Big and Loud Therapy Program Helps Patients With Parkinson’s Disease

By Briana Vannozzi

It’s called big and loud. For Parkinson’s patients like 69 year-old Mary Aklonis, this therapy is critical to reclaiming pieces of life after such a daunting diagnosis. The month long intensive rehab program is fittingly named after two of the most predominant symptoms that come with the disease, small, rigid movements and soft, slowed speech.

“All of a sudden it was hard to get out of a chair,” said Aklonis.

The neurological disorder causes degeneration in the brain and loss of important chemicals like dopamine. The rehab is complex, administered four days a week during hour long sessions, and the effectiveness is undeniable.

“They force them to do large awkward feeling movements so that by the end of the four week period they’re actually moving in a cadence and a pace and an amplitude that is normal,” said Dr. Jill Farmer.

The repetitive nature of exercises retrains the neuropathways and increases brain plasticity. For Aklonsis, diagnosed just two years ago, each bit of progress offers more hope.

“Her husband had to provide a lot of assistance for her and so did we for her to sit and stand we had to provide maximum assistance and now as you can see we can just hold hands and she’ll get up on her own,” said Physical therapist Yuliana.

That reduced muscle activation throughout the body compounds the problem leading to respiratory issues like reduced breath support and inevitably poor speech.

“Take a nice deep breath and then give me a long strong ahhh,” said speech pathologist Emily Cannavaro.

That’s where speech pathologists with the “loud” portion step in.

“Its just highly intensive working the small muscles in your voicebox and also working on the breath support and it’s the combo of those two and the thinking of being loud,” said Cannavaro.

Often patient’s are unable to sense the changes within their own voice, normal tone feels like shouting and many stop participating in conversations all together.

“She has increased her loudness and her endurance. For example she came in and she could hold an ahh for seven to nine seconds on average and now shes hitting 25-30 seconds,” said Cannavaro.

In fact we saw changes just within the few hours spent at the hospital.

Best results come from starting during the early to middle stages treatment also helps maintain current levels of functioning and prevents further decline.

And while the steps toward treating the disease may be slow and at times unsteady, they are steps nonetheless.