Occupational Performance and Hand Function in People With Parkinson’s Disease After Participation in Lee Silverman Voice Treatment (LSVT) BIG®

Abstract

Importance: People with Parkinson’s disease (PD) experience motor and functional impairment that can negatively affect daily living and participation. Objective: To examine the occupational performance and hand function outcomes of people with PD who participated in a Lee Silverman Voice Treatment (LSVT) BIG® program. Design: Retrospective record review. Setting: Outcomes were extracted from patient charts at a hospital outpatient clinic. Participants: Sixty-six clinic outpatients with PD who completed the LSVT BIG program. Intervention: An occupational therapist and a physical therapist who were certified in LSVT BIG administration delivered the 16-session LSVT BIG program. Outcomes and Measures: The Canadian Occupational Performance Measure (COPM), grip strength, and Minnesota Manual Dexterity Test (MMDT) were administered before and after participation in LSVT BIG training. Results: For participant-identified COPM goals, pre–post changes were significant, ranging from 3 to 6 points for performance and satisfaction (p < .001). Grip strength in both hands showed significant gains; median scores for the right hand increased from 55.0 lb (interquartile range [IQR] 41.0, 70.0) to 64.0 lb (IQR 46.0, 80.0; p < .001) and for the left hand from 52.0 lb (IQR 39.0, 64.0) to 63.0 lb (IQR 44.5, 79.5; p < .001). MMDT median scores for right to left also significantly improved, from 124.0 s (IQR 113.0, 181.0) to 119.5 s (IQR 105.5, 163.5; p = .014). Conclusions and Relevance: Participation in the LSVT BIG program can improve perceived occupational performance and satisfaction and produce gains in hand strength and dexterity for people with PD. What This Article Adds: This study is the first retrospective review of data on occupational performance and hand function outcomes after participation in the LSVT BIG program. The findings of beneficial outcomes support the use of LSVT BIG in occupational therapy services to increase functional abilities among people with PD.