Parkinson’s disease is a chronic and progressing neurological disorder that causes shaking, rigidity and difficulty with balance. According to the National Institutes of Health, Parkinson’s disease affects about half a million people in the Unites States. It is currently the second most common neurodegenerative disease worldwide.

What is Parkinson’s disease?

Parkinson’s disease is caused by a decrease in dopamine, which is the chemical in the brain that helps to transmit signals from one neuron/nerve to another. When we do not have sufficient amounts of dopamine, we have difficulty initiating movements. This causes a multitude of symptoms that affect our ability to walk and perform activities of daily living.

What are the signs and symptoms of Parkinson’s disease?

Symptoms of Parkinson’s disease begin gradually and worsen over time. These can include tremors that often take the form of “pill rolling” where a person rubs their thumb and fingers together as if they are rolling a pill between them. The lack of initiation causes small movements that lack power, such as walking with short, stuttered steps, writing that becomes smaller and a softer, lower voice.

Parkinson’s can also cause a more slouched posture, difficulty with balance and muted facial expressions, often referred to as a “masked face.” Another common symptom of Parkinson’s disease is an increase in muscle stiffness in the upper and lower limbs. If you are experiencing any of these symptoms, it is important to speak with your medical provider for an evaluation. This will allow for early detection and treatment.

What treatments are available for Parkinson’s disease?

Although there is not currently a cure for Parkinson’s disease, there are medications and surgeries that are very helpful. Physical and occupational therapy have a positive impact, too, as they can improve your balance, walking and ability get dressed, write and perform other self-care activities.


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What is LSVT?

Lee Silverman Voice Treatment (LSVT) is an effective treatment option that was developed in 1987. The treatment was researched over a 20-year period with 8 million dollars in funding by the National Institute of Health. LSVT has a speech therapy component, LSVT LOUD and a physical/ occupational therapy component, LSVT BIG. These programs were developed to improve communication and movement for people with Parkinson’s disease.

Research has shown LSVT BIG to be an effective means of improving a patient’s ability to walk with faster, bigger steps, improve balance, increase trunk flexibility and improve overall quality of life.

What does an LSVT BIG program consist of?

The LSVT BIG program consists of 16 sessions. four consecutive days a week for four weeks. Each one-on-one session involves one hour with a certified physical therapist and/or occupational therapist. The sessions focus on intensive, high-effort practice in order to produce the amount of effort required for normal movement. The exercises are specifically tailored to address the unique movement impairments found in Parkinson’s, as well as additional exercises, specific to each individual, based on their interests. The exercises are both intensive and complex, with many repetitions of core movements that are used in daily living. This type of treatment is necessary to optimize learning and carryover into everyday life.

How can I learn more?

IU Health Ball Memorial Hospital Rehabilitation Services will host a free Parkinson’s Seminar 6:30-7:30 p.m. July 27 at 3300 W. Community Drive, Muncie. John Wulff will discuss recent advances in treatments for patients with Parkinson’s disease. The seminar also will feature physical and occupational therapists from IU Health Ball Memorial Rehabilitation Services who are specially certified in Parkinson’s rehabilitation treatments. To register, call 765-741-1073.

Stephanie Harms is physical therapist for IU Health Ball Memorial Hospital Rehabilitation Services. She has been practicing physical therapy for 24 years and specializes in neurological rehabilitation. For more information, visit

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