Abstract
Date Presented 03/22/24
Lee Silverman Voice Treatment (LSVT)–BIG® clinicians provided feedback on their execution of the program, identifying high-frequency visits and high patient payment burden as barriers. Further research is needed to explore the differences in implementation.
Primary Author and Speaker: Leah Botkin
Contributing Authors: Rachel Proffitt
The Lee Silverman Voice Treatment–BIG® (LSVT-BIG®) program, originally designed for patients with Parkinson’s disease, is a high amplitude, repetitious therapy protocol with a special focus on functional movements and gait training. The purpose of this study was to gather provider perspectives of the LSVT-BIG® program from certified clinicians. Mixed-methods approach. A survey was distributed to LSVT-BIG® certified clinicians via the Facebook page run by parent company, LSVT Global Inc. Participants were offered the opportunity to provide further feedback on the LSVT-BIG® program through semi-structured interviews. Respondents were mostly clinicians in the outpatient setting (n = 30). Forty-seven percent reported using the LSVT-BIG® program for patient populations outside of the Parkinson’s Disease diagnosis (n = 17). Sixty-one percent of respondents reported using the same assessment battery with all patients (n = 22). Ninety-five percent of respondents reported billing insurance for their services (n = 21). Neuro-Muscular Re-Education (n = 17), Therapeutic Activity (n = 16), and Therapeutic Procedure/Exercise (n = 15) were the highest reported CPT® codes. Twenty-three percent reported offering the LSVT-BIG® program via telehealth (n = 5). Semi-structured interviews identified patient payment burden, frequency of in-clinic visits and clinical space as barriers to implementation. High frequency of in-clinic visits was a feasibility challenge as well as a contributor of high payment burden on the patient. Clinicians vary in their settings, use of assessment and billing. A deeper look into the clinician perspectives on the protocol, such as the high frequency of in-clinic visits, should be explored to identify ways to make the LSVT-BIG® program more feasible. Additionally, further research should continue to explore the differences in implementation between clinicians in areas of assessment and billing to understand best implementation practices.
References
Schaible, F., Maier, F., Buchwitz, T. M., Schwartz, F., Hoock, M., Schönau, E., . . . & Eggers, C. (2021). Effects of Lee Silverman Voice Treatment BIG and conventional physiotherapy on non-motor and motor symptoms in Parkinson’s disease: a randomized controlled study comparing three exercise models. Therapeutic Advances in Neurological Disorders, 14, 1756286420986744.
Proffitt, R., Henderson, W., Stupps, M., Binder, L., Irlmeier, B., & Knapp, E. (2021). Feasibility of the Lee Silverman Voice Treatment-BIG Intervention in Stroke. OTJR: Occupation, Participation and Health, 41(1), 40–46.
