2. DPT graduate, Misericordia University, Dallas, PA, 18612, USA.
Background: Parkinson’s Disease can lead to deficits that impair quality of life. Common impairments include freezing of gait, balance deficits, and slowed gait speed. There has been limited research done involving the effects of the Lee Silverman Voice Treatment (LSVT) BIG home exercise program (HEP) and T’ai Chi Exercises on an individual with late stage Parkinson’s Disease. The purpose of this case study was to determine the effectiveness of T’ai Chi and the LSVT BIG HEP in improving gait and balance deficits in a subject with Parkinson’s Disease.
Methods: The subject was an 82-year-old woman with Parkinson’s Disease who was classified as Stage 4 on the Hoehn and Yahr scale. She used a power wheelchair independently, and a walker with supervision. The subject participated in an 18-week study with three phases of 6 weeks. Phase A incorporated the LSVT BIG HEP; phase B included a T’ai Chi video program; and Phase C included a combination of both programs. Gait and balance were assessed every six weeks, and after 12 weeks of no intervention.
Results: Walking velocity and step length increased slightly following the first two phases of treatment, and then declined in the follow-up phase. The subject’s Berg Balance score improved from the beginning of the study to the end of Phase B. The subject declined only slightly after twelve weeks without intervention.
Conclusion: This subject with Stage 4 PD demonstrated improvements in balance and gait with supervised exercise that included the LSVT BIG HEP and T’ai Chi exercises. Without intervention, there was a slight decline beyond baseline status. These results indicate a need for more research looking at how exercise affects subjects who are functioning at Hoehn and Yahr Stage 4. Continued supervised exercise may help maintain or improve function in the later stages of Parkinson’s disease.
Keywords: Parkinson’s Disease, LSVT BIG, Tai Chi, Parkinson’s, high amplitude exercise, case study