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

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.