title: Comparing exercise in Parkinson's disease--the Berlin LSVT®BIG study.
abstract: Physiotherapy is widely used in Parkinson's disease (PD), but there are few controlled studies comparing active interventions. Recently, a technique named "LSVT®BIG" has been introduced. LSVT®BIG is derived from the Lee Silverman Voice Treatment and focuses on intensive exercising of high-amplitude movements. In the present comparative study, 60 patients with mild to moderate PD were randomly assigned to receive either one-to-one training (BIG), group training of Nordic Walking (WALK), or domestic nonsupervised exercises (HOME). Patients in training (BIG) and WALK received 16 hours of supervised training within 4 (BIG) or 8 (WALK) weeks. The primary efficacy measure was difference in change in Unified Parkinson's Disease Rating Scale (UPDRS) motor score from baseline to follow-up at 16 weeks between groups. UPDRS scores were obtained by blinded video rating. ANCOVA showed significant group differences for UPDRS-motor score at final assessment (P < 0.001). Mean improvement of UPDRS in BIG was -5.05 (SD 3.91) whereas there was a mild deterioration of 0.58 (SD 3.17) in WALK and of 1.68 (SD 5.95) in HOME. LSVT®BIG was also superior to WALK and HOME in timed-up-and-go and timed 10 m walking. There were no significant group differences for quality of life (PDQ39). These results provide evidence that LSVT®BIG is an effective technique to improve motor performance in patients with PD.
authors.affiliation: Movement Disorders Clinic, Beelitz-Heilstätten, Germany. ebersbach@parkinson-beelitz.de
authors.forename: Georg
authors.initials: G
authors.lastname: Ebersbach
authors.forename: Almut
authors.initials: A
authors.lastname: Ebersbach
authors.forename: Daniela
authors.initials: D
authors.lastname: Edler
authors.forename: Olaf
authors.initials: O
authors.lastname: Kaufhold
authors.forename: Matthias
authors.initials: M
authors.lastname: Kusch
authors.forename: Andreas
authors.initials: A
authors.lastname: Kupsch
authors.forename: Jörg
authors.initials: J
authors.lastname: Wissel
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000534:rehabilitation*; D011788:Quality of Life; D016896:Treatment Outcome; D016138:Walking