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LSVT therapy helping some Parkinson's patients

Wednesday January 26, 2011

Lois K. Solomon,

Sun Sentinel.com - Sit down. Stand up. Reach up. Reach down. Take big steps.

A new physical therapy program for Parkinson's disease patients is retraining their brains and bodies to make the expansive movements many have lost because of tremors, stiffness and muscle atrophy.

The treatment emphasizes big, repetitive motions and operatic voice exercises to help patients speak louder, correct their posture and walk with agility instead of taking baby steps.

"I look much different from last year," said Rabbi Merle Singer, 71, retired from Temple Beth El of Boca Raton. "I was a prisoner of the disease. Against my will, it was taking over my life."

Singer was diagnosed five years ago and tried several medications and physical therapy programs before finding LSVT — the Lee Silverman Voice Treatment — in the fall. He said he now walks with confidence, without the stiffness and slumping that had characterized his Parkinson's.

Many people are devastated by a diagnosis of Parkinson's, a nervous system disorder that often starts with tremors in the hands and progresses to rigid muscles, weak speech, stooped posture, physical instability and dementia. The disease alters the brain's capacity to monitor itself, so patients often are unaware that they are whispering, hunched over or hardly moving.

There is no cure.

Actor Michael J. Fox, 49, who was diagnosed with the disease at the unusually young age of 30, has become the face of Parkinson's for many Americans. A million Americans, including Muhammad Ali and the Rev. Billy Graham, have the disease, with about 90 percent developing weak voices.

Doctors generally recommend a combination of medication, daily exercise and healthy lifestyle to ease symptoms. But they say some patients have been showing impressive progress with LSVT, which works both the voice and the body.

"I've seen benefits within six months," said Dr. Thomas Hammond, a Pompano Beach neurologist and medical director of the South Florida chapter of the American Parkinson's Disease Association. "Patients have to be motivated no matter what the therapy is."

The treatment is named for an Arizona Parkinson's patient whose family members sought assistance from speech therapists because they could not hear her.

LSVT LOUD, which has been around since 1993, helps patients by making them speak louder, which usually is standard volume to those with normal hearing. LSVT BIG, which is only three years old, includes repetitive physical exercises, some similar to yoga and tai chi, that open the chest and stretch the muscles.

LSVT is being offered by a growing number of speech therapists and rehabilitation centers, but only two sites in Broward and Palm Beach counties have therapists who offer LSVT BIG: HealthSouth in Sunrise and Avenue Therapy and Wellness west of Boynton Beach.

Avenue has devoted its entire practice to helping Parkinson's patients through LSVT. BIG patients occupy the main open room, pulling on ropes, lifting weights, boxing with their therapists and twisting in deep yoga lunges, while LOUD patients can be heard in speech-therapy rooms exercising their voices in operatic crescendos.

Jim Rosenberg, 75, of Boynton Beach, has been exercising at Avenue for the past three months. He became aware of his Parkinson's nine years ago, when his right hand shook as he played the trumpet. He ultimately had to stop playing. Now he takes five medications a day, including Sinemet, which many consider the gold standard for Parkinson's treatment.

Rosenberg said LSVT LOUD helped him with swallowing and drooling problems when he was first diagnosed eight years ago. He said LSTV BIG, which he practices almost every day, has helped his stability, strength and attitude. He said he can now run without falling, although he can't get rid of his tremors.

"There's no question I'm stronger now and my balance is better," Rosenberg said. "I've found exercise is better than all the pills."

For more information on LSVT, contact: Avenue Therapy and Wellness, 12040 S. Jog Road, west of Boynton Beach, 561-733-5083; Sunrise Rehabilitation Hospital, 4399 Nob Hill Road, Sunrise, 954-315-3421, 954-746-1340 (speech therapy); or go to LSVTGlobal.com.

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