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Lee Silverman Voice Treatment® (LSVT) - Big and Loud

Physical therapy and speech therapy for people with Parkinson’s Disease.

Lee Silverman Voice Therapy® (LSVT) Big and Loud is intense physical therapy and speech therapy is proven for people with Parkinson’s Disease. It helps you to move and to speak better. After completing the outpatient therapy, community classes can help maintain your speech and physical improvements.


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What it is

If you have been diagnosed with Parkinson’s Disease or other medical conditions that impact your movement and speech, you may benefit from LSVT therapy.

If you have Parkinson’s Disease, you may see a decline in your vocal strength, have muffled speech and difficulty swallowing. This can cause you difficulty with communication and eating. You may also have tremors, slower body movements, and impaired balance and stiffness. 

LSVT, which stands for Lee Silverman Voice Treatment (LSVT), is a four-week intense therapy program which has been proven to help people with Parkinson’s Disease better move and speak. LSVT Big is led by occupational and physical therapists and LSVT Loud is led by speech therapists.

If you are not a good candidate for LSVT Big and Loud, a less-intensive traditional therapy may be recommended.

What to expect

LSVT Big: Your physical therapist or occupational therapist will work with you on a series of exercises to improve your major motor skills, such as walking, moving your arms and legs, balance and fine motor skills, such as handwriting.

LSVT Loud: Through a series of vocal exercises, your speech therapist will help you improve the loudness of your voice. Don’t worry. This therapy doesn’t train you to yell or shout, instead it leaves you with a voice people can hear and better understand.

After completing outpatient LSVT therapy, community classes can help maintain your improvements.

Good to know

The LSVT method was developed through rigorous research funded by the National Institutes of Health. LSVT Big and Loud is most effective if begun as soon as possible after a diagnosis of Parkinson’s Disease.

Research outcomes show a dramatic improvement in a person’s balance and speed of walking, movement and daily living tasks. Also, 90 percent of LSVT participants said they saw improvement in the loudness of their speech. A majority of participants maintain this improvement from one to two years after treatment.

Good for treating

In addition to treating people with Parkinson’s Disease, LSVT can also help people with:

  • cerebral palsy
  • Down syndrome
  • multiple sclerosis
  • multiple systems atrophy
  • stroke

Related links

Source: Courage Kenny Rehabilitation Institute
Reviewed by: Jane Chandler, coordinator, Speech Therapy

First published:
Last reviewed: 4/11/2019