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‘It’s hard to stay motivated to do it on my own’

Exercise, education and camaraderie at heart of free Parkinson’s classes at Methodist Outpatient Therapy

Published on November 29, 2023
By Susan Christensen

Occupational therapist Ashlee Ricotta leads Sheri Carter through exercises designed to improve walking speed, balance and trunk rotation during a class for people with Parkinson’s disease at Methodist Outpatient Therapy in Flowood.

Mark Heusel says attending BIG & LOUD for Life: A Parkinson’s Disease Wellness Program keeps him motivated to continue exercising so he can maintain an active lifestyle.

Speech therapist Kim Boyd times Calvin Sibley as he tries to hold a note as long and loudly as possible. Voice strengthening helps people with Parkinson’s improve disease-weakened voices that can be difficult to understand.

As a graduate of LSVT BIG & LOUD therapy for Parkinson’s disease, Mark Heusel of Madison knows he’s supposed to continue the program’s intensive exercises at home.

“But it’s hard to stay motivated to do it on my own,” confesses the retired mechanical engineer.

That’s why he’s delighted to have discovered BIG & LOUD for Life: A Parkinson’s Disease Wellness Program. Free classes are now available at Methodist Outpatient Therapy clinics in Ridgeland and Flowood.

Methodist received a $17,000 grant from the Parkinson’s Foundation to fund the program, which addresses voice and mobility problems that accompany the neurological disease.
Methodist physical therapist Lisa Indest said it’s a great example of how Methodist and the Parkinson’s Foundation work together to support Parkinson’s patients in Mississippi. Methodist recently sponsored and hosted the foundation’s Moving Day walk at its Ridgeland clinic.

The next collaboration will be Strategies for Improved Living with Parkinson’s Disease, a program set for Dec. 8 at Methodist Rehabilitation Center in Jackson. Topics for the free event include adaptive equipment and home modifications, adaptive yoga, therapeutic interventions and non-motor symptoms of Parkinson’s.
While Strategies for Improved Living is open to anyone with Parkinson’s and their caregivers, BIG & LOUD for Life is limited to people who’ve undergone LSVT therapy at Methodist or elsewhere.

LSVT stands for Lee Silverman Voice Training and initially started with the “LOUD” portion of the program. The “BIG” portion of the program was later added to provide exercises to improve walking speed, balance and trunk rotation.

While the schedule for LSVT therapy is four days a week for four weeks, the BIG & LOUD for Life class meets two times a week for only an hour. Still, Sheri Carter of Pearl finds it a nice adjunct to her other Parkinson’s activity—Rock Steady Boxing.

“This is more of a stretching workout. It helps with flexibility,” Carter said. “The camaraderie encourages me, and the group exercise makes it fun.”

Another plus is participants work with therapists who are well-acquainted with how Parkinson’s disease progresses. “This allows them an assessment of the changes that are possibly taking place in terms of fall risks and ongoing mobility needs,” Indest said.
Carter said Methodist occupational therapist Ashlee Ricotta has been a great resource. “She’s good at identifying areas of weakness and giving me exercises to address it,” she said.

On a recent Monday morning in Flowood, Ricotta warmed up the group with movements that target impairments such as postural changes and muscle rigidity. The activity is paired with loud counting, which addresses another problem of Parkinson’s—disease-weakened voices that can be difficult to understand.

“The LSVT Loud catch phrase is: ‘If you don’t feel like you’re yelling, you’re not loud enough,’” said Methodist speech therapist Kimberly Boyd. “People with Parkinson’s disease talk low and feel like they are yelling when they speak at a normal volume. The catch phrase is a reminder.”

Practical applications abound in the program, even for a game of Yahtzee.  Participants addressed various therapy goals as they walked to a table to toss oversized wooden dice, then calculate their score. “They’re working on gross motor coordination, sit to stand skills, walking, cognitive skills and their voices,” Ricotta said.

Boyd puts participants through a number of strategies aimed at voice strengthening. She has the group verbally hold a note as long as they can and go high to low and low to high on the musical scale. Next, they say sentences that each participant has written for themselves. The idea is to focus on words that they’ll use in their everyday lives.  

One of Heusel’s phrases is Ho-Ho-Ho. The white-bearded retiree and his wife, Jan, were recently asked to play Mr. and Mrs. Santa Claus for parades in Ridgeland and Madison, as well as at other local holiday events.

It’s part of the couple’s already long list of activities, including travel, visiting with the grandkids and senior exercise classes. And it’s indicative of Heusel’s mindset since being diagnosed with Parkinson’s in December 2022.

“I’m not laying down with Parkinson’s,” he said. “I don’t intend to stop doing anything until I just can’t do it anymore.”

Free classes for BIG & LOUD for Life: Parkinson’s Disease Wellness Program are offered at Methodist Outpatient Therapy clinics in Flowood and Ridgeland for people who’ve previously undergone LSVT therapy.

Strategies for Improved Living with Parkinson’s Disease is 10 a.m. to 2 p.m. Dec. 8 in the second floor Bankplus Conference Center at Methodist Rehabilitation Center in Jackson. Valet parking is available. The free event will feature presentations by University of Mississippi Medical Center neurologist and neurodegenerative movement disorders specialist Dr. Juebin Huang, Methodist speech therapist Kelli Priest and Methodist occupational therapists Adrienne Brumfield and Tina Marshall.

For information on either program, contact Heather Maloney at or 601-936-8838.