Big and Loud: Parkinson's therapy best described as an exercise regimen

By Andy Fitzpatrick
Battle Creek Enquirer

BATTLE CREEK, Mich. (AP) - Dan Crumrine of Marshall may have been diagnosed with Parkinson's disease, but he's not taking it lying down.

"I feel like I'm fighting back," Crumrine told the Battle Creek Enquirer.

Since September, Physical Therapist Hannah Ehrenhardt and others have used a therapy program known as "Big and Loud" at Borgess Health Park to help Parkinson's patients such as Crumrine.

Crumrine, 61, was diagnosed with the neurological disease in 2006, but began having more problems in February, he said. His neurologist, Dr. Jeffrey Jones, recommended the Big and Loud program.

Parkinson's disease is the result of loss of brain cells that produce dopamine. That causes a loss of control over some muscles and related body functions.

Jones said the disease affects motor systems in the body that control movements such as facial expressions and even swinging arms when walking.

"That's the system that's messing up with Parkinson's disease," Jones said. "It's a whole slew of things you don't think about. There's a center in the brain that operates that. We don't know the cause of it but those nerve cells are dying out too quickly."

Jones said there are about 1 million people in the U.S. with the disease. The National Parkinson Foundation said there are about 50,000-60,000 new cases diagnosed each year.

Crumrine said he was shuffling when walking, and his speech became affected when he started mumbling. Those new difficulties were on top of other Parkinson's problems, such as trouble shaking hands with people and buttoning his shirt.

On a recent Monday, though, his handshake was strong and he spoke clearly. He credits Big and Loud with his success.

Ehrenhardt said the program is best described as an exercise program for people with Parkinson's.

"It's teaching them different ways that they can work around some of the motor deficits that they have and give them a way that they can be more in control of their own life," Ehrenhardt said.

The Loud portion of the program is done with a speech therapist, although Ehrenhardt said she works in those skills as well during the physical regimen.

In the Borgess Health Park physical therapy department, Crumrine moved in exaggerated ways, stretching his arms into space and moving his feet back and forth while loudly counting. At one point, he marched backward down a long hallway while he and Ehrenhardt tossed a ball back and forth - likely a physically complicated task for the most coordinated of people.

Crumrine does the exercises twice a day - except in the case of very nice weather, when he's more likely to go outside - and does many of them at home.

"It feels great," Crumrine said. "She's put me on the treadmill going backwards and playing word games." He contrasted that from when he began his therapy, when he was told to simply reach down and touch the floor.

Crumrine slightly rolled his eyes at that, recalling the difficulty.

Jones explained that these exercises are ways of retraining the brain to carry out those functions, such as arm-swinging, that are no longer automatic for people like Crumrine.

Jones said that in 1980 he was the only neurologist in Battle Creek. He had about 10 Parkinson's patients who could not walk. Today, he has none that can't.

"There are some that are quite debilitated, but programs like this and the participation of it have made spectacular changes," Jones said.

A search of accrediting agency LSVT Global's website at www.lsvtglobal.com shows Big and Loud therapists also offering services at Oaklawn Physical Rehabilitation in Marshall, Bronson Battle Creek and other health care providers in the area.

Crumrine said that, really, he just wants more people to know about Big and Loud.

"If you can get one or two people into this program, it's a win," