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Angels on Duty – CPA credits therapists with getting him on course

Posted on February 21, 2018 in Patient Stories

CPA credits therapists with getting him on course

With one angel looking over his shoulder and another hanging on his every word, Dennis Overton knew he was in good hands with the therapists at Parkwest Therapy Center at Fort Sanders West.

“When I first got here and began dealing with the people of Covenant Health, it was unbelievable,” said Overton, who was diagnosed with Parkinson’s disease (PD) in December 2016. “It was like they were angels!”

He was referring specifically to physical therapist Suzanne Moskal and speech therapist Tonya Connell. They were the two “angels” who helped slow the progress of his PD through therapy programs called LSVT BIG® and LVST LOUD®. In doing so, they gave him back his voice – and his golf game.

Parkinson’s causes the brain to produce insufficient levels of dopamine, which affects movement and speech. BIG and LOUD are separate four-week, 16-session therapy programs to improve motor and speech skills lost by patients with PD.


Since Parkinson’s can minimize a patient’s ability to speak and be heard well, LOUD therapy uses strengthening exercises that target the respiratory and laryngeal muscles used to produce voice. These exercises are progressively customized to help the patient achieve appropriate volume at a conversation level. The patient is also taught to accurately hear their own voice volume through repetition of voice exercises as well as verbal and visual feedback. The goal of the training is not to shout, but to bring the voice to a healthy loudness without strain – an improvement that can last as long as two years.


“These specific strategies give patients proven tools to combat the effects of PD,” said Connell, who has worked with 75 to 100 patients since earning her LOUD certification six years ago. “Just like medication, it does not cure PD but it helps people continue to live without as many limitations.”

Connell said Overton’s main limitation was maintaining sufficient volume so people could understand him. “He thought he was talking loud enough but often trailed off in volume toward the end of sentences, causing people to not understand his entire message,” she said.

“Tonya was fantastic!” said Overton, a 65-year-old certified public accountant. “I hadn’t noticed that my voice was not strong enough but when she used the machine that tests the volume, it was very obvious.”

“He did remarkably well,” said Connell. “He was diligent with completing exercises on a daily basis and began using therapy strategies to improve his voice volume after the first few sessions at work and in social settings. He no longer gets tired when talking all day at work and people understand him consistently, even in noisy environments like restaurants. He can now judge his own voice accurately and increase his volume as needed.”    

After finishing his LOUD therapy, it was on to BIG therapy to work on physical limitations. Moskal’s preliminary evaluation revealed problems with balance, endurance, mild gait deviations with arm swing, slower walking speed and difficulty walking on uneven ground.

“That Suzanne is a smart, smart lady,” Overton said. “She knows what she’s doing. I loved the exercise part of it because, as a CPA, I was working 10 hours a day five days a week. So doing physical exercise just sort of took a backseat.

“Suzanne said it would be better for me to work six hours a day instead of eight to 10. That made a big difference. I turned those hours into exercise. I had to get to the point where I could ‘single task’ – close the door, turn the phone off and get my work done, as opposed to taking calls one after another after another.”

Exercises at the therapy center and at home included different arm movements, stretching, sit-down bicycling, and getting up and out of a chair without using his hands. But his favorite was an exercise to improve his trunk rotation.

“I’m a golfer and I miss it,” he said. “But I needed to get my body back in shape to play golf. So Suzanne gave me this lead pipe that has a handle and is about a foot long and weighs seven to 10 pounds. Just like she was giving me golf lessons, she had me outside swinging this thing as far back as I could go and then swing all the way through. Oh, it felt so good! That was very, very encouraging.”

Moskal said Overton’s progress during the BIG program was “excellent.”

“His whole countenance changed to reflect strength and confidence,” said Moskal, who estimates she has worked with about 50 patients with Parkinson’s since earning her BIG certification four years ago. “It’s different for each patient, but research shows that those who do ‘BIG’ exercises daily have significantly slower progression. He was so committed to attending therapy and doing his exercises on a daily basis. That’s the secret to his successful outcome. Patients can’t just come here and magically get better. You’ve got to commit, and that’s why he’s done so well. He’s all in.”

Overton says that’s because he had one angel on his shoulder and another at his ear. “Suzanne and Tonya are just really very, very sweet people – both of them – and so were all the other people I met,” he said. “I would highly recommend BIG and LOUD to anybody who has Parkinson’s. No doubt about it.”

For more information about BIG & LOUD therapy, or any other services offered at Parkwest Therapy Centers, call (865) 531-5710.