Abstract
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.
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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.