Comparing Exercise in Parkinson’s Disease—The Berlin LSVT1BIG Study

Abstract: Physiotherapy is widely used in Parkinson’s disease (PD), but there are few controlled studies compar-ing active interventions. Recently, a technique named ‘‘LSVT1BIG’ ’ has been introduced. LSVT1BIG is derived from the Lee Silverman Voice Treatment and focuses on in-tensive exercising of high-amplitude movements. In the pres-ent comparative study, 60 patients with mild to moderate PD were randomly assigned to receive either one-to-one training (BIG), group training of Nordic Walking (WALK), or domes-tic nonsupervised exercises (HOME). Patients in training (BIG) and WALK received 16 hours of supervised training within 4 (BIG) or 8 (WALK) weeks. The primary efficacy measure was difference in change in Unified Parkinson’s Dis-ease Rating Scale (UPDRS) motor score from baseline to fol-low-up at 16 weeks between groups. UPDRS scores were obtained by blinded video rating. ANCOVA showed signifi-cant group differences for UPDRS-motor score at final assess-ment (P < 0.001). Mean improvement of UPDRS in BIG was 25.05 (SD 3.91) whereas there was a mild deterioration of 0.58 (SD 3.17) in WALK and of 1.68 (SD 5.95) in HOME. LSVT1BIG was also superior to WALK and HOME in timed-up-and-go and timed 10 m walking. There were no sig-nificant group differences for quality of life (PDQ39). These results provide evidence that LSVT1BIG is an effective tech-nique to improve motor performance in patients wit