LSVT Therapy is Changing Lives of Parkinson’s Patients in Arizona
By June C. Hussey

Parkinson’s disease, the incurable, progressive disorder of the nervous system that affects movement for thousands of Arizonans, has met a formidable new enemy in Arizona and elsewhere. The enemy is not a drug. It comes in the form of speech and physical therapies known as LSVT BIG and LSVT LOUD.  While not cures, these therapies are proving successful in restoring considerable function in patients who receive the treatments.

Pioneered in part at the University of Arizona by LSVT Global’s co-founder Dr. Cynthia Fox, these therapies are giving Parkinson’s patients right here in Arizona and around the U.S. new hope as more and more therapists become LSVT-certified to provide the therapy as part of skilled home care services.

Watermark at Home, with offices in Scottsdale and Southern Arizona, recently became the first home care agency in Arizona -- and one of the first in the nation -- to offer these breakthrough treatments for Parkinson’s patients at home. Using LSVT therapies (an acronym for Lee Silverman Voice Treatment), Watermark at Home’s specially-trained and certified speech, physical and occupational therapists are now producing life-changing results for home care patients like Roberto.
Roberto, who lives in Mesa AZ, was 67 when his bout with Parkinson’s began three years ago. The early signs of Parkinson’s can be difficult to assess. As with Roberto, they usually begin with a tremor in one hand. Other signs, such as change in muscle tone, facial “freezing,” problems walking, a soft voice and unsteady posture become clearer as the illness progresses.
Parkinson’s is one of the most common nervous system disorders of the elderly. It most often develops after age 50 though sometimes it occurs in younger adults. Many know it as the disease that forever changed the bright acting career of Michael J. Fox, who was first diagnosed with young-onset Parkinson’s disease in 1991 at the age of 30.
Once diagnosed with Parkinson’s, patients like Roberto are usually prescribed medications designed to quiet their symptoms. Until recently, medications have provided the only hope. Like others affected by the disease, Roberto and his family felt otherwise helpless as they watched their loved one’s condition deteriorate. Within two years, Roberto could no longer get himself out of a chair or out of bed without the assistance of his wife or a family member.

In the summer of 2011, Roberto and his family enlisted the support of Watermark at Home. Larry Bates, one of Watermark at Home’s first LSVT-certified physical therapists, began treating Roberto in his home four times a week. He progressed so rapidly that his family was amazed. Less than two weeks into his therapy sessions, Tresa Stapleton, RN, Watermark at Home’s Clinical Supervisor, accompanied Larry to Roberto’s home to observe his progress in person. Here’s what she witnessed.

When I arrived with Larry, I noticed a large number of cars parked in the driveway. As we walked inside, we were greeted by a group of friendly family members who had come to support their father during his LSVT BIG treatment session. Larry was almost two weeks into his treatment plan which is four times per week for four weeks with Roberto. Directly after Larry and Roberto were given some bottled water, I was directed to my place on the couch to watch the session. There was an air of excitement among the family members. They were eager to see how well their husband and father would do, since they were noticing improvements in his mobility.
Facing each other while sitting on chairs, Larry called out “1, 2, 3.” to Roberto. Roberto parroted back. Together, therapist and patient did the exercise in unison. They extended their arms out in front, gently rocked forward to a standing position while keeping their arms outstretched for balance, and returned to a sitting position on the chair. During the previous visit, Roberto was able to do this three times. Today he did it ten times. With each successfully completed sequence, the members of the family cheered and clapped. As Larry went through the exercises, I was impressed with the loving involvement of Roberto’s family. His son and son-in-law stood by, one on the left and one on his right, as he was making the sweeping BIG arm gestures, in case he lost his balance. They gently coached, “higher” while he was reaching over to his right then left sides.  His daughter was holding his 11-month old grandson who was watching all of the activity with shy attentiveness. His wife was watching from the kitchen, smiling and noticing every improvement with loving pride. 
Since commencing his LSVT BIG Therapy, Roberto’s quality of life has improved immensely. In fact, he is moving so much better that his doctor has reduced his medications. His wife commented to Stapleton, “He is now able to go in and out of the kitchen onto the patio by himself. And recently he is able to sit on the leather couch and get himself up for the first time in several years.” The family cheered with this comment, and Roberto made a BIG smile, something Larry says they work on to improve facial muscles.
As Roberto’s session with Larry continued, Stapleton observed Roberto’s son walking backwards down the hallway, facing his father. He kept in step while his father marched BIG, lifting his feet and moving his arms in rhythm to Larry’s “left, (pause) left, (pause) left right left.”
Stapleton couldn’t help but notice the BIG poster hanging on the wall, decorated brightly to remind Roberto to make all of his movements BIG. The family was quick to credit the posters around the house to Roberto’s daughter, who managed to put her little son’s hand prints on the posters to make them “extra special.”
Clearly this was a family effort – and a family victory. It was very obvious how much the family appreciated the therapy Watermark at Home was providing for Roberto. There is no doubt that the LSVT BIG program is changing lives, one therapy treatment at a time.

About Watermark at Home
Watermark at Home is an Arizona licensed home care agency committed to helping people thrive throughout metropolitan Phoenix and Southern Arizona. For more information, visit www.watermarkathome.com or call Watermark at Home at 480-946-4145.
LSVTR BIG therapy contributes to:
Reduced risk of falls
Improved balance
Focused larger movements
Faster walking with bigger steps
Quality and safety in walking
Better balance 
Increased trunk flexion

LSVTR LOUD therapy contributes to:
Increased vocal intensity
Improved swallowing
Enhanced voice quality
Improved facial expression
Improved communication
Improved quality of life
Suggested Pullout: Parkinson’s is one of the most common nervous system disorders of the elderly. It most often develops after age 50 though sometimes it occurs in younger adults. Many know it as the disease that forever changed the bright acting career of Michael J. Fox, who was first diagnosed with young-onset Parkinson’s disease in 1991 at the age of 30. While there’s still no cure for Parkinson’s, LSVT Therapy, pioneered in Arizona, is giving patients relief.