Objective: To investigate the effects of telepractice-based LSVT-BIG training on balance and mobility parameters in patients with Parkinson’s Disease (PD).

Background: Patients with PD who are in a risky group in Covid 19 pandemics have needed to continue regular exercise with telerehabilitation (1,2). Lee Silverman Voice Treatment- BIG (LSVT-BIG) therapy, which aims to regain normal amplitude of motion, is recommended for patients with PD to improve gait  and balance. LSVT-BIG is a concept which is designed to perform minimum 16 sessions (4 consecutive days a week and four weeks). Therefore, accessibility of patients to the clinical environment of LSVT BIG can be compelling(3). The effects of face to face LSVT BIG training were well known from clinical studies but there is insufficient evidence about real time remote practices of LSVT BIG. It can be considered that performing LSVT BIG via video conferencing method may increase applicability to the LSVT BIG training. The aim of our study is to investigate the effects of telepractice-based LSVT-BIG protocol in patients with PD.

Method: Eight subjects with idiopathic PD (Hoehn and Yahr stage 2-3) at “on” stage were included to this study [Table 1]. Patients received the 4-week LSVT BIG program with real time video conference from LSVT-BIG certified physiotherapist. Treatment was lasted 4 weeks at the frequency of 4 consecutive days/week.  Timed Up and Go(TUG) test in a single and during backward counting and Five Times Sit to Stand Test (FTSTS), were used to assess functional mobility. Balance performance was assessed with postural stability program in Biodex Balance System at the most stable level and with MiniBESTest.

Results: Telepractice-based LSVT BIG training program had statistically significant improvements on TUG, MiniBESTest and FTSTS. According to postural stability measurements, positive improvements in overall stability and sway indexes were demonstrated in this study [Table 2].

Conclusion: All components of LSVT BIG protocol could be performed with tele-practice based intervention. Positive improvements on mobility and balance parameters were obtained after tele-practice based LSVT BIG. The protocol can be an option for telerehabilitation intervention in patients with PD as a means of overcoming barriers in Covid 19 pandemic.

References: 1)Ellis T, Latham NK, DeAngelis TR, et al. Feasibility of a virtual exercise coach to promote walking in community dwelling persons with Parkinson disease. Am J Phys Med Rehabil 2013; 92(6): 472–482. 2) Helmich, R. C., & Bloem, B. R. (2020). The impact of the COVID-19 pandemic on Parkinson’s disease: hidden sorrows and emerging opportunities. Journal of Parkinson’s disease, 10(2), 351 3) McDonnell MN, Rischbieth B, Schammer TT, Seaforth C, Shaw AJ, Phillips AC. Lee Silverman Voice Treatment (LSVT)-BIG to improve motor function in people with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil. 2018;32(5):607-618. doi:10.1177/0269215517734385

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-telepractice-based-lsvt-big-training-in-patients-with-parkinsons-disease-in-covid-19-pandemic-preliminary-results/