Effects of Lee Silverman Voice Treatment® BIG on At-Home Physical Activity in Individuals with Parkinson’s Disease: A Preliminary Retrospective Observational Study
Source abstract
Abstract
In individuals with Parkinson’s disease (PD), bradykinesia severity is related to physical activity (PA) inside homes. We aimed to investigate the effectiveness of the Lee Silverman Voice Treatment (LSVT)® BIG intervention in increasing at-home PA in individuals with PD. To evaluate the effect of the intervention, we compared pre- and post-intervention scores on the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts 3 and 2, as well as the time spent at home in three categories of PA intensity. For statistical testing, paired t-tests were used when the data met the assumptions of normality, and the Wilcoxon signed-rank test was applied otherwise. Differences were considered statistically significant at p < 0.05. This preliminary retrospective observational study included 10 eligible individuals with PD (4 males). The participants’ mean age was 71.0 ± 10.8 years, with median Hoehn and Yahr stage 3 [interquartile range: 1 to 4]. The MDS-UPDRS Part 3 score, bradykinesia score calculated from a part of that score, and the MDS-UPDRS Part 2 score significantly improved after the intervention (Wilcoxon signed-rank test, p < 0.05). The time spent in sedentary behavior (SB) significantly decreased from 516.4 ± 72.6 to 484.0 ± 70.0 min, whereas that spent in light PA (LPA) significantly increased from 137.8 ± 46.2 to 169.5 ± 32.1 min (paired t-test, p < 0.05). The time spent on moderate-to-vigorous PA (MVPA) did not change significantly (paired t-test, p = 0.533). The results suggested that LSVT® BIG is an effective intervention for increasing at-home PA in individuals with PD. In addition, regarding the specific details of the increase, the time spent on MVPA may not change, and the increase may be mainly attributed to increased LPA and reduced sedentary time.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Voice and Speech Disorders · Parkinson's Disease Mechanisms and Treatments · Balance, Gait, and Falls Prevention
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Rehabilitation, Kawamura Hospital, 1-84 Daihannya Akutami, Gifu 501-3144, Gifu Prefecture, Japan
Graduate School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi Prefecture, Japan
Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi Prefecture, Japan
Department of Neurology, Kawamura Hospital, 1-84 Daihannya Akutami, Gifu 501-3144, Gifu Prefecture, Japan
References (55)
Show source-provided references
1. GBD 2016 Neurology Collaborators (2019). Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol., 18, 459–480.
2. The emerging evidence of the Parkinson pandemic10.3233/JPD-181474 ↗
3. Parkinson’s Foundation P4 Group. Prevalence of Parkinson’s disease across North America10.1038/s41531-018-0058-0 ↗
4. Projections for prevalence of Parkinson’s disease and its driving factors in 195 countries and territories to 2050: Modelling study of Global Burden of Disease Study 202110.1136/bmj-2024-080952 ↗
5. Hoehn and Yahr stage 3 and postural stability item in the movement disorder society-unified Parkinson’s disease rating scale10.1002/mds.27453 ↗
6. Current perspectives on the assessment and management of gait disorders in Parkinson’s disease10.2147/NDT.S304567 ↗
7. Pahwa, R., Lyons, K., and Koller, W.C. (2020). Assistive technologies in Parkinson’s disease. Handbook of Parkinson’s Disease, CRC Press. [5th ed.].
8. A cane improves postural recovery from an unpracticed slip during walking in people with Parkinson disease10.2522/ptj.20120036 ↗
9. Parkinson’s disease: Clinical features and diagnosis10.1136/jnnp.2007.131045 ↗
10. Pharmacological management of PD motor symptoms: Update and recommendations from an expert
11. Enhancement of executive functions but not memory by multidomain group cognitive training in patients with Parkinson’s disease and mild cognitive impairment: A multicenter randomized controlled trial
12. Effectiveness of long-term physiotherapy in Parkinson’s disease: A systematic review and meta-analysis10.3233/JPD-212782 ↗
13. Parkinsonism: Heterogeneity of a common neurological syndrome10.4414/smw.2011.13293 ↗
14. Stoker, T.B., and Greenland, J.C. (2025, November 01). Parkinson’s Disease: Pathogenesis and Clinical Aspects, Available online: http://www.ncbi.nlm.nih.gov/books/NBK536721/.
