Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Türkiye.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ordu University, Ordu, Türkiye.
Brain Behav. 2024 Mar;14(3):e3458. doi: 10.1002/brb3.3458.
Lee Silverman voice treatment (LSVT) BIG is an exercise program developed for patients with Parkinson's disease (PwPD), consisting of sets of exercises performed for 4 consecutive days a week for 4 weeks. However, the standard protocol suggests a treatment frequency difficult to follow for most patients who have difficulties reaching rehabilitation clinics. Our aim was to compare the standard LSVT BIG protocol with a modified LSVT (m-LSVT) BIG protocol (twice a week in the clinic for 4 weeks and twice a week at home for 4 weeks).
In this randomized controlled trial, 16 PwPD (aged 18-80 years, Hoehn and Yahr stages I-III) were recruited into two groups. The LSVT group received standard LSVT BIG training (four times per week for 4 weeks at the clinic). The other group was given m-LSVT BIG exercises, but unlike the LSVT group, the m-LSVT group exercised twice a week at the clinic and twice a week at home for 4 weeks. The Berg Balance Scale was used to assess functional balance. Biodex Balance System was used to assess laboratory balance measures. Timed Up and Go test and G-Walk sensor system were used to assess functional mobility and spatiotemporal gait analysis.
Significant group-by-time interactions on the eyes open-firm surface score of the modified clinical test of sensory integration of balance (F = 10.138, p = .007) and gait cycle symmetry index (F = 10.470, p = .010) were found to be in favor of the LSVT group. Additionally, post hoc analyses revealed that both groups significantly improved postural stability, gait speed, motor symptoms, and functional mobility (p < .05).
The results revealed the beneficial effects of the modified protocol on balance and gait in PwPD, as well as the superiority of the standard LSVT BIG protocol. The m-LSVT BIG protocol may be an effective intervention method, especially for PwPD who have difficulty adapting to the treatment frequency of the standard protocol.
李·西尔曼语音治疗（LSVT） BIG 是为帕金森病（PwPD）患者开发的一项锻炼计划，包括每周连续 4 天进行的一系列锻炼，持续 4 周。然而，标准方案建议的治疗频率对于大多数难以到达康复诊所的患者来说很难遵循。我们的目的是比较标准的 LSVT BIG 方案和改良的 LSVT（m-LSVT） BIG 方案（每周在诊所进行两次，持续 4 周，每周在家进行两次，持续 4 周）。
在这项随机对照试验中，招募了 16 名 PwPD（年龄 18-80 岁，Hoehn 和 Yahr 分期 I-III），分为两组。LSVT 组接受标准的 LSVT BIG 训练（每周 4 次，持续 4 周，在诊所进行）。另一组接受 m-LSVT BIG 锻炼，但与 LSVT 组不同，m-LSVT 组每周在诊所和每周在家进行两次锻炼，持续 4 周。Berg 平衡量表用于评估功能性平衡。Biodex 平衡系统用于评估实验室平衡测量。计时起立行走测试和 G-Walk 传感器系统用于评估功能性移动性和时空步态分析。
改良临床感觉综合平衡测试（modified clinical test of sensory integration of balance，mCTSIB）睁眼-硬表面评分（eyes open-firm surface score）和步态周期对称性指数（gait cycle symmetry index）的组间时间交互作用有统计学意义（F=10.138，p=0.007），有利于 LSVT 组。此外，事后分析显示，两组的姿势稳定性、步态速度、运动症状和功能性移动性均显著改善（p<0.05）。
结果表明，改良方案对 PwPD 的平衡和步态有有益影响，标准 LSVT BIG 方案具有优越性。m-LSVT BIG 方案可能是一种有效的干预方法，尤其是对于难以适应标准方案治疗频率的 PwPD 患者。
