Lisa Dix lost her ability to speak clearly in December 2015.

After a visit to the Mayo Clinic in Rochester, Minn., the Bowling Green woman found out she had cerebellar ataxia, which affects muscle coordination.

“We’re not sure why I have it,” Dix said. “I’ve had difficulty with balance, some speech problems (and problems with) gross motor skills and fine motor skills.” 

Dix is speaking clearer these days thanks to a therapy she received at Southern Kentucky Rehabilitation Hospital called LSVT LOUD. LSVT stands for Lee Silverman Voice Treatment. LSVT LOUD develops the voice. The perceived voice is soft, and the technique increases vocal loudness and also higher and lower pitch training, said Sylvia Justice, a SKY Rehab speech therapist.

“We have computer software where she’s able to see progress of how long and how loud she is,” she said. “She has to sustain that loud voice.”

SKY Rehab is the only free-standing outpatient facility within a 50-mile radius that has LSVT LOUD and LSVT BIG, which works with amplitude and movements that are big and purposeful. The therapies are a significant intervention for patients living with conditions such as Parkinson’s disease, multiple sclerosis, cerebral palsy, stroke and Down syndrome.

“The patient has to identify something they want to do or that takes a long time to do and we incorporate that into the exercise,” Justice said.

With LSVT BIG, there are eight core exercises that patients do in therapy and at home. Some of the exercises include sit to stand, step and reach and side lunges.

“It’s a huge commitment, but it’s doable. Their posture is better. Their balance is better,” said Kristy Salmon, an occupational therapist at SKY Rehab. “The exercises are intense. We take those exercises and incorporate them in things they do in the home.”

LSVT LOUD and LSVT BIG can work together if patients need both, Justice and Salmon agreed. They are each four one-hour sessions a week for four consecutive weeks.

“The LSVT LOUD program builds into the LSVT BIG program because patients have to use loud voices in order to count during exercises,” Salmon said.

“Posture changes carry over to voice production,” Justice said.

While Dix used LSVT LOUD, she wan’t an official LSVT BIG patient. Salmon used some of the techniques on her, though.

“I was using some of the LSVT BIG, but I didn’t establish a protocol with her,” she said. “I was still in training.”

Homework happens from day one in both therapies.

“When the program is over, they carry it over into their everyday lives,” Salmon said. “The reason for the program is to improve the quality of life.”

Patients have to be referred to the programs by a physician.

“We’ve also done some education to let the doctors know it’s available,” Justice said.

As the LSVT LOUD program progresses, patients take what they learn from the lessons to using them within SKY Rehab, Justice said. Then they take it home to their families before taking it out into the community and on the telephone.

“I used it with my neighbors,” Dix said. “I have to do that every day. …”

What she learned in occupational therapy has carried over to the aquatics exercise group Dix participates in at SKY Rehab.

“We have a group of five women and one man who go to the group,” she said. “We’ve kind of become friends.”

Dix has been receiving outpatient occupational therapy at SKY Rehab for two years. What she has learned has helped, she said. 

“When I first came here I couldn’t sit up by myself. I’m almost walking without a cane now,” she said. “I can sew. I can cook. I can use a vacuum cleaner.”

Dix, a dietitian, plans to resume teaching a night class at Western Kentucky University in the spring. She said using LSVT LOUD has improved her social life.

“I was too embarrassed to talk before,” she said. “Now I can talk.”

— Follow features reporter Alyssa Harvey on Twitter @bgdnfeatures or visit bgdailynews.com.