Parkinson’s BIG program: What’s it all about?

Parkinson’s BIG program: What’s it all about?

Think BIG for Parkinson's

By Mindy Treon, DPT & Landmark Physical Therapy


Previously, we discussed what Parkinson’s disease is and some of the common symptoms. If you missed that blog post follow this link. As promised, we wanted to share with you a generalized overview of the Parkinson’s BIG Program.  

To recap – Parkinson’s disease is a neurological degenerative disease that affects one’s sensory neurological system by creating small, slow movements. The BIG program is specifically designed to combat those little movements. The BIG program “re-calibrates” people with Parkinson’s using a high amplitude, highly intensive, and high effort program.


How the Parkinson’s BIG program works


If you’re like most, you may be wondering – what does the re-calibration address? And how does it work?  The re-calibration works to improve sensory problems, internal cueing, and neurophysiological problems. For instance, since people with Parkison’s disease develop small movements (hypokinesia), the program forces people to utilize BIG movements. A patient may even find themselves saying “I feel like I am moving too big,” when in fact they are creating a normal system movement. They are literally re-calibrating their neurological system to move BIGGER, which appears as normal movement to the outside world.  Additionally,  the program teaches individuals to utilize the internal cueing of BIG movements with all activities in life. Lastly, the program can address challenges with procedural memory and attention since it is a standardized hour long protocol.


How the BIG program is designed

The BIG program’s design if very fun for the patients and therapists! It consists of 7 standardized exercises, 5 functional tasks specific to the patients’ goals, and a hierarchal task specific to that patient’s needs.  Hierarchy tasks are everyday tasks that the patient picks such as golfing, gardening, or going to a restaurant.  The program is fun but intensive as it involves 4 sessions a week for 4 weeks (16 sessions in a month).  It also includes daily homework or exercise.   

Where to find the Big program

The BIG program should only be lead by a BIG certified physical therapist (PT), Physical therapist assistant (PTA), Occupational therapist (OT) or occupational therapy assistant (OTA). A list of certified therapists throughout the country can be found on the LSVT website.  Here at Landmark Physical Therapy in Arizona, we have 3 physical therapists (both in our Paradise Valley and Scottsdale locations) that are certified in the BIG program, and who work with patients one-on-one for the full hour! In the upcoming weeks, be on the look out for a further break down of BIG program’s standardized exercises.  Or call our office for more information about the program.

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