The JFK BIG study: the impact of LSVT BIG® on dual task walking and mobility in persons with Parkinson's disease

Abstract

[Purpose] The aim of this study was to test the hypothesis that Lee Silverman Voice Treatment-BIG decreases the negative impact of hypokinesia on dual task performance in persons with Parkinson's disease. [Subjects and Methods] The records of 114 patients with Parkinson's admitted to outpatient rehabilitation at a suburban hospital were reviewed. Demographics and data for 8 outcome measures were extracted for subjects that completed 14 of 16 sessions of BIG. 93 of these subjects had records of pre and post-test Timed Up and Go, Timed Up and Go Motor, and Timed Up and Go Cognitive scores. Average age was 68.4 years (SD=10.6) and average disease duration was 4.9 years (SD=5.3). [Results] Subjects demonstrated statistically significant improvements for Timed Up and Go (3.3 SD=4.5), Timed Up and Go Motor (4.4 SD=5.8) and Timed Up and Go Cognitive (4.7 SD=5.4). Concurrent motor and cognitive performance remained stable. Dual task cost decreased at a statistically significant level for Timed Up and Go Cognitive (7% SD=31%) but not Motor (4% SD=32%). [Conclusion] These findings suggest that cueing strategies associated with LSVT BIG become internalized and decrease the negative impact of hypokinesia on mobility and cognitive performance while performing two tasks simultaneously in persons with Parkinson's.

Keywords: Dual task; LSVT BIG; Parkinson’s disease.

Fig. 1.

LSVT BIG intervention substantially decreased TUG MOTOR and TUG COG dual task cost in subjects that initially presented with DTC >10%. Note that 24 subjects improved their DTC score to within normal limits.

Fig. 2.

Dual task interference is reduced as a result of LSVT BIG intervention. Change scores are z-normalized to eliminate the impact of change score magnitude27⁾.