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The Difference Between LSVT Big and PWR for Parkinson's Disease

LSVT Big and PWR! (Parkinson's Wellness Recovery) are two very popular therapeutic approaches to treat Parkinson’s specific symptoms and improve quality of life. Both programs help patients to emphasize large amplitude or exaggerated movements, which can become difficult for individuals diagnosed with Parkinson’s disease. The goal of these programs is to work on making movements bigger, which may seem strange compared to others around you at first, but over time, the body starts to realize that these large movements are normal. Both of these programs help to improve balance, strength, and mobility and are backed by research on motor learning and neuroplasticity. Therapists get certified in these approaches in order to give patients their specialized treatment program.

LSVT Big is a structured protocol of 4x/week treatments for 4 weeks. These treatments are performed one-on-one with physical therapy in an individualized session for the patient for 60 minutes. The program focuses on movements to aid with small and large motor tasks, which can become difficult for those with Parkinson’s. These movements have to improve daily activities and routines. There is a daily carryover of exercises/assignments for patients to perform at home within that 30-day timeframe. Daily homework is typically 10-20 min/day. This structured protocol has to occur within the 30-day timeframe at the structured 4x/week for 4 weeks. If there are vacations or events that may interfere with sessions, it is best to hold off and look into the future when you can fully commit to the 16 sessions. There are other options if one cannot commit to the structured protocol such as using telehealth if offered or a LSVT Coach Software System. These options can be discussed with the therapist to allow for accessibility to the LSVT Big program. There is also LSVT Loud which is a specific program for speech and language for individuals with Parkinson’s that is delivered in a similar format to LSVT Big, but with a speech therapist.

PWR! Moves utilizes similar principles of treatment, but it is a less structured protocol, giving patients and therapists more flexibility with treatment. The flexibility allows for the treatment plan to be personalized to each individual person, as well as their schedule and specific needs. If there is a vacation coming up, or time off needs to be taken, the program does not have to be restarted as it would with LSVT Big. PWR! Uses 4 basic moves that can be performed in various positions that can be progressed to challenge cognition and physical abilities. The different positions can be beneficial in stand-alone sessions or exercise at home or in group fitness classes. These can easily be adapted into daily activities to improve one’s movements, balance, and overall routines. There are therapy intensives for PWR! Moves that are 3-5 days in length at a PWR! Gym for individuals who would like to have a structured intensive with PWR! Experts. All of our physical therapists are certified in PWR! Moves and can guide patients through the treatment.

Both the LSVT Big and PWR! Moves programs are very beneficial for individuals living with Parkinson’s and require repetition of movements in order to address small and large motor skills for everyday life. Research backs each of the programs and their movements. The right program for you may depend on your schedule, lifestyle, and accessibility to treatment. Not all therapists are certified in each technique so finding someone who is certified in these approaches is crucial.

Here at Wellness 360, we specialize in neurorehabilitation and working with people with Parkinson’s disease. Our physical therapists are PWR! Moves certified and can answer your specific questions about the treatment and incorporate it into physical therapy sessions. If you or a loved one are interested in starting physical therapy, give us a call to schedule an evaluation: (585) 259-0782. To learn more about Wellness 360, visit our website at


-LSVT Global. Home.

-Parkinson Wellness Recovery | PWR!. 


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