15. Activities of daily living and quality of life in persons with newly diagnosed Parkinson’s disease according to subtype of disease, and in comparison to healthy controls10.1111/j.1600-0404.2010.01344.x ↗
16. Bradykinesia akinesia inco-ordination test (BRAIN TEST): An objective computerised assessment of upper limb motor function10.1136/jnnp.67.5.624 ↗
17. Hirakawa, Y., Sakurai, H., Takeda, K., Koyama, S., Iwai, M., Motoya, I., Kanada, Y., Kawamura, N., Kawamura, M., and Tanabe, S. (2025). Relationship between each of the four major motor symptoms and at-home physical activity in individuals with Parkinson’s disease: A cross-sectional study. Neurol. Int., 17.10.3390/neurolint17090139 ↗
18. Definition, measurement, and health risks associated with sedentary behavior10.1249/MSS.0000000000000517 ↗
19. Light-intensity activity attenuates functional decline in older cancer survivors10.1249/MSS.0000000000000241 ↗
20. MacIntosh, B.R., Murias, J.M., Keir, D.A., and Weir, J.M. (2021). What Is Moderate to Vigorous Exercise Intensity?. Front. Physiol., 12.10.3389/fphys.2021.682233 ↗
21. Training BIG to move faster: The application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease10.1007/s00221-005-0179-7 ↗
22. Comparing exercise in Parkinson’s disease--the Berlin LSVT®BIG study10.1002/mds.23212 ↗
23. LSVT LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson disease
24. Intensive amplitude-specific therapeutic approaches for Parkinson’s disease10.1097/01.TGR.0000318898.87690.0d ↗
25. Effect of Lee Silverman Voice Treatment® BIG on the major motor symptoms in persons with moderate Parkinson’s disease: An observational study10.36150/2499-6564-N711 ↗
26. Effect on gait speed, balance, motor symptom rating, and quality of life in those with stage I Parkinson’s disease utilizing LSVT BIG®
27. Application of LSVT BIG intervention to address gait, balance, bed mobility, and dexterity in people with Parkinson disease: A case series10.2522/ptj.20130232 ↗
28. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies10.1016/j.ijsu.2014.07.013 ↗
29. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable10.1177/0962280215588241 ↗
30. The Mini-Mental State Examination (MMSE)
31. Systematic review of levodopa dose equivalency reporting in Parkinson’s disease10.1002/mds.23429 ↗
32. Parkinsonism: Onset, progression and mortality10.1212/WNL.17.5.427 ↗
33. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results10.1002/mds.22340 ↗
34. Randomized controlled trial of community-based dancing to modify disease progression in Parkinson disease10.1177/1545968311421614 ↗
35. ParkWest Study: ParkWest Principal investigators; Study personnel; ICICLE-PD Study. Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson’s disease10.1016/j.parkreldis.2020.05.034 ↗
36. Measurement of physical activity divided into inside and outside the home in people with Parkinson’s disease: A feasibility study10.1111/jep.14251 ↗
37. Validity of estimating physical activity intensity using a triaxial accelerometer in healthy adults and older adults10.1136/bmjsem-2019-000592 ↗
38. Accuracy of 12 wearable devices for estimating physical activity energy expenditure using a metabolic chamber and the doubly labeled water method: Validation study10.2196/13938 ↗
39. Effects of walking speed and step frequency on estimation of physical activity using accelerometers10.2114/jpa2.30.119 ↗
40. Nagaki, K., Fujioka, S., Sasai, H., Yamaguchi, Y., and Tsuboi, Y. (2022). Physical activity and its diurnal fluctuations vary by non-motor symptoms in patients with Parkinson’s disease: An exploratory study. Healthcare, 1.10.3390/healthcare10040749 ↗
41. Number of days required for reliably estimating physical activity and sedentary behaviour from accelerometer data in older adults10.1080/02640414.2017.1403527 ↗
42. How many days of monitoring predict physical activity and sedentary behaviour in older adults?10.1186/1479-5868-8-62 ↗
43. Physical activity in the United States measured by accelerometer10.1249/mss.0b013e31815a51b3 ↗
44. Ito, H., Yokoi, D., Kobayashi, R., Okada, H., Kajita, Y., and Okuda, S. (2020). The relationships between three-axis accelerometer measures of physical activity and motor symptoms in patients with Parkinson’s disease: A single-center pilot study. BMC Neurol., 2.10.1186/s12883-020-01896-w ↗
45. Testing self-report time-use diaries against objective instruments in real time10.1177/0081175019884591 ↗
46. Hillsdale, L. (1988). Statistical Power Analysis for the Behavioral Sciences, Erlbaum Associates. [2nd ed.].
47. Clinical and biomechanical factors in the sit-to-stand decline in Parkinson’s disease10.1002/mdc3.70122 ↗
48. Relation of chair rising ability to activities of daily living and physical activity in Parkinson’s disease10.1186/s40945-020-00094-8 ↗
49. Quantitative clinical assessment of motor function during and following LSVT-BIG® therapy10.1186/s12984-020-00729-8 ↗
50. Long-term effects of exercise and physical therapy in people with Parkinson disease10.1038/nrneurol.2017.128 ↗
51. Effects of physical activity in Parkinson’s disease: A new tool for rehabilitation10.5662/wjm.v4.i3.133 ↗
52. Short-term effect and its retention of LSVT® BIG on QOL improvement: 1-year follow-up in a patient with Parkinson’s disease
53. Physical activity, exercise, and physiotherapy in Parkinson’s disease: Defining the concepts
54. Feil, K., Allion, S., Weyland, S., and Jekauc, D. (2021). A systematic review examining the relationship between habit and physical activity behavior in longitudinal studies. Front. Psychol., 12.10.3389/fpsyg.2021.626750 ↗
55. Promoting habit formation10.1080/17437199.2011.603640 ↗