Effect of LSVT big protocol on memory cognition endurance gait speed and balance in patients with Parkinsons disease A Randomized Controlled trial

LSVT Big Protocol The LSVT Big protocol is a physical therapy program that emphasizes large, purposeful movements to improve motor function in patients with PD. It is based on the principle of neuroplasticity, which suggests that intensive practice of motor skills can help the brain form new pathways and improve function. LSVT Big is primarily designed to improve motor symptoms like gait and balance but may also have effects on endurance due to the increased level of physical activity

Conventional Therapy Conventional therapy usually refers to standard approaches used in physical occupational or speech therapy to manage PD symptoms This can include strength training balance exercises aerobic activities or cognitive rehabilitation Adding LSVT Big to conventional therapy may enhance overall outcomes combining the benefits of motor improvement with cognitive and functional exercises

Cognitive and Memory Function in PD Memory and cognitive deficits in PD particularly in the later stages can have a profound impact on daily functioning Research into the potential cognitive benefits of therapies like LSVT Big is important because treatments that improve motor function may have secondary benefits for cognition through enhanced physical activity reduced anxiety and improved mood Additionally the attention required for large intentional movements may improve aspects of executive function which is often impaired in PD Endurance Patients with PD often experience a decline in endurance due to bradykinesia slowness of movement and muscle rigidity Combining LSVT Big with conventional therapies that focus on endurance eg aerobic exercises might lead to greater improvements in cardiovascular fitness mobility and energy levels

Gait Speed and Balance Impaired gait speed and balance are hallmark symptoms of PD leading to an increased risk of falls and decreased independence LSVT Big has been shown to improve gait speed by focusing on larger more exaggerated movements which helps in overcoming some of the motor limitations of PD Balance training is also crucial for preventing falls and combining LSVT Big with other balance focused interventions in conventional therapy could lead to even more significant improvements

Need for This Study While the individual effects of LSVT Big on motor symptoms like gait and balance are well-documented there is less research into its impact on cognitive functions memory attention and executive function and endurance especially when combined with other conventional therapy approaches Such a study would have to done

Establish comprehensive treatment protocols A combined approach can address both motor and non motor symptoms Provide personalized treatment plans Understanding the full scope of LSVT Bigs benefits can help clinicians tailor treatments Improve quality of life Enhancing cognition memory endurance gait speed and balance would allow PD patients to maintain a higher level of independence Guide future interventions This study would provide evidence for whether combining LSVT Big with conventional therapy could be more effective than using either treatment alone In summary a study on the combined effects of LSVT Big protocol and conventional therapy on memory cognition endurance gait speed and balance in Parkinsons disease is crucial to advance treatment protocols and improve the overall quality of life for PD patients

MATERIAL AND METHODOLOGY Source of Data will be collected from In Patient Department Pravara Medical Trust Loni and Arihant neuro centre Nashik  Method of collection of data Type of Data Quantitative Study Design Randomised Control Trail Study Setting InPatient department of Medicine and Department of Neuro Physiotherapy at Dr APJAK College of Physiotherapy PIMS Loni Sample size 20 participants Patient diagnosed with Parkinson  Sampling Method Coin toss Lottery toss of dice shuffling cards etc Study Duration 1 years. Material to be used are Consent form MoCA scale  6 min walk test  10 meter walk test  Berg Balance Scale  and assess the stage of parkinsons using H and Y scale

Group A  Convetional

Exercise 1 8 repetitions sustain biq stretch floor to ceiling Exercise 2 8 repetitions sustain big stretch side to side

Exercise 2 16 repetitions big step forward 8 repetitions each leg Exercise 2 16 repetitions big step sideways 8 repetitions each side

Exercise 3 16 repetitions big step backward 8 repetitions each leg

Exercise 4 20 repetitions forward big rock and reach 10 repetitions each side

Exercise 5 20 repetitions sideways big rock and reach 10 repetitions each side

Group B  Experimental

Exercise 1 8 repetitions sustain big stretch floor to ceiling

Exercise 2 8 repetitions sustain big stretch side to side

Exercise 1 16 repetitions big step forward 8 repetitions each leg

Exercise 2 16 repetitions big step sideways 8 repetitions each side

Exercise 3 16 repetitions big step backward 8 repetitions each leg

Exercise 4 20 repetitions, forward big rock and reach 10 repetitions each side

Exercise 5 20 repetitions, sideways big rock and reach 10 repetitions each side

Patient identifies 5 movements he or she does in functional everyday living eg, sit to stand Clinician and patient select one simple component of each of these movements There are 5 repetitions for each of the component movements Do your movement with the same effort bigness that you do during daily exercises