LSVT Global Launches Online LSVT LOUD Training and Certification for Speech Clinicians

QUARTERLY NEWSLETTER OF LSVT GLOBAL Vol. 3, No. 1 Fall 2010 6890 E. Sunrise Dr., Ste. 120-241 Tucson, AZ 85750 1.888.438.5788 LSVT Global Launches Online LSVT LOUD Training and Certification for Speech Clinicians LSVT Global, Inc. introduces Online LSVT LOUD Training and Certification. Until now, LSVT LOUD Training and Certification has only been available to clinicians attending intensive two day in-person workshops. Now, with the Online LSVT LOUD Training and Certification System, speech clinicians can complete the training course from their work or home office and without the expense of travel. Comprehensive LSVT LOUD Curriculum The Online LSVT LOUD Training and Certification program delivers 35 training modules based on the same content as in-person training workshops. These modules include narrated slides, as well as audio and video examples of techniques and client treatment examples. You can repeat content as many times as desired to re-enforce your learning. Maintaining training effectiveness and client treatment fidelity is of foremost importance to LSVT Global. Studies of clinician learning and comprehension of LSVT LOUD show comparable results for those trained at in-person workshops and those who used the Online training. Online LSVT LOUD Training and Certification Workshop Log-in screen Come See Us at the ASHA Convention Booth 439! See page 3 for ASHA special events. LSVT COMPANION ~ Clinician Edition A Significant Aid To Assessment And Therapy For LSVT LOUD Integrated Sound Pressure Level (SPL) Measurement & Frequency Counter Log SPL, Duration & Fundamental Frequency Automatically Individual Client Performance File Updating Real Time Performance Line Graphing LSVT COMPANION Home Version For Client Independent Practice Monitor Client Performance & Adjust Targets Via Email LSVT COMPANION allows you to set individual client goals for all LSVT LOUD tasks LSVT COMPANION walks you through your initial voice assessments while automatically collecting and analyzing your clients voice data (sound pressure level, fundamental frequency and duration). No more sound pressure level meter and frequency counter needed! In this Issue Dr. Lorraine Ramig Receives Honors...3 ASHA Convention Details...3 New LSVT Global President and CEO...3 Research Spotlight...4 LSVT BIG in Action...5 Patient s Corner...5 Global offerings...6 Summer Events...7 Latest Publications...8 Upcoming Events...8 1

Online LSVT LOUD Training Continued At the end of each learning module, there are a series of questions for knowledge reinforcement. In addition, slides and attachments can be downloaded for review. Online LSVT LOUD Training and Certification includes 35 training modules with narrated slides as well as audio and video examples LSVT faculty and staff are available to answer questions from online users by email and during regularly scheduled Webinars. The Online LSVT LOUD Training program culminates with a final exam to complete your LSVT LOUD certification, and qualifies for ASHA approved Continuing Education Units (1.2 hours) required to maintain your professional certification. Online LSVT LOUD Training Licensing The Online LSVT LOUD Training and Certification program is licensed for individual clinician use. Each clinician must complete testing individually to earn their LSVT LOUD certification and deliver LSVT LOUD voice/speech therapy to their clients. Minimum System Requirements High speed internet connectivity (not dial-up) Microsoft Internet Explorer version 6.0 or higher. For accurate answer tracking it is essential for users to use the Internet Explorer browser. If you have questions about the Online LSVT LOUD Training and Certification program or know of a clinician that might benefit from this new Online training, please contact us at training@lsvtglobal.com. Knowledge reinforcement questions are included at the end of each learning module. LSVT COMPANION Continued LSVT COMPANION walks you through each treatment session. After you set each client s specific goals, the software will automatically collect and analyze data on each treatment variable. No more writing down your assessment and treatment data by hand! I am absolutely delighted with the LSVT COMPANION Software, The more I use it, the more essential it becomes in my treatment of patients with Parkinson s disease. The data collection function is extremely helpful and frees