Objective: The aim of the study was to investigate if Lee Silverman Voice Therapy BIG (LSVT)-BIG®  programme was more effective than conventional physiotherapy for People with Parkinson’s disease(PwPD) in Singapore.

Background: LSVT BIG® is a new therapy technique that incorporates high amplitude movements to target impairments and movement disorders in PwPD. The protocol consists of seven LSVT BIG® exercises along with functional component and hierarchy tasks. Hierarchy tasks are tasks identified by each participant that affect their activities of daily living. Functional component tasks consist of practicing simplified steps required to complete these hierarchy tasks.

Method: A quasi-experimental design study with convenience sampling was conducted. Sixteen PwPD were recruited from National University Hospital outpatient physiotherapy service. The experimental group underwent 16 sessions of LSVT BIG programme over 4 weeks. The control group underwent once a week of conventional physiotherapy for 4 weeks which simulate standard individualised therapy provided in the outpatient setting. Outcomes measured were Mini BESTest, 10-meter walk test (10MWT), UPDRS-III Scale, Parkinson’s Disease Questionnaire 39 (PDQ 39), Clinical global impression-Improvement (CGI-I) Scale and Fatigue severity scale (FSS).

Results: Participants had a mean age of  69.25(SD 5.88) with a mean MMSE score of 27.8(SD 1.71). One participant from the control group dropped out. The pre- and post- scores of UPDRS, mini-BESTest, 10MWT and PDQ-39 were analysed using paired T- test. Statistically significant differences were found in UPDRS (p=0.04) and mini-BESTest (p<0.001) of the LSVT BIG group. For the control group, statistically significant differences (p=.044) were found in the steps taken during the 10MWT.  Analysis using Fisher’s exact test found statistically significant differences in the CGI-I scores between LSVT BIG group and control group (p=.041) but not in the FSS scores.

Conclusion: LSVT BIG program is more effective in improving PD motor symptoms and balance in PwPD compared to conventional therapy. Lack of attrition in the LSVT BIG group demonstrates compliance to the LSVT BIG program. Higher CGI-I scores in LSVT BIG group suggests that participants perceived the program to be better than conventional therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-an-intensive-and-structured-therapy-lsvt-big-in-comparison-to-conventional-therapy-for-people-with-parkinsons-disease-in-singapore/