Big and Loud Treatment Programs

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BIG and LOUD are two treatment programs that together have proven to reduce the negative effects of Parkinson’s disease on speech and movement.   All patients with Parkinson’s disease, no matter what stage they’re at, can benefit from BIG and LOUD.


BIG is a four-week treatment program which targets the movement difficulties that usually occur in Parkinson’s disease, including:

  • Shuffling feet when walking
  • Poor balance
  • Difficulty in starting any movement

Participants work with Kinisi physical therapists to reduce negative movement effects over four weeks. They finish BIG with a home exercise program that becomes part of their daily life.

LOUD, the companion program to BIG, focuses on speech. LOUD is proven to reduce the speech difficulties associated with Parkinson’s disease, which include:

  • Reduced loudness
  • Mumbling and talking too rapidly
  • Monotone speech
  • Rough/scratchy voice

LOUD is also a four-week treatment program, and sessions are usually planned together with a BIG session the same day. Patients often report improvements in facial expression and self-confidence, in addition to speaking more easily.


At Kinisi, participants can often attend back-to-back BIG and LOUD treatment sessions for all four weeks. Talk with your doctor about a referral for BIG and LOUD or call 715-483-0241 to speak to a physical therapist or speech therapist about the programs.