Tom Kral has a new outlook on life after his BIG & LOUD therapy at Covenant Health Therapy Center-West Knoxville.

After a while, it became all too predictable. When Tom Kral, 73, tried to carry on conversations, he was constantly asked to repeat himself.

Parkinson’s disease was not only affecting his ability to move well, it was impacting his ability to speak, too. Kral began retreating to his bedroom to watch TV to avoid conversation. The constant isolation led to depression.

“Parkinson’s is not a death sentence,” Kral says adamantly. “You tend to want to feel sorry for yourself, but what good does that do?”

Everything changed for Kral when a physician recommended LSVT BIG and LOUD at Covenant Therapy Center – West Knoxville, a department of Parkwest Medical Center. BIG and LOUD are therapy programs that focus on body movement (BIG) and speech (LOUD). The physical and speech therapies can give patients with Parkinson’s new hope and literally give them a voice.

“BIG actually means big steps, big movements, and LOUD means when we get in there and we’re doing our exercises and counting the sets and repetitions, we’re shouting out loud,” Kral says. “That’s why they call it BIG and LOUD.”

By sharing his experience with the therapy, he hopes to help others who may be struggling the way he once was. He understands how the limitations of Parkinson’s plus a year in a pandemic can press down on a person’s spirit.

“This therapy will pull you out of that slump, you’ll start feeling better about yourself and about what you’re doing for yourself,” Kral says.

Speech-language pathologist Jenna Whipple says LSVT BIG and LOUD are two intensive programs that both typically last four weeks. “The programs are aimed at helping those
with Parkinson’s disease or other neurological conditions improve communication and movement,” says Whipple. “The LOUD program focuses on improving one’s voice to be understood, while the BIG program focuses on improved movement for everyday activities.

“Exercises are repetitive and personalized to the patient to keep things functional and motivating,” Whipple says.

It didn’t take long for Kral to notice a difference. By the end of the four-week therapy period, his life and his outlook had changed.

Jenna Whipple, Speech Language Pathologist

“They showed me exercises for buttoning my buttons, tying my ties, putting on my jacket and how to roll over and get out of bed easier,” Kral says. “Even picking up coins that I drop on the floor, picking up things that are small, and writing.”

With speech therapy, Kral’s voice regained volume and power. “People are able to hear me better,” he says. “They’re not asking me to repeat myself.” When anyone does have trouble understanding, Kral now knows how to make himself heard instead of making himself disappear.

His message to others who have been diagnosed with Parkinson’s is that physical therapy  and speech therapy can change everything.

“That four weeks made a big difference in my life,” Kral says. “It got me up out of bed, it got me up out of depression – it got me out of just trying to enclose myself from the world.

Whipple says a key element to the success of the program is making sure the patient is encouraged to put in the work. Kral is a prime example of a patient who not only received therapy, but actively participated on his own.

“Since day one, he never missed a beat,” Whipple says. “He attended every session with an optimistic attitude, completed daily home exercises and left the clinic feeling stronger. Others started to notice his improved voice, which served as more motivation to keep up with his exercises at home.”

Kral was already feeling more capable and confident when the real affirmation the therapy was working came from his young grandson.

“He said, ‘Peepaw, you look better, you’re standing up straight!’” Kral says with a laugh. “My daughters have noticed a difference, too. It really does pay off. There’s no better investment than yourself, that’s for sure.”

As Kral rolls out of bed, gets dressed and walks out of his bedroom to greet the world, he faces each day with renewed energy. While there is no cure for Parkinson’s, there is hope for a better quality of life through medication and measures like physical therapy and speech therapy.

If you think you or a loved one could benefit from LSVT BIG and LOUD, consult a physician and visit TreatedWell.com/covenant-therapy-west-knoxville to learn more.

Go Big and Be Loud

Movements, steps, vocal volume and pitch range can all shrink with Parkinson’s. It’s common for patients to end up talking very softly without much inflection or emotion, to slump their shoulders, shuffle with small steps and even write with smaller strokes.

It takes much more effort for a patient with Parkinson’s to make movement patterns that most people take for granted, and more effort to speak at the same volume, too. It’s not uncommon for patients with Parkinson’s to become withdrawn when they start to perceive that others can’t hear or understand them. The same thing can happen when patients realize they can’t keep up with others physically.

The LSVT BIG and LOUD therapies at Covenant Therapy Center – West Knoxville include exercises specifically designed for people who have Parkinson’s disease and Parkinsonisms.

The BIG portion of the therapy focuses on large-amplitude movements so patients can have more normal movement patterns, improve balance, and reduce the risk of falls. The LOUD portion of the therapy strengthens the voice and enhances vocal range and inflection, so the patient can communicate more effectively and be heard.

“It’s so important to get physical therapy and speech therapy,” Kral says. “It helped me tremendously. They have great therapists and teachers and I really enjoyed it. It’s really made a
difference in my life.”

If you think you or a loved one could benefit from LSVT BIG and LOUD, consult a physician and visit TreatedWell.com/covenant-therapy-west-knoxville to learn more.

Safe and Effective Treatment

Physical therapy is the treatment or management of physical problems like disability and pain using drug-free, non-invasive means. Specially designed exercises, massage, aquatic therapy and other tools can help reverse damage, return function and restore quality of life.

Covenant Therapy Center–West Knoxville offers individualized physical rehabilitation, including specialty services like rehabilitation for cancer patients and amputees, and treatment for dizziness, vertigo and headaches.

Dry Needling is available, along with Astym® treatment that reduces scar tissue. LSVT BIG and LOUD is used to treat patients whose speech and movement have been affected by Parkinson’s disease. The McKenzie Method can provide superior functional outcomes for the back, neck, arms and legs.

Physical therapists also treat lymphedema, TMJ and address pelvic health for both men and women. Occupational therapy and speech therapy are offered as well.

These specialty services are in addition to the traditional core services that are changing the lives of patients who are dealing with issues such as:

  • Ankle and foot pain
  • Arthritis
  • Back and neck pain
  • Balance issues
  • Carpal tunnel syndrome
  • Chronic pain
  • Fibromyalgia
  • Knee and hip pain
  • Neurological issues
  • Orthopedic problems
  • Osteoporosis
  • Plantar fasciitis
  • Post-surgical rehabilitation
  • Repetitive/overuse injuries
  • Athletic injuries