LSVT BIG Therapy is Now Available at Rock Hill!

We’re excited to announce that Carolina NeuroSurgery & Spine Associates is now offering the LSVT BIG Program in Physical Therapy at our Rock Hill office! Madison Domico PT, DPT, will serve patients with Parkinson’s Disease and other neurological conditions through this standardized physical therapy program. Keep reading to learn more about the program and Madison’s background in treating patients with Parkinson’s Disease. 

What is the LSVT BIG Program? 

LSVT BIG is an intensive treatment program that trains patients with Parkinson’s Disease or other neurological conditions to use their body more normally. It involves four weeks of 16 sessions of physical therapy that are directed at symptoms of Parkinson’s Disease, as well as gait training and training in functional skills personalized to the patient. The hour-long, one-on-one treatment sessions are designed to improve risk of falls, increase independence in daily activities, and create normalized amplitude of movement.

People living with Parkinson’s Disease or other neurological conditions often move with gestures and actions that become smaller and slower, making it difficult to get around, get dressed, or complete other activities of daily living. LSVT BIG helps improve movements for any activity, from small motor tasks like buttoning a shirt to large motor tasks like getting up from a seated position. Patients learn how and when to apply extra effort to produce bigger motions. 

Research on the LSVT BIG program has documented improved motor functioning in people with Parkinson’s Disease following treatment, including faster walking and a larger step length, improved balance, improved trunk mobility, and reduced risk of falling.

What might an individual session include? 

The 60 minute-long sessions start with a warmup to get the patient’s heart rate up. Then, the physical therapist and patient go into the seven maximal daily exercises that were specifically made for LSVT BIG therapy that work to combat the main symptoms of Parkinson's. These exercises include forward flex posture, rigidity through the trunk, and decreased arm swing. The seven exercises can be adapted to the patient’s needs, such as being done standing, sitting, or lying down. 

After completing those exercises, the physical therapist and patient begin working on functional component tasks. They may pick around five everyday activities that the patients want to improve, including putting on a jacket, typing on their phone, pulling keys out of their pocket, or going up stairs. Next, they work on hierarchy tasks, which are broad goals like going out to dinner that include multiple parts. The patient and physical therapist could work on getting dressed to go out to dinner, getting in and out of the car, then sitting at the table and using utensils.

Every session ends with “big walking,” which includes working on walking and trying to normalize gait patterns. The patient and physical therapist work on making big arm swings and big steps to get the patient moving more, then scale it to the point where they’re walking with a normal gait pattern and normal gait mechanics. 

We also asked Madison to share how she began working with patients with Parkinson’s Disease and some of her hopes for offering LVST BIG therapy at CNSA’s Rock Hill location. 

How did you first start working with patients with Parkinson’s Disease? 

I began working with this patient population when I was in my first year of physical therapy school. I was in charge of a geriatric special population group within my cohort that put on a Parkinson’s Exercise class once a week for this population. I got to talk to, work with, and improve the health of these folks on a weekly basis. I’ve been interested in working with them ever since!

What made you interested in running the LSVT BIG Program at the Rock Hill office? 

We get patients all the time who have much more going on medically than just any kind of joint pain. A fair amount of these folks also carry neurological diseases such as Parkinson’s Disease. I became more intrigued to introduce something to our clinic that is unique and extremely beneficial to this population.

What makes you the most excited about implementing the LSVT BIG program? 

The ability to provide such individualized treatment for these patients is such a unique and rewarding experience, both for the patients and myself! Up to 8 million people worldwide are living with this disease. Its prevalence is expected to double by 2040, which means resources for rehabilitation need to increase as well. I am happy to contribute to the cause and to provide myself as a resource to those living with PD in the greater Charlotte area.  

If you or anyone you know may benefit from this program, you can contact us to learn more or request an appointment today. Physical therapist Madison Domico is now accepting new patients at our Rock Hill location

About our Comprehensive Services 

Carolina NeuroSurgery & Spine Associates, established in 1940, is one of the nation's largest and most highly respected neurosurgical private practices. Our group provides brain and spine care services, including adult and pediatric neurosurgery, spine surgery, physiatry, neurology, pain management, and physical therapy

We offer advanced surgical and non-surgical treatment for the entire spectrum of brain, spine, and peripheral nerve disorders, including brain tumors, spine deformities and injuries, stroke, epilepsy, congenital anomalies, concussions, neck and lower back pain, and pituitary tumors.

Carolina NeuroSurgery & Spine Associates’ commitment to advancing the science and delivery of brain and spine care has remained the driving force for its success. 

The group comprises 49 physicians, 41 advanced practice providers, and over 550 employees. With nine office locations, the group primarily brings the latest, technologically advanced neurosurgical therapies to adults and children across the Carolinas.

Our experts are here to help. Call our office or click below to request an appointment online to take the next step.


This content is for informational and educational purposes only. For specific medical questions, please consult your doctor. New and current patients can call our offices to make an appointment or request an appointment online.

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