LSVT BIG® and Functional Outcomes in Parkinson’s Disease

Baylor University’s Barbara M. Doucet, PhD, OTR, Clinical Associate Professor and Post-professional Doctor of Occupational Therapy (OTD) Program Director, recently appeared on the Think Big and Loud podcast by LSVT Global along with collaborators Ingrid Franc, PhD, OTR, and Mark Blanchard, OTD, OTR, ATP, to discuss new research examining how LSVT BIG® impacts activities of daily living in people with Parkinson’s disease experiencing bradykinesia.  

What Is LSVT BIG®?

LSVT BIG® is a structured, intensive four-week therapy program, delivered four days per week, designed to recalibrate movement patterns. Patients practice large-amplitude, high-effort movements that gradually become automatized, meaning they can perform them without conscious effort.

Understanding Bradykinesia

A hallmark symptom of Parkinson’s is bradykinesia, defined as slowness of movement. One of Doucet’s patients described it as feeling like “moving through sludge” or soft clay—an invisible resistance that slows even simple tasks like getting dressed or preparing to leave the house.

Why Study Functional Outcomes?

LSVT BIG® is commonly used to improve movement in people with Parkinson’s, but there is currently no research showing if it directly improves bradykinesia or improves the ability to complete activities of daily living (ADL). Most research on LSVT BIG® focuses on motor outcomes and not functional performance of ADLs. However, the neurological processes involved in improved strength or posture are not the same sensory processes used when someone is performing a task like getting dressed, which is why the perspective of an occupational therapy researcher can be so beneficial.

Inside the Study

To directly assess functional outcomes, Doucet and her colleagues measured the speed of three standardized tasks:

• Putting on and removing a jacket
• Putting on and taking off socks
• Placing a pillow into a pillowcase

These tasks were chosen because they are common activities of daily living (ADLs) with existing standardized assessments. All materials—jackets, socks, and pillows—were standardized across testing sites. Participants completed LSVT BIG® during medication “on” times, when Parkinson’s medications were most effective.

Can LSVT BIG Improve Bradykinesia?

The study found statistically significant improvements in task completion speed across participants at different stages of Parkinson’s, suggesting the intervention helps reduce bradykinesia and makes everyday activities easier to perform.

• Putting on and removing a jacket – 14.5 seconds faster
• Putting on and taking off socks – 18.3 seconds faster
• Placing a pillow into a pillowcase – 21.4 seconds faster

Importantly, gains were seen not only in tasks participants identified as meaningful goals (such as getting dressed), but also in tasks they did not prioritize (like the pillowcase task). This points to strong generalization and carryover of skill gains, supporting the idea that LSVT BIG® recalibrates overall movement patterns rather than improving isolated skills.

Looking Ahead

Doucet hopes to see continued expansion of occupational therapy literature examining LSVT BIG® and its impact on functional measurements to validate how occupational therapists are essential to restoring patients’ abilities to do meaningful tasks, which Doucet describes as “Being able to do the things we love to do—playing with your grandchildren, cooking a meal for your family—give us our quality of life and keep us healthy.”

ABOUT BAYLOR UNIVERSITY'S POST-PROFESSIONAL OTD PROGRAM

In addition to her research, Doucet brings this commitment to evidence-based care to her role as a faculty member and Program Director of Baylor’s Post-professional Doctor of Occupational Therapy (OTD) program in Robbins College of Health and Human Sciences. In the program, practicing occupational therapists engage with current research, explore evolving best practices, and consider how new insights can inform clinical practice and professional growth.

Curriculum includes:

• Core Courses focused on advances in occupational therapy, clinical reasoning, evidence-based practice, and leadership.
• Doctoral Capstone Courses supporting the development and dissemination of clinically focused capstone projects.
• Certificate in Hybrid Teaching examining hybrid pedagogical strategies for academic and healthcare settings.

Learn more about Baylor’s Post-professional Doctor of Occupational Therapy (OTD) program

ABOUT THE PUBLICATION

Doucet BM, Blanchard M, Franc I. Effects of LSVT BIG® on Bradykinesia During Activities of Daily Living. OTJR: Occupational Therapy Journal of Research. 2025;0(0). doi:10.1177/15394492251367275