me to do what I value most which is to provide feedback and guidance to my patients. Very significantly, my patients enjoy it and the visual feedback it provides is highly motivating. Karen Slotnick, MA CCC-SLP, Beth Israel medical Center, NYC LSVT COMPANION allows your client independent LSVT LOUD practice either in your office or at home by prescribing them the LSVT COMPANION Home version. You can communicate your treatment goals to your client and receive treatment results directly through the internet. At home sessions are now a reality! Seven years in development, the LSVT COMPANION has grown from a research concept to a commercial product designed to facilitate your treatment, increase treatment accessibility and encourage treatment maintenance by at home use. To learn more contact LSVT Global, Inc at Phone: +1 (888) 438-5788 Email: info@lsvtglobal.com Website: www.lsvtglobal.com LSVT COMPANION data are automatically written, averaged, and stored in an Excel spreadsheet LSVT COMPANION displays client performance during voice and speech exercises 2

Special Events At the Upcoming American Speech-Hearing-Language Association Convention in Philadelphia, PA, November 18-20, 2011 Thursday, November 18 to Saturday, November 20 Visit the LSVT Global Booth (439) in the Exhibits Hall: Special Discounts on Registrations, Product Previews, Meet the Experts Thursday, November 18, 7:00 pm to 8:30 pm Special Reception for LSVT LOUD Certified Clinicians Philadelphia Marriott Hotel, Room 407/408 RSVP Required Friday, November 19, 8:00 pm to 10:00 pm Open House Honoring Dr. Lorraine Ramig on her Prestigious ASHA Award, The Honors of the Association Loews Hotel, Washington C Room To RSVP and/or receive additional information on any of these events contact: Phone: 888-438-5788 Email: info@lsvtglobal.com LSVT Global Appoints Frank Shinneman as President and CEO building corporate value. LSVT Global, Inc. is pleased to announce the appointment of Frank Shinneman to the position of President and Chief Executive Officer, effective July 6, 2010. Following 20 years in specialty materials and equipment management, Mr. Shinneman has led a number of technology development companies including nano-materials, sterilization and solid-state lighting. He brings to LSVT Global over 37 years of broad experience in the commercialization of new products and We are extremely excited to welcome Frank to LSVT Global, stated Dr. Lorraine A. Ramig, Chairman of the Board. He brings the right combination of entrepreneurial, management and technology experience. This marks a new era of growth for our company. I am very pleased to join the LSVT Global team, said Mr. Shinneman, I look forward to bringing LSVT Global s world-class health care products and services to the next level. Dr. Lorraine A. Ramig Receives Honors from ASHA LSVT Global, Inc. is extremely pleased to announce that Dr. Lorraine A. Ramig, LSVT Global, Inc. Co-Founder and Chairman of the Board, will receive the prestigious Honors of the Association from the American Speech Language and Hearing Association at its upcoming national conference in Philadelphia. This is the highest honor this association can bestow and recognizes outstanding contributions to the discipline of communication sciences and disorders. It is awarded only to those individuals that have enhanced and altered the course of the profession through exceptional and creative clinical practice, research, teaching and professional contributions. We are extremely pleased that Dr. Ramig is being recognized for her lifetime contribution to the field of Speech Language Pathology. said Frank Shinneman, President and CEO of LSVT Global, Inc. Dr. Ramig has changed the face of research and practice in the area of communicative impairments associated with Parkinson disease and has created and refined the world renowned treatment, LSVT LOUD, that is the basis of all of our business interests. We could not be more proud of her. Please join us in celebrating this most prestigious honor while you are at ASHA this year. An open house will be held just following the ASHA Honors Event in the Washington C Room of the Loews Hotel from 8:00 pm to 10:00 pm. 3

