the disease may appear in younger people (even teenagers), it usually affects people in late middle age.

The Outer Banks Hospital (TOBH) recently built a state-of-the-art rehabilitation therapy services building on the north end of its campus where there are three therapists certified to work with patients who experience the symptoms caused by Parkinson’s.

Angela Goetsch, OTR/L, CLT, and Lisa Minerich, OTR/L, both occupational therapists, are certified in the LSVT BIG program, and Nicole Kalkhoff, MA, CCC-SLP, speech pathologist, is certified in the LSVT LOUD program.

LSVT BIG

The LSVT BIG program focuses on training individuals with Parkinson’s and other neurological conditions to use bigger physical movements throughout their daily lives, which helps them stay active.

Mindy Thompson, the first patient to complete the LSVT BIG program at TOBH, was diagnosed with Parkinson’s in 2007 and referred by her neurologist to the four-week program with Goetsch.

The therapy, which is composed of intense exercising four times a week, involves big body movements that are timed and includes things like walking six feet as fast as possible, using the hands for hand-eye coordination, and negotiating over blocks, around objects, and in between lines.

The first visit with Goetsch entails an initial assessment to get baseline times for endurance, speed, balance, and coordination. The goal is to improve the times throughout the program. The patient is also given a set of exercises to do twice a day on his or her own. Knowing how to do these allows the patient to continue the benefits of the program once the sessions are over.

During the final session, Thompson’s fast walking time decreased by 5.4 seconds compared with her initial effort. “My motor skills and my back stiffness are much better,” she says. “This program gives you strategies to deal with your balance and strengthens your muscles so you can sustain longer periods of movement.”

LSVT LOUD

Michael Thompson (no relation to Mindy) was diagnosed with Parkinson’s in 2012. While driving down the Outer Banks Bypass, he noticed the new rehabilitation therapy services building and stopped in for a visit. This is how he found out about the LSVT LOUD program. With Parkinson’s, Thompson’s voice has gotten progressively hoarse and quiet. Being asked to repeat himself during conversations was frustrating for him, so he asked his neurologist to refer him for therapy.

Like LSVT BIG, this program includes 16 sessions, four days a week for four weeks. The hour-long program is combined with daily homework practice that is done on the patient’s own time.

During the hour session, Thompson takes a breath and then begins voice exercises, speaking sentences, reading out loud, and engaging in conversation. Using a computer software program, the therapist watches to see whether the decibels are in the range they should be. If they are too low, she repeatedly instructs, “Catch your breath and BE LOUD!” Kalkhoff’s motto is: It’s not about how you look, but how you sound. Often during the session, she tells Thompson to take a sip of water to help with the overuse of his vocal cords.

In the last session, Thompson’s volume was exceptional and he conversed with his wife using great enunciation. She attends the sessions as well so that she can learn how to work with Thompson at home. “It’s a lifelong program,” explains Thompson. “I got my voice back!”

Kalkhoff noted that Thompson now has the tools he needs to be loud in his everyday life and, if a refresher session is needed, he can simply ask his physician for another referral.

To learn more about the LSVT BIG and LOUD programs at TOBH, please call 252-449-4560. We can help those who want to continue to be BIG and LOUD as they learn to function with Parkinson’s.


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See what people are saying:

  • William M Downing

    I RECENTLY COMPLETED THE LSVT BIG AND LOUD PROGRAM FOR PEOPLE WITH PARKINSON’S CONDUCTED AT THE OB HOSPITAL’S OUTPATIENT REHAB SERVICES BUILDING. I CAN HARDLY EXPRESS HOW THRILLED I WAS WITH THE RESULTS-SIGNIFICANT IMPROVEMENT IN EVERY ASPECT- THAT OCCURED AFTER ONLY 4 WEEKS THAT JUST FLEW ON BY. THESE IMPROVEMENTS WERE THE DIRECT RESULT OF THE PROFESSIONALISM ,KNOWLEDGE, KINDNESS, CARING, AND ENTHUSIASM OF THE 3 INDIVIDUALS; LISA MINERICH, ANGIE GOETSCH, AND NICOLE KALKHOFF, MENTIONED IN YOUR ARTICLE. THEY PRESENTED NEW CHALLENGES TO TASKS THAT I HAD SUCCESSFULLY COMPLETED AND KEEP CHEERING ME ON TO SUCCEED. THEY TRULY ARE INTERESTED IN HELPING EACH INDIVIDUAL LIVE TO THE FULLEST.
    I WOULD ALSO LIKE TO COMMENT THAT THE FACILITY ITSELF WAS A PLEASURE TO WORK IN.
    THANK YOU!

    Tuesday, Mar 19 @ 6:39 pm