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Treating Parkinson’s with exaggerated movements

There are approximately 1.5 million people living with Parkinson’s disease in the United States alone, with another 50,000-60,000 new cases diagnosed each year.

Since Parkinson’s is more common in people 60 years or older, it is expected that the numbers will only increase as the baby boomers age. Considering that close to 20 percent of Nevada County’s population is 65 and older, chances are good that many of our friends, family and neighbors will be facing the challenges the disease presents.

“What was that you said?”



“I can’t hear you.”

“Can you speak a little louder?”




“Here, let me do that for you.”

Welcome to the world of Parkinson’s patients, where speech and motion gradually slow as the disease progresses. Speech becomes softer and every movement measured.

The disease is named after Englishman James Parkinson, who made a detailed description of the disease in his essay: “An Essay on the Shaking Palsy” (1817).

Parkinson’s is a progressive, neurological disease that destroys nerve cells in one part of the brain. That destruction leads to a decrease in the production of dopamine, a chemical that tells our bodies to move. Without sufficient dopamine, the signal to move doesn’t get communicated, leading to the characteristically-slow, small movements experienced by the great majority of patients.

Frustration often prevails, as Parkinson’s takes its toll on speech and movement. Many victims simply stop speaking altogether, retreating further and further inward because speech is central to socialization. Better to remain silent than endure the frustration of trying to be heard and understood.

Not surprisingly, these slow/small movements often lead to difficulty completing simple daily tasks, like buttoning a shirt or folding the laundry, as well as walking and balance problems. Speech and swallowing difficulties are also common symptoms of Parkinson’s. Just as the muscles of the arms and legs produce slower/smaller movements in the absence of dopamine, the vocal cords and articulation muscles can produce weak, slow, and garbled speaking that can affect successful communication.

Fortunately, much research has been done over the past 20 years into methods for helping people living with the disease relearn to move more normally.

One of the results of that research was LSVT LOUD, an intensive exercise program for the speech motor system. Kathleen O’Dea, a speech therapist at Sierra Nevada Memorial Hospital, has been utilizing the program for the past year with her Parkinson’s patients.

“I have felt frustrated for years because we couldn’t offer our patients a program that improved vocal weakness,” said O’Dea. “It’s exciting to hear my patients now! They are speaking up and are finally being heard.”

The LSVT LOUD program was found to be so successful that researchers determined how to apply the same principles to the limb (arms and legs) motor system and created LSVT BIG.

Sierra Nevada Memorial Hospital physical therapists Katie Garcia and Maggie Edwards have recently become certified in the LSVT BIG exercise program and have now joined forces with O’Dea to offer a new class called Moving Big & Loud for people with Parkinson’s, or with Parkinson-like symptoms.

Often Parkinson victims do not realize that their voice/movements are smaller than normal. Therefore, the approach used in the Moving Big & Loud class is to teach the participants to move/speak bigger/louder, to put maximal effort into all of their movements and conversation, and, perhaps most importantly, to learn how to self-assess.

The class meets on Fridays, 9-10:15 a.m., at SNMH’s Neurological Rehabilitation Clinic located at 375 Brunswick Drive, in Grass Valley. It is an ongoing class and the cost is $60 per eight sessions. For information, call the clinic at (530) 274-6170.


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