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Volume 15
Issue 19
10.3390/app151910611
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

In-Hospital LSVT BIG Training Versus Structured Rehabilitation Treatment in Parkinson’s Disease: Feasibility and Primary Evaluation on Functional and Respiratory Outcomes

by
Francesco Estatico
1,†,
Adriana Olivares
2,†,
Laura Comini
2,*,
Mara Paneroni
3,
Michele Vitacca
3,
Francesca Tavolazzi
1,
Giovanna Maffi
1,
Chiara Forlani
1 and
Giuliana Vezzadini
1
1
NeuroRehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, MN, Italy
2
Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, BS, Italy
3
Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, BS, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Appl. Sci. 2025, 15(19), 10611; https://doi.org/10.3390/app151910611
Submission received: 20 August 2025 / Revised: 23 September 2025 / Accepted: 25 September 2025 / Published: 30 September 2025
(This article belongs to the Special Issue Advances in Neurological Physical Therapy)
Versions Notes

Featured Application

These findings highlight the crucial role of the FITT principle (frequency, intensity, time, type) in rehabilitation programs. They suggest that specific interventions, such as LSVT BIG, might offer distinct advantages over traditional care, particularly for improving dynamic balance and effort tolerance. In particular, specific elements of respiratory training and vocalization could be integrated earlier into standard rehabilitation for patients with Parkinson’s disease. Whether motivational factors made a difference to patients undergoing LSVT treatment remains to be evaluated.

Abstract

Lee Silverman Voice Treatment (LSVT) BIG, primarily developed for outpatient use, is a prominent intervention for patients with Parkinson’s disease thanks to its high-intensity, repetitive exercises involving large movements. This study first evaluated the feasibility of an in-hospital LSVT BIG training program by assessing recruitment capability, compliance, and adherence. The secondary objective was to evaluate the effects of LSVT BIG training on gait, balance, and functional outcomes, as well as respiratory function and quality of life, in comparison with a progressive structured rehabilitation program (SC) of similar intensity and frequency. In-hospital LSVT BIG training for people with Parkinson’s disease was feasible, with 95% recruitment rates and 100% safety and adherence. SC (n = 19) and LSVT BIG (n = 19) significantly improved (for all, p < 0.05) pre-to-post balance (MiniBESTest) and lower limb effort tolerance (6MWT). Delta changes between groups favored LSVT for upper limb effort tolerance (UULEX level, time, p < 0.001), gait speed, and UULEX SatO2 mean, PCEF, MiniBESTest and 6MWT (for all, p < 0.05). Evaluation of the probability associated with the LSVT BIG showed MiniBESTest as being 8.5 times more likely to exceed the MCID compared to SC. Quality of life was unchanged across both groups. This study successfully demonstrates the feasibility of in-hospital LSVT-BIG® training, and comparison of outcomes, although exploratory and underpowered, showed better improvements in mobility, balance, and effort tolerance, suggesting a complementary role within traditional rehabilitation protocols.
Keywords: LSVT BIG; Parkinson disease; exercise; dynamic balance; gait; effort tolerance LSVT BIG; Parkinson disease; exercise; dynamic balance; gait; effort tolerance

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MDPI and ACS Style

Estatico, F.; Olivares, A.; Comini, L.; Paneroni, M.; Vitacca, M.; Tavolazzi, F.; Maffi, G.; Forlani, C.; Vezzadini, G. In-Hospital LSVT BIG Training Versus Structured Rehabilitation Treatment in Parkinson’s Disease: Feasibility and Primary Evaluation on Functional and Respiratory Outcomes. Appl. Sci. 2025, 15, 10611. https://doi.org/10.3390/app151910611

AMA Style

Estatico F, Olivares A, Comini L, Paneroni M, Vitacca M, Tavolazzi F, Maffi G, Forlani C, Vezzadini G. In-Hospital LSVT BIG Training Versus Structured Rehabilitation Treatment in Parkinson’s Disease: Feasibility and Primary Evaluation on Functional and Respiratory Outcomes. Applied Sciences. 2025; 15(19):10611. https://doi.org/10.3390/app151910611

Chicago/Turabian Style

Estatico, Francesco, Adriana Olivares, Laura Comini, Mara Paneroni, Michele Vitacca, Francesca Tavolazzi, Giovanna Maffi, Chiara Forlani, and Giuliana Vezzadini. 2025. "In-Hospital LSVT BIG Training Versus Structured Rehabilitation Treatment in Parkinson’s Disease: Feasibility and Primary Evaluation on Functional and Respiratory Outcomes" Applied Sciences 15, no. 19: 10611. https://doi.org/10.3390/app151910611

APA Style

Estatico, F., Olivares, A., Comini, L., Paneroni, M., Vitacca, M., Tavolazzi, F., Maffi, G., Forlani, C., & Vezzadini, G. (2025). In-Hospital LSVT BIG Training Versus Structured Rehabilitation Treatment in Parkinson’s Disease: Feasibility and Primary Evaluation on Functional and Respiratory Outcomes. Applied Sciences, 15(19), 10611. https://doi.org/10.3390/app151910611

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