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RiverView Rehab Services Team Helps those with Parkinson's Disease

Community news | Monday, April 27, 2020

April is Parkinson’s Awareness Month, and RiverView Health’s Rehab Services Team is proud to support those impacted by the disease with a variety of services to help improve their daily lives.

Two of the services offered by RiverView include LSVT LOUD and LSVT BIG.

‘’Think LOUD and think BIG’’ are two suggestions you might hear from RiverView therapists Erin Jore, MS, CCC-SLP; Lori Hefta, MPT; and Madeline Graff, MOTR/L. All three therapists are certified in the LSVT (Lee Silverman Voice Treatment) LOUD and LSVT BIG programs designed to help individuals with Parkinson’s disease (PD) and other neurological conditions.


As a speech pathologist, Jore works with the LSVT LOUD program to help patients improve vocal loudness by stimulating the muscles of the voice box (larynx) and speech mechanism through a variety of exercises. Focused on the single goal to “think LOUD!” – the treatment improves respiratory, laryngeal, and articulatory function to maximize speech intelligibility.

Jore reports that the patients she has worked with have not only increased their vocal loudness but have also increased their intonation and expressiveness.

“A person’s voice is a part of their identity. It is amazing to give that back to them,’’ she shared. “This program helps restore confidence and a desire to interact with others that they thought was lost.’’

LSVT LOUD, named for Mrs. Lee Silverman, was developed in 1987 and has had funding support from the National Institute for Deafness and other Communication Disorders of the National Institutes of Health. Published research documents improvements maintained up to two years after treatment. Research studies have also documented the effectiveness of this therapy in improving the common problems of disordered articulation, diminished facial expression, and impaired swallowing. Additionally, two brain-imaging studies have documented evidence of positive changes in the brain following administration of the therapy.


Physical Therapist Lori Hefta and Occupational Therapist Madeline Graff are certified in the LSVT BIG treatment approach. LSVT BIG training is driven by exercises of high intensity, amplitude, and calibration.

The goal of LSVT BIG is to increase the amplitude of limb and body movement in people with PD and other conditions; therefore, decreasing the number of tremors and shuffling and improving trunk rotation and gait. The program has also been generalized to improve speed, balance, and quality of life. In addition, people can maintain these improvements when challenged with a dual-task. LSVT BIG is credited with bringing better movement into everyday life. There has been documentation of both long term and short-term improvements when utilizing the LSVT BIG approach.

LSVT LOUD and LSVT BIG are often completed as a program by the Rehab Team to provide the patient with a more holistic approach.

“It really is an amazing program,’’ Jore reported. “The earlier an individual is seen for treatment, the better.’’

Jore shared that referrals often come from family members because individuals may not realize their voice or gait has changed. If you or someone you know would benefit from LSVT, contact Rehab Services at 218-281-9463. LSVT is also compatible with telehealth (video) visits now offered at RiverView.

Pictured above, left to right: Lori Hefta, Madeline Graff and Erin Jore