Research Spotlight: Training LSVT BIG Improves Motor Performance in Parkinson s Disease (Reprinted with permission) MEGAN BROOKS, Medscape Medical News 2010, LLC June 18, 2010 (Buenos Aires, Argentina) In a comparative study, 4 weeks of supervised physiotherapy consisting of repetitive high-amplitude movements yielded greater improvements in motor performance in patients with Parkinson s disease than either Nordic walking or nonsupervised in-home exercises. Georg Ebersbach, MD, from the Movement Disorders Clinic, Beelitz- Heilstatten, Germany, presented the study here June 14, during the Movement Disorders Society 14 th International Congress of Parkinson s Disease and Movement Disorders. In the physiotherapy program, derived from the Lee Silverman Voice Treatment (LSVT), and now known as LSVT BIG, patients complete multiple repetitions (minimum, 12) of increasingly complex sustained whole-body movements at maximal amplitude. Examples of BIG exercises include: Reach left arm across the body to opposite side, keep hand open, palm up, right leg fully extended, toe pushing into the floor. Repeat on other leg and alternate. Step out and land BIG, pushing the left foot into the floor while reaching out the right side with bilateral BIG arms, open hands, palms up. Return the foot back to the start, end BIG. Repeat on other leg and alternate. Training BIG is delivered by a physiotherapist 4 days a week for 4 weeks, in 1-hour sessions. Therapists push patients to perform at a patient-perceived effort level of 8 or more (on a scale of 1-10, with 10 being the highest effort level) on every repetition. Goal-directed activities of daily living (ie, getting out of bed, dressing, doing household chores) are also a focus. The goal of LSVT BIG is to improve movement perception and to recalibrate disturbed scaling of movement amplitudes, the study team explains in the meeting poster. The Study The value of LSVT BIG movements approach became evident in a prospective, rater-blinded, comparative study in which 60 patients with mild to moderate Parkinson s disease were evenly and randomly assigned to one-on-one BIG training, Nordic walking in groups (the WALK group), or in-home nonsupervised exercises (the HOME group). The primary efficacy measure was difference in change in United Parkinson s Disease Rating Scale (UPDRS) motor score from baseline to follow-up at 16 weeks between groups. All but 2 patients (1 in the WALK group and 1 in the HOME group) completed the trial and 16-week follow-up. In an email to Medscape Neurology, Dr. Ebersbach said there was sustained improvement of motor performance 3 months after termination of supervised BIG training, [with] superior effect compared to Nordic walking and HOME (P<.001). Intensive training with BIG can improve motor performance to an extent comparable to current drug treatment, Dr. Ebersbach noted. Average improvement in UPDRS motor score in the BIG trainers was 5.05 (standard deviation [SD], 3.91, which is considered clinically relevant, the study team notes. In contrast, the UPDRS motor score shoed mild deterioration of 0.58 (SD, 3.17) in the WALK group and of 1.68 (SD, 5.95) in the HOME group. BIG was also superior to Nordic walking and in-home exercises in the timed up-and-go test and timed 10-m walking. There were no significant between-group differences in Parkinson s-related quality of life. The study is scheduled for publication in an upcoming issue of Movement Disorders. High-Amplitude Exercise Christopher G Goetz, MD, director of the Movement Disorders Program at Rush University Medical Center, Chicago, Illinois, and member of the Movement Disorders Society, told Medscape Neurology: This type of exercise is a notch above average exercising and is purposefully aimed to stress the patient s effort by asking him or her to exercise with high amplitude. Dr. Goetz was not involved in the study. Such methods would need to be trained initially, he added, but conceivably can be incorporated into a patient s self-designed home exercise routine. It is likely, however, that a professional trainer or therapist will help in this effort in order to train the high amplitude efforts. In a statement from the Movement Disorders Society, Cynthia Cornella, MD, from Rush University Medical Center in Chicago, calls the study innovative and notes that the result, extends the findings of the [LSVT] and suggests that similar techniques may be of benefit in other areas of motor impairment in Parkinson s disease. Although the results require confirmation, she adds, this study provides the impetus for continued investigations into the effects of specific training programs in [Parkinson s disease]. Dr. Ebersbach and Dr. Goetz have disclosed no relevant financial relationships. Movement Disorders Society (MDS) 14 th International Congress of Parkinson s Disease and Movement Disorders: Abstract LB-08. Presented June 14, 2010 4

