Parkinson rehabilitation and LSVT protocol: toward an interdisciplinary approach. A narrative review

Autori

Bonanno Francesco (Università degli studi di Messina, Messina, Italia)

Cavallaro Filippo (Università degli studi di Messina, Messina, Italia)

Lizio Alice (Università degli studi di Catania, Catania, Italia)

Di Dio Antonio (Università degli studi di Messina, Messina, Italia)

Sposito Francesca (Università degli studi di Messina, Messina, Italia)

Saraceno Silvia (Università degli studi di Messina, Messina, Italia)

Rizzo Vincenzo (Dipartimento di Medicina Clinica e Sperimentale, Università degli studi di Messina, Messina, Italia)

Background and aims

Rehabilitative interventions play a crucial role in all progressive neurological diseases, such as Parkinson’s disease (PD). PD impairs speech, swallowing, limb function, gait, balance, and activities of daily living. For this reason, an interdisciplinary rehabilitative approach can be very useful to improve health outcomes, motor and non-motor functioning. A clear example of interdisciplinary rehabilitation for PD is represented by the Lee Silverman Voice Treatment (LSVT), a treatment protocol addressed to patients with PD. It is possible to distinguish LSVT LOUD and LSVT BIG. The first is a standardized, research-based speech treatment protocol consisting of exercises aimed at voice enhancement and voice perception. The LSVT BIG is a set of exercises based on speed-amplitude regulation to overcome bradykinesia. With this project, we want to highlight the efficacy of LSVT LOUD and LSVT BIG related to an interdisciplinary context.

Methods

Authors searched for English articles published from 2005 to 2025 in the electronic database PubMed using the following search string: (“Parkinson’s disease”) AND (“Parkinson rehabilitation” AND (“LSVT”). Articles were screened by title and abstract, using the following inclusion criteria for selection: (1) randomized controlled trials; (2) written in English; (3) published in indexed journals; and (4) dealing with Parkinson rehabilitation and LSVT protocols. The exclusion criteria were (1) non-randomized trials; (2) reviews; (3) papers written in languages other than English; and (4) other rehabilitative approaches. 8 articles were included in this study.

Results

Of these 8 articles, 3 showed the efficacy of LSVT LOUD for speech and voice disorders in patients with PD, while 4 papers analysed the use of LSVT BIG for gait, balance, and movement disorders. Only one article highlighted how, with a combined use of LSVT LOUD and LSVT BIG protocols, patients with PD could improve their motor, non-motor, and psychological functions.

Conclusion

Nowadays, despite the scientific community well knowing the importance of an interdisciplinary team for the management of pathologies (such as PD), we realized that there is still little scientific literature on this topic. Further studies are needed to strengthen this concept. With this work, we want to raise a small critical issue about the rehabilitation management of chronic degenerative diseases. There are still a few articles in which it is possible to observe an interdisciplinary management of the patients. LSVT is only an example we used to raise this discrepancy. Ours is a call for a future in which there can be a true collaboration between multiple healthcare professionals.

REFERENCES

Fox C et al. LSVT LOUD and LSVT BIG: Behavioral Treatment Programs for Speech and Body Movement in Parkinson Disease