LSVT® BIG versus progressive structured mobility training through synchronous telerehabilitation in Parkinson's disease: A randomized controlled trial

Background Parkinson's disease (PD) is a common neurodegenerative illness associated with motor symptoms.Aim The aim of study was to compare the effects of synchronous telerehabilitation-based Lee Silverman Voice Treatment (R) BIG (LSVT (R) BIG) protocol and progressive structured mobility training in patients with Parkinson's disease (PD).Methods Thirty-two patients diagnosed with PD (aged 40-72 years, Hoehn-Yahr stage 1-3) were randomly allocated into LSVT (R) BIG (Group 1) and Progressive Structured Mobility Training (Group 2) groups. Exercises were performed in both groups for 60 min a day, 4 days a week, for 4 weeks under the supervision of a physiotherapist with synchronous online videoconference method. Dynamic balance was assessed with Mini-Balance Evaluation Systems Test (Mini-BESTest) as a primary outcome measure. The secondary outcome measurements were Timed Up and Go Test (TUG), spatiotemporal parameters of gait from Kinovea (R) software, and postural stability from the Biodex Balance System. Other outcome measures were Activity-Specific Balance Confidence Scale-Short Form (ABC-SF), Parkinson's Activity Scale (PAS), and Parkinson's Disease Quality of Life Questionnaire (PDQ-39).Results This study showed significant group-by-time interactions on Mini-BEST (p = 0.042), ABC-SF (p = 0.029), and PAS (p = 0.022) in favor of group 1. Also, TUG (p < 0.01), spatiotemporal parameters of gait (p < 0.01), and PDQ-39 (p < 0.01) were improved in both groups.Conclusion Both synchronous telerehabilitation-based exercise protocols enhanced balance and gait, as well as activity level and quality of life in patients with PD. LSVT (R) BIG may be preferred to improve dynamic balance, balance confidence, and activity status in the early stages of PD. These results should be confirmed in future studies with more robust methodology.Trial registrationNCT04694872.