Triumph Home Care Invests in LSVT BIG Treatment! Triumph Home Health Care, a Medicare certified home health care company based in Livonia, Michigan, recently sent all of their physical therapists to a LSVT BIG Training and Certification Workshop. Triumph Home Health Care has served over 12,000 patients in the metro Detroit area over the last eight years. Triumph s objective is to help patients gain and maintain as much control and independence in their lives as possible. The LSVT BIG Training and Certification Workshop allowed Triumph to fulfill this objective for their patients living with Parkinson s disease. Kyle Lanterman, a physical therapist with Triumph has seen tremendous progress in his patients after applying the methods learned during the LSVT training. The results in every individual patient have been rewarding Lanterman stated. Corrine Christensen is a perfect example of how the LSVT BIG therapy can improve a person s quality of life. Corrine lives with Parkinson s disease and has been wheelchair bound for the past five years. She endured multiple courses of therapies without any success. Dr. Aaron L. Ellenbogen DO, MPH with the Michigan Institute for Neurological Disorders suggested that Mrs. Christensen try the LSVT BIG therapy with Triumph Home Health Care. Kyle Lanterman, Triumph s physical therapist came out to see Mrs. Christenson. She said the LSVT therapy was very different than any therapy she ever had before. Mrs. Christensen said, Kyle is so unique. He came in the home with a big voice and quick and deliberate motions. Within the second week she started noticing results. She also felt that it was easier to learn the information given to her and receive the therapy. Mr. Christenson stated, In our home she accepts the information better. Kyle incorporated the LSVT BIG therapy with Mrs. Christenson while working on entering and exiting the family car. She is now able to use a U-step walker along with her wheelchair and this has made her more independent. She now walks around the house and even cooks. Mr. Christenson said that this has given them both a new level of independence. As Mrs. Christensen said, I can get up and go! A testimonial says it all. LSVT BIG therapy has enabled Triumph Home Health Care to continue improving patients quality of life by increasing their independence. Patient s Corner A Father s Day Gift As Father s Day approached this year, I asked my dad how he would like to spend the day. I was very surprised when he said he wanted to attend a seminar at Rush Presbyterian Medical Center. My sister, who is a physical therapist, had mentioned to our parents that there was a LSVT BIG conference being held at Rush and how she wished she could attend to further her training in the area of neurological rehabilitation. She also suggested that it may be beneficial for dad to attend...needless to say we went. Dad, Mom and I attended with a very open mind (but also a bit skeptical) about the possibilities this technique could provide. Before long, dad was walking across the room, moving freely and with such a sense of confidence...it was truly amazing! To this date when dad and I walk together, I remind him to THINK BIG - THINK LOUD and away he goes! While he still has episodes of freezing, he is able to re-focus on BIG and get moving! Finally, I must mention the professional and caring instructors who made Dad feel comfortable and confident enough to jump in and have faith in what they were suggesting as a method to help him with his daily challenges. Much of his ability to try, as well as, to feel success had to do with their support and encouragement. Thank you for a wonderful Father s day gift! 5

LSVT Global Offerings LSVT Global has exciting products and workshops for patients and clinicians alike. DVDs LSVT LOUD Homework Helper Speech exercises for people with Parkinson Disease and other neurological conditions. Available in English and Cantonese. LSVT LOUD 101 DVD A 42 minute introduction lecture ideal for patient support groups, introductory student lectures, or basic in-service presentations. The DVD includes an example of a person with PD PRE/POST LSVT LOUD and an example of vocal folds of a person with PD PRE/POST LSVT LOUD. LSVT LOUD & LSVT BIG Marketing Brochures As a Certified LSVT Clinician, you need to get the word out that you are ready for LSVT business. LSVT marketing brochures are the perfect way for you to advertise yourself as a Certified LSVT Clinician. WORKSHOPS LSVT LOUD & LSVT BIG Training and Certification Workshops are offered in multiple locations nationally and internationally. New ONLINE courses are now available for LSVT LOUD. Check the website for locations and registration information. LSVT eloud Treatment Delivery An on-line treatment method where patients can receive therapy from the comfort of their own homes via webcam. LSVT COMPANION SOFTWARE A new software program for LSVT Certified Clinicians that will facilitate data collection, analysis, and treatment delivery... plus a version for clients that will allow for continued home-treatment, practice, and exercise at the end of therapy. LSVT LOUD Training & Certification Workshop Schedule 2010 Atlanta, GA... November 4-5 St. Louis, MO... November 4-5 New York, NY... December 3-4 Boca Raton, FL... December 2-3 2011 Boulder, CO... January 7-8 Mulingar, Ireland... February 17-18 Scottsdale, AZ... February 24-25 Jacksonville, FL... March 17-18 Nagoya, JP... May 21-22 Chicago, IL... May 26-27 Dallas, TX... June 16-17 London, England... June 23-24 Brisbane, Australia... July 21-22 Fraiture-en-Condroz, Belgium... Sept. 10-11 Check our website for additional 2011 dates and locations. Join the over 6,000 clinicians worldwide already certified in this valuable treatment technique for patients with neurological disorders! LSVT BIG Training & Certification Workshop Schedule 2010 Boca Raton, FL...December 11-12 2011 Kingston, RI...January 21-22 Scottsdale, AZ...March 12-13 Chicago, IL...July 23-24 Check our website for additional 2011 dates and locations. For more information and to register for either LSVT LOUD or LSVT BIG Workshops visit: website: www.lsvtglobal.com Call: 1-888-438-5788 Email: info@lsvtglobal.com 6

LSVT Global, Impacting Parkinson Communities Worldwide! International Conferences Summer 2010 articulatory changes following LSVT, and a series of case studies. One of the highlights of this trip for our team was an excursion to the Demilitarized Zone (DMZ). LSVT Global founders and collaborative researchers had the opportunity to attend a number of International Conferences this summer. It was a unique year where a combination of events that individually happen every 2-5 years all occurred between June-September, 2010! While this made for a full travel schedule, it was a wonderful opportunity to share our research and learn from others, connect with colleagues and friends from around the world, and soak in the beauty and culture of many different countries. Below is a brief summary of the activities and research presented at these events. The Basal Ganglia Speech Disorders And Deep Brain Stimulation 2nd International Symposium June 29th July 1st Aix-en-Provence, France The symposium was organized and hosted by Serge PINTO and François VIALLET ( LPL- Laboratoire Parole et Language, Aix, France) and Elina TRIPOLITI (London, UK). The international faculty represented fields of neurosurgery, neurology, speech science, speech therapy among others. The focus of presentations and discussions was on the role of basal ganglia in speech and the impact of deep brain stimulation surgery on speech function. Drs. Lorraine Ramig, Cynthia Fox, and Shimon Sapir presented lectures on LSVT, LSVT and DBS and Neuroprotection, Plasticity, and Compensation in relation to DBS and speech. The next Symposium will take place in Ulm, Sweden in June, 2012. The 28th World Congress of the International Association of Logopedics and Phoniatricians (IALP) August 22-26 Athens, Greece There were numerous seminars, workshops, special sessions, free papers and poster presentations that highlighted the diversity of our field and the advances reached in different countries. Drs. Ramig and Fox presented a seminar on the Evolution of Evidence Based Practice: LSVT LOUD and paper on New Perspectives of Treating Pediatric Motor Speech Disorders. The next World Congress of IALP will occur in Turin, Italy 2013! Immediately following the conclusion of IALP, there was an LSVT LOUD Training and Certification Workshop held on August 27-28 in Athens. This was the first ever course held in Greece. A special thank you to Ilias Papathanasiou, PhD for coordinating this event. The 4th World Voice Congress September 6-9, 2010 Seoul, South Korea This congress was a great gathering of roughly 900 participants who attended various lectures and presentations on the Multidisciplinary Voice Communication in Harmony. Drs. Ramig, Fox and Sapir presented a session on Motor Speech Disorders focusing on LSVT for Parkinson disease, The 2nd World Parkinson Congress September 28th October 1st Glasgow, Scotland LSVT Global was delighted to participate in this unique congress that includes participation from physicians, scientists, allied health professionals and patients and families living with the disease. Glasgow was a wonderful host for this congress. It was exciting to see the emphasis that was placed on the importance of rehabilitation and exercise at this congress as evidenced by the many presentations, posters and booth exhibits on this topic. We met numerous individuals with PD who are living exercised-filled lives and feeling the impact of taking control of this aspect of their disease management. One particular woman with PD sticks out in our minds. She was 62 years old, had PD for over 10 years and her maximum weight-lifting dead lift was 220 pounds!!! We were also delighted to see so many individuals with PD who had received LSVT LOUD and were proud to stop by our booth and demonstrate their improved communication. This is a testament to the dedication of LSVT LOUD certified clinicians in the UK who are improving the lives of people living with the disease. 7

Upcoming Events: Neuroscience November 13-17, 2010, San Diego, CA Neural Mechanisms Underlying Vocalization in Multiple Species: A Special Focus on Parkinson s Disease. November 13, 2010, 1:30-4pm Room 30E, San Diego Convention Center This mini-symposium will highlight the voice/speech deficits seen in human Parkinson s Disease, discuss current, effective therapeutic strategies, and explore the progress being made to understand the neurological bases of vocalization in animal models as pertains to neurological disease, including the potential for behavioral or neural recovery. Speakers: Jessica Huber, Ph.D., Associate Professor, Purdue University Cynthia Fox, Ph.D., CCC-SLP, Research Associate, National Center for Voice and Speech, University of Colorado - Denver Roian Egnor, Ph.D., HHMI Fellow, Janelia Farms Michelle Ciucci, Ph.D., CCC-SLP, Assistant Professor, University of Wisconsin - Madison Mimi Kao, Ph.D., Postdoctoral fellow, University of California - San Francisco Julie E. Miller, Ph.D., Postdoctoral fellow, University of California - Los Angeles Calling all LSVT LOUD and LSVT BIG Certified Clinicians! Have you joined our Discussion Board? Post your questions and share your insights. Go to www.discuss.lsvtglobal.com and apply for membership. Latest Publications Blitzer, A., Brin, M., & Ramig, L. (2009). Neurological Voice Disorders. NYC: Thieme Medical, Inc. Ebersbach G, Ebersbach A, Edler D, Kaufhold O, Kusch M, Kupsch A, Wissel J.(2010). Comparing exercise in Parkinson s disease--the Berlin LSVT BIG study. Mov Disord. 25(12):1902-8. Goetz, C.G., Stebbins, G.T., Wolff, D., DeLeeuw, W., Bronte-Stewart, H., Elble, R., Hallett, M., Nutt, J., Ramig, L., Sanger, T., Wu, A.D., Kraus, P.H., Blasucci, L.M., Shamim, E.A., Sethi, K.D., Spielman, J., Kubota, K., Grove, A.S., Dishman, E., & Taylor, C.B. (2009). Testing objective measures of motor impairment in early Parkinson s disease: Feasibility study of an at-home testing device. Mov Disord, 24(4), 551-6. Hirsch MA, Farley BG. (2009) Exercise and neuroplasticity in persons living with Parkinson s disease. Eur J Phys Rehabil Med. 45(2): 215-29. Howell S, Tripoliti E, Pring T. (2009) Delivering the Lee Silverman Voice Treatment (LSVT) by web camera: a feasibility study. J Lang Commun Disord. 44, 287-300. Little, M.A., McSharry, P.E., Hunter, E., Spielman, J., & Ramig, L. (2009). Suitability of dysphonia measurements for telemonitoring of Parkinson s disease. IEEE Trans Biomed Eng, 56 (4), 1015-1022. Mahler, L., Ramig, L., & Fox, C. (2009). Intensive voice treatment (LSVT LOUD) for dysarthria secondary to stroke. J Med Speech Lang Pathol, 17(4), 165-182. Narayana S, Fox PT, Zhang W, et al. (2010) Neural correlates of efficacy of voice therapy in Parkinson s disease identified by performance-correlation analysis. Hum Brain Mapp, 31,222-236. Sapir, S., Ramig, L., Spielman, J., & Fox, C. (2010). Formant Centralization Ratio (FCR) as an acoustic index of dysarthric vowel articulation: comparison with vowel space area in Parkinson disease and healthy aging. J Speech Lang Hear Res, 53, 114-125. 8