CentraState - Healthy Directions

9 www.centrastate.com Spring 2015 The 16 physical and speech therapy sessions that make up the program weren't easy, but Mark powered through them. Barbara says she realized the program was effective when Mark began to be very serious about doing the exercises at home. "I thought to myself that this is working not only physically but psychologically, too," she recalls. "It was a big deal." Lenahan recalls that when Mark started the program, he would often take small, choppy steps, referred to as festinating. "This usually occurred when starting to walk, or when going around obstacles," Shannon says. "The great thing about LSVT BIG is that we include functional tasks addressing the individual's deficits." As part of the BIG program, Mark worked hard on picking up objects from various heights and being able to walk around obstacles without losing his balance. Initially, the tasks required all of his concentration to perform, but in four weeks, he was able to talk and perform the tasks without festinating. "The program was not easy for Mark," Lenahan says. "As he moved bigger and further into his range of motion, he experienced some soreness and back pain; however, he was able to work through the soreness and continue the program four days in a row. One of the main reasons the program has been so successful is the initiative the patients take and carry over to manage their progressive disease." As Mark continued to work hard, he realized that the program was making a real difference. "It was like a lightbulb going off. He never once stopped doing what he was supposed to do," Barbara recalls. "At home, he would say to me, 'When are we doing my exercises; I have to do my exercises.' This is a guy who, once he retired, anything sports on TV was his life. And getting him up off that seat and moving was huge." Through the program, Mark learned to slow his movements and speech down, and control them to a degree. "He went from falling every day to twice a month, maybe," Lenahan says. Bonner points out that Mark was hardworking and highly motivated throughout the LOUD program. "When he began therapy, both Mark and his wife Barbara expressed concern that he was unable to participate in social situations at the level he used to," she says. "Conversational loudness was a huge concern for him, and we targeted that daily during his sessions." Bonner says that over the course of therapy, Mark was able to drastically improve his loudness and has become more comfortable speaking at family gatherings and over the phone. "It's a great feeling when a patient tells me, 'My children can't believe how loud I am!'" Bonner says. "Mark is very dedicated to continuing his daily exercises, which helps him to maintain his new LOUD voice." Barbara also thinks that Mark has become more self- confident. "Our kids were very concerned as they were watching him basically deteriorate, and they've noticed an improvement," she says. "He's gotten more determined. He had been falling constantly—in the bathroom, getting out of bed, walking around. Now he has not fallen in weeks, which is just awesome. Even when he has a close call where he's very wobbly and unsure of himself, he's been able to catch himself, and that's tremendous. He's not afraid anymore." TOUGH, BUT READY Lydia Arana, 79, is a soft-spoken woman, living with Parkinson's disease but not willing to let it keep her down. The Matawan resident was diagnosed with the degenerative neurological disease in 2007 and has lived with fluctuating levels of intense tremors for years, but last year she started the LSVT BIG & LOUD Parkinson's program at CentraState. It's a tough protocol, but one Lydia gently says has made a difference. She says the program isn't easy, but she's committed to it. "It has helped a lot," she says. "Those therapists are great there." Jennifer Morelli, PT, DPT, and LSVT-certified, is one of Lydia's physical therapists. She worked with Lydia, who attended sessions along with her husband, George. Morelli says she followed the LSVT protocol of performing the eight maximal daily exercises and then focused on functional activities, such as transfers in and out of a chair, a car and a bed. "Everything is geared toward large movements," Morelli says. Exercises focus on sitting, standing, static holds, standing/ stepping, weight shifting, trunk rotation, arm swinging and walking, among other tasks. Lydia completed both the BIG and LOUD programs, which are hour-long sessions held four times a week for four weeks. After completing the protocol, patients are sent home with exercises to complete on their own. Patients are to continue their daily exercises with reassessments at intervals specified by the treating therapist, which Lydia has been doing. Brittany Bonner, who was also Lydia's LOUD speech therapist, says that Lydia was incredibly dedicated to the program "She always gave 100 percent during treatment," Bonner says. "It was rewarding to see how Lydia progressed and how drastically her loudness and vocal quality improved." Spouses are a big part of post-program support. "The spouses and partners are just terrific, " says Jacqueline Acampora, LSVT program assistant, who noted how especially attentive Lydia's husband was during the therapies. When he saw how much better his wife was doing, Acampora says, "I saw tears in his eyes." For more information about CentraState's Parkinson's services, visit www.centrastate.com/neuroscience, or call 866-CENTRA7 (866-236-8727). HD Mark goes through one of his BIG exercises with his physical therapist, Shannon Lenahan.

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