13- FOXcast OT: Chatting LSVT at AOTA 2018

Bernie: This is amazing: the changes you can make with your patients. And when I noticed the changes almost immediately after I was certified, I spread the word: LSVT BIG has truly changed the way I practice and now, because of the things that I can do, so many other occupational therapists are practicing in that way as well.

Jimmy: This is FOXcast OT, a podcast fo­r clinicians made by clinicians. It’s brought to you by FOX Rehabilitation. Find out more at foxrehab.org.

Alright, welcome to FOXcast OT. I’m your host Jimmy McKay and we’re talking LSVT right now with some  LSVT experts. Introduce yourself to the audience.

Laura: My name is Laura Guse. I’m a physical therapist and one of the instructors for LSVT BIG which is a physical therapy and occupational therapy intervention for Parkinson’s disease. And, I’m also the chief clinical officer of LSVT BIG.

Jimmy: And with her is…

Bernie: My name is Bernadette Kosir, Bernie Koris. And I’m an occupational therapist and I’m also on faculty for LSVT BIG. I train physical and occupational therapists on this wonderful technique. I am one of two OTs currently on the training team and we are here at the AOTA conference just having a ball.

Jimmy: I love the fact that LSVT specializes in OT and PT and we’ve got a PT and an OT together right now to talk about it. So I heard about it all through school in our classes and everybody raves about it so give somebody the 30,000 foot view what’s the overview of what LSVT actually is.

Laura: So LSV stands for Lee Silverman voice treatment because it started as a speech treatment for people with Parkinson’s disease. And more recently it evolved into a physical and occupational therapy approach for people with Parkinson’s. It’s evidence based. It’s a one month intensive treatment protocol that really helps patients with Parkinson’s to learn how to move in everyday life with their mobility with their ADL’s and basic function.

Jimmy: How was it instructed or used differently from PTs to OT’s or is there a difference?

Bernie: There is no difference in the training we kind of are an interdisciplinary approach in training or both. However it’s very it’s a very interesting question because what we need to do as individual professions is use our strengths with our patients. And we often even recommend a collaboration between OT and PT for that reason. So that I as an occupational therapist might focus more on the activities of daily living and everyday self care activity that needs to be needs to be looked at. The patient has a priority for a physical therapist may focus more on the mobility skills that are underlying. But the overall concepts that are taught in the LSVT BIG curriculum are the same. It really strengthens I think both professions.

Laura: The treatment intervention itself can be delivered exclusively by physical therapy or exclusively by occupational therapy. And often that’s driven by the patient’s needs or the four times a week can be divided out twice a week peaty twice a week ot which is really convenient for the therapist sometimes helps with reimbursement. But first and foremost addresses that patient’s needs and goals more holistically.

Jimmy: What are the underlying themes of LSVT and why it works so well?

Laura: Yeah that’s a really great question. The main target for both LSVT LOUD and LSVT BIG is amplitudes so either moving bigger or talking louder. Not in an exaggerated fashion but just scaling them back up to normal again. And interestingly we found through that really singular focus on amplitude is that many things improve. Balance, coordination, speed of movement with mobility and ADL’s, efficiency safety and with speech intelligibility, articulation, respiration. There’s a of static curves with one focus on amplitude.

Jimmy: Love that. What are some of the things that you see people change, the people that you work with clients that you interact with describe some of the changes that you see from beginning to end. Because it is a one month as you mentioned.

Bernie: It’s A very intensive protocol but almost immediately you begin to see changes begin to see people being able to move using that single cue. But they still require some external cueing from us. They need that shaping and that modeling with us which we pull back over the course of four weeks we start to see functional improvements in so many areas. Handwriting may improve the ability to get dressed. The efficiency of getting dressed and being able to do their everyday activities. These are things I focus on as an occupational therapist. Their ability be able to get out into the community. Our patients once they graduate then they’re able to resume activities out in the community such as shopping and you know enjoying themselves with their families at a restaurant and being able to get in and out of movies and restaurants more easily and safely. Their efficiency increases we see their affects improve their interaction with others becomes that much more possible. Just a real blossoming in so many functional ways. And what’s also interesting is that it continues even after our LSVT treatment is completed and that has been pretty consistently in the research as well.

Jimmy: Talk about the training if you’re an OT or a PT listening to this show is designed for OTs but sometiems PTs sneak over to this program as well. What can they look forward to or what can they expect from the training from the course?

Laura: Yes well there’s two ways that therapist can get trained. It’s open to occupational therapists. Kodos and students in those professions as well as physical therapists, physical therapist assistants, and students in those professions.

Jimmy: All bases covered.

Laura: Yep you have two choices You can either go to the traditional route and go to a two day live course and we have courses literally all over the world. We train about 18,000 therapists in 45 countries. Or you can take the entire training and certification program online at self-paced. You have 90 days to do the same CEU’s same certification same training and the results have been amazing for that too.

Jimmy: That’s great. We have a tradition on the show are you guys ready?

Laura: Yep. At the end of the show since it’s FOXcast it’s called Your FOXtale. So why did you choose to work with this particular population through LSVT working with patients with Parkinson’s disease. Why for you?

Laura: My grandfather had Parkinson’s disease and so I was always interested in that disorder helping people with Parkinson’s disease worked as a therapist for many years treating patients with Parkinson’s disease before getting certified got certified in 2009. And it was revolutionary in my practice and the outcomes that I was getting so quickly with my patients in a way that I had never experienced before. I eliminated burnout for me I’d no longer avoid people with Parkinson’s. I was confident I could help. And I’m just like so happy to share that with other therapists.

Jimmy: That’s great Laura. Bernie same question.

Bernie: So my FOXtale is I was turned on to LSVT BIG by an LSVT LOUD certified speech pathologist who said you’ve got to check this out. Bernie you just got to check this out. This is amazing the changes you can make with your patients. And when I notice the changes that happened after I was trained almost immediately after I was certified I spread the word. The reason that I went into it was kind of by accident. Where I am now is just amazing. LSVT BIG has truly changed the way I practice and now because of the things that I can do so many other occupational therapists are practicing in that way as well.

Jimmy: That’s a great way to put it. If someone wants more information they want to learn about where are they going to go.

Bernie: You can email info at lsvtglobal.com or you can see it on our website. www.lstglobal.com.

Jimmy: Appreciate you guys taking time out of a busy event like AOTA conference. Love everything we’ve heard about LSVT. You guys always focus on the end. It’s always about the people you’re working with which is what we love.

Bernie: Thank you guys very much for having us.

Jimmy: Thank you. Thanks for listening to FOXcast OT, a clinically excellent podcast. It’s brought to you by FOX Rehabilitation listen to other episodes or read articles and position papers at foxrehab.org.