What is Big and Loud Therapy? How does it Help People with Parkinson’s?

Big and Loud therapy is a training program that is designed to deal with movement and speech problems. The training is especially recommended for Parkinson’s patients. But it can also benefit those suffering from other brain conditions.

big and loud therapy for Parkinson's

People with Parkinson’s disease often have difficulty with speech and trouble in performing different body movements. These problems become more evident when the disease reaches its advanced stage. Besides medication, the patient is recommended to participate in exercise programs to overcome these problems. Big and Loud therapy is one such program that got much attention in recent years.

But what is Big and Loud therapy? What kind of exercises are involved in this therapy? And how does it help Parkinson’s patients?

Here, you will get answers to these questions!

What is Big and Loud Therapy?

This therapy approach was first introduced in 1987 and initially it was used to improve voice and speech in people with Parkinson’s disease. Later on, some additional changes were made to make it effective for treating the motor problems of the disease.

The Big and Loud therapy has two segments: the big segment that involved different body movements and the loud segment that deals with the speech.

In the big segment, a patient needs to perform very large awkward feeling movements. This refers to the large extended movement of hands, legs, and exaggerated trunk rotation. These movements are performed either seated or standing. The aim is to improve the overall posture, arm movement, and increase in the step size.

The loud segment aims to regain the communication ability of a patient. During the training, a patient is trained to say “ah” in loud good quality voice going high in pitch. The patient is also trained to say daily phrases loudly. This improves the vocal quality and helps the patient to speak in a clear and louder voice.

How Long does it Take to Complete the Big and Loud Therapy Course?

Big and Loud therapy course consists of a highly intensive training program and like many other training it is performed under a qualified trainer. In this course, there are 16 sessions in total and each session lasts for 1 hour. It takes around 4 weeks to complete the course and a patient has to go through 4 sessions per week. The exercises used in this training program may vary according to the patient needs.

How does it Help People with Parkinson’s?

Slow movement and trouble in speech are the two primary problems faced by Parkinson’s patients. They often walk slowly with smaller steps and find it difficult to speak in a clear and louder voice. The Big and Loud therapy helps them to deal with these problems effectively.

There are many clinical trials and some anecdotal evidence published in the last few years claiming that patients got significant improvement in their movements (like walking, setting and bed mobility) following this therapy. The patients reported that they found improvement in their walking speed and performing small movements like getting in and out of the chair, sofa or bed. In addition, the therapy also helped in improving balance, strength, and endurance.

Similarly, the therapeutic effects of this therapy on speech has been reported in many studies. A study involving 28 patients has concluded that it is effective for improving orofacial functions like speech, swallowing, and facial expression. The same study also reported that this therapy is also helpful in improving respiratory and laryngeal (the part that creates voice) functions in patients.

In addition to movement and speech, researchers think that this therapy may also help to improve the cognitive functions in patients.

The Takeaway

Big and Loud therapy is considered as a standard, research-based treatment protocol for Parkinson’s patients. Whilst there is little evidence of its efficacy in slowing the disease progression, starting it at the early stages may possibly delay the onset of motor symptoms. If you are Parkinson’s patient and interested in attending this therapy, it is good to take the advice of your doctor first. Your doctor may recommend the one that suits you the best.

Disclaimer: The information shared here should not be taken as medical advice. The opinions
presented here are not intended to treat any health conditions. For your specific medical problem, consult with your health care provider.

4 thoughts on “What is Big and Loud Therapy? How does it Help People with Parkinson’s?”

  1. My husband’s doctor just put an order in for physical therapy. He has not started yet. When he was visited last year after being in a rehab center, the physical therapist suggested the Big and Loud program. I think I would like him to try this program instead of physical therapy. How do I get him enrolled?


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