As soon as I got my unconfirmed initial diagnosis in November 2019, I sat at my notebook and Googled what it took. I quickly came across the LSVT form of therapy, which from then on never let me go.
Strictly speaking, I had no chance to get past LSVT, because (almost) every Parkinson's-relevant webpage deals with it more or less in detail. Exercise tips are offered for sale in numerous videos on YouTube. There are two variants: LSVT LOUD deals with voice, language and swallowing and LSVT BIG focuses on the musculoskeletal system. In this post we deal with LSVT BIG.
I was quickly convinced that BIG was made for me, looked for a nice exercise video and got started before my second confirmation diagnosis. I still do these exercises almost every day and they were an integral part of physiotherapy both in my complex treatment and in my ReHa. So that I don't always have to use the television or smartphone, I have one Exercise cardprinted out on which the individual starting positions are sketched.
What do the therapists say about LSVT BIG?
The LSVT therapists "Medpol" in Kassel have put the LSVT concept very nicely on their homepage:
“The LSVT BIG treatment concept has the same guiding principle as the Lee Silverman Voice Treatment established in speech therapy: Targeted practice of movements with large amplitudes is intended to improve the speed and range of movement in patients with Parkinson's typical movement disorders.
As with LSVT LOUD in speech therapy, particularly intensive training is an important basis for LSVT BIG therapy. Over a period of four weeks, the patient should complete four one-hour training units per week.
The focus of the training is practicing large-scale movements. Parkinson's patients usually perceive their own range of motion and the volume of their voices to be much larger than they actually are. The therapist therefore motivates the patient to carry out every movement with the greatest possible effort and a noticeable expenditure of energy. By intensively repeating the exercises in combination with constant feedback from the therapist, previously unused capacities are activated and expanded. In addition, the patient learns to recalibrate the perception of his movements. LSVT BIG significantly increased the speed, strength and range of movements. Compared to a home exercise program and Nordic Walking, LSVT BIG has been shown to be significantly more effective. "
The German offshoot of LSVT Global gives the following information on his website:
“LSVT BIG is prescribed by neurologists, internists, ENT doctors or general practitioners on Model 13 - Therapeutic Products Ordinance.
The doctor (neurologist) prescribes: 18 x PT individual treatments (16 x LSVT BIG; 2 x findings) of 60 minutes each, 4 therapy units / week.
Since LSVT BIG therapy has not yet been included in the physiotherapy catalog of remedies as a therapy that can be prescribed, the assumption of costs must be applied for individually for the respective patient. Many health insurance companies decide on a case-by-case basis in the interests of their member to cover the costs. You can find a sample application below in the Resources section. Submit the justification letter with a cost estimate via the patient. The treatment first NACH start with the approval of the health insurance company.
The doctor (neurologist) prescribes: 18 x individual treatments (16 x LSVT BIG; 2 x findings) psychological-functional therapy of 60 minutes, 4 therapy units / week
or alternatively: 36 x motor-functional double treatments of two times 30 minutes (32 x LSVT BIG; 4 x findings)
Since the LSVT BIG therapy has not yet been included in the catalog of remedies for occupational therapy as a therapy that can be prescribed, the assumption of costs must be applied for individually for the respective patient. Many health insurance companies decide on a case-by-case basis in the interests of their member to cover the costs. A sample application can be found below under the resources. Submit the letter of motivation with a cost estimate via the patient. The treatment first NACH start with the approval of the health insurance company.
The entire therapy can be issued by the doctor on ONE or divided into three remedy prescriptions.
Note: I was paid for the LSVT BIG therapy by TK without any problems after a telephone request. Occasionally, the staff in the doctor's office do not know how to fill out the forms. I have therefore listed two sample ordinances for download under the help center.