Lee Silverman voice treatment

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A man with Parkinson's disease showing a flexed walking posture pictured in 1892. Photo appeared in Nouvelle Iconographie de la Salpètrière, vol. 5.

The Lee Silverman voice treatment - LOUD (LSVT LOUD) is one of the most widely practiced treatments for speech disorders associated with Parkinson's disease (PD). It focuses on increasing vocal loudness and has an intensive approach of one month.[1][2] Speech therapy and specifically LSVT LOUD may improve voice and speech function in PD.[1]

A derivative of the Lee Silverman voice treatment, known as LSVT BIG, is used by speech and language therapists, physiotherapists, and occupational therapists to promote high-amplitude movements in people with Parkinson's disease.[3] The quick, explosive movements characteristic of LSVT® BIG are aimed at reversing one of four cardinal movement symptoms in PD, bradykinesia.[4] The Berlin Big Study[5] compared the effectiveness of three distinct exercise programs in people with mild to moderate Parkinson's disease. Subjects were randomly assigned to receive either one-on-one LSVT BIG training, group Nordic walking training, or domestic unsupervised exercises. At the conclusion of the training period, the LSVT BIG group demonstrated a significant improvement in unified Parkinson's disease rating scale (UPDRS) motor score and 10-m timed up and go test timing compared with the Nordic walking and home exercise group.


  1. ^ a b The National Collaborating Centre for Chronic Conditions, ed. (2006). "Other key interventions". Parkinson's Disease. London: Royal College of Physicians. pp. 135–146. ISBN 1-86016-283-5. 
  2. ^ Fox CM, Ramig LO, Ciucci MR, Sapir S, McFarland DH, Farley BG (November 2006). "The science and practice of LSVT/LOUD: neural plasticity-principled approach to treating individuals with Parkinson disease and other neurological disorders". Seminars in Speech and Language 27 (4): 283–99. doi:10.1055/s-2006-955118. PMID 17117354. 
  3. ^ http://www.lsvtglobal.com/index.php?action=home
  4. ^ Farley, BG; Koshland, GF (Dec 2005). "Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson's disease.". Experimental brain research. Experimentelle Hirnforschung. Experimentation cerebrale 167 (3): 462–7. doi:10.1007/s00221-005-0179-7. PMID 16283401. 
  5. ^ Ebersbach, Georg; Ebersbach, Almut, Edler, Daniela, Kaufhold, Olaf, Kusch, Matthias, Kupsch, Andreas, Wissel, Jörg (15 September 2010). "Comparing exercise in Parkinson's disease-the Berlin BIG Study". Movement Disorders 25 (12): 1902–1908. doi:10.1002/mds.23212.