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Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: A Case Report.
J Neurol Phys Ther. 2020 07; 44(3):220-227.JN

Abstract

BACKGROUND AND PURPOSE

There is no literature exploring physical therapy interventions for individuals with idiopathic normal pressure hydrocephalus (iNPH). There are parallels between symptoms of iNPH and Parkinson disease (PD), suggesting that similar interventions may be beneficial. An approach that promotes recalibration of movements to produce bigger motions (Lee Silverman Voice Treatment BIG [LSVT BIG]) is an evidence-based intervention for individuals with PD, which could potentially improve function in individuals with iNPH. This case report documents functional outcomes of LSVT BIG in an individual with iNPH.

CASE DESCRIPTION

The participant was a 62-year-old man with a 16-year history of iNPH. He demonstrated hypokinesia, impaired balance, and cognitive deficits. These resulted in frequent falls and limited community ambulation.

INTERVENTION

The participant completed the standardized 4-week LSVT BIG program in addition to 5 tune-up sessions 7 months later. Outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG), TUG cognitive and manual, Activities-Specific Balance and Confidence (ABC) scale, Five Times Sit to Stand (5TSTS) test, and a timed floor transfer.

OUTCOMES

Improvements, exceeding minimal detectable change values, were noted on the BBS and the ABC scale immediately following intervention. Scores declined at 4-month follow-up, but BBS scores increased again after the tune-up sessions. Quicker floor transfer times were also noted. There were no changes in TUG, TUG cognitive and manual, or 5TSTS times.

DISCUSSION

Therapists may wish to consider the use of the LSVT BIG program in persons with iNPH; however, a longer program and/or regular tune-up sessions may be necessary for best outcomes.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A315).

Authors+Show Affiliations

Utica College, Utica, New York.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32516302

Citation

Fillmore, Shannon, et al. "Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: a Case Report." Journal of Neurologic Physical Therapy : JNPT, vol. 44, no. 3, 2020, pp. 220-227.
Fillmore S, Cavalier G, Franke H, et al. Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: A Case Report. J Neurol Phys Ther. 2020;44(3):220-227.
Fillmore, S., Cavalier, G., Franke, H., Hajec, M., Thomas, A., & Moriello, G. (2020). Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: A Case Report. Journal of Neurologic Physical Therapy : JNPT, 44(3), 220-227. https://doi.org/10.1097/NPT.0000000000000319
Fillmore S, et al. Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: a Case Report. J Neurol Phys Ther. 2020;44(3):220-227. PubMed PMID: 32516302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes Following LSVT BIG in a Person With Idiopathic Normal Pressure Hydrocephalus: A Case Report. AU - Fillmore,Shannon, AU - Cavalier,Gianna, AU - Franke,Holly, AU - Hajec,Marissa, AU - Thomas,Anthony, AU - Moriello,Gabriele, PY - 2020/6/10/entrez PY - 2020/6/10/pubmed PY - 2021/1/26/medline SP - 220 EP - 227 JF - Journal of neurologic physical therapy : JNPT JO - J Neurol Phys Ther VL - 44 IS - 3 N2 - BACKGROUND AND PURPOSE: There is no literature exploring physical therapy interventions for individuals with idiopathic normal pressure hydrocephalus (iNPH). There are parallels between symptoms of iNPH and Parkinson disease (PD), suggesting that similar interventions may be beneficial. An approach that promotes recalibration of movements to produce bigger motions (Lee Silverman Voice Treatment BIG [LSVT BIG]) is an evidence-based intervention for individuals with PD, which could potentially improve function in individuals with iNPH. This case report documents functional outcomes of LSVT BIG in an individual with iNPH. CASE DESCRIPTION: The participant was a 62-year-old man with a 16-year history of iNPH. He demonstrated hypokinesia, impaired balance, and cognitive deficits. These resulted in frequent falls and limited community ambulation. INTERVENTION: The participant completed the standardized 4-week LSVT BIG program in addition to 5 tune-up sessions 7 months later. Outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG), TUG cognitive and manual, Activities-Specific Balance and Confidence (ABC) scale, Five Times Sit to Stand (5TSTS) test, and a timed floor transfer. OUTCOMES: Improvements, exceeding minimal detectable change values, were noted on the BBS and the ABC scale immediately following intervention. Scores declined at 4-month follow-up, but BBS scores increased again after the tune-up sessions. Quicker floor transfer times were also noted. There were no changes in TUG, TUG cognitive and manual, or 5TSTS times. DISCUSSION: Therapists may wish to consider the use of the LSVT BIG program in persons with iNPH; however, a longer program and/or regular tune-up sessions may be necessary for best outcomes.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A315). SN - 1557-0584 UR - https://www.unboundmedicine.com/medline/citation/32516302/Outcomes_Following_LSVT_BIG_in_a_Person_With_Idiopathic_Normal_Pressure_Hydrocephalus:_A_Case_Report_ L2 - https://doi.org/10.1097/NPT.0000000000000319 DB - PRIME DP - Unbound Medicine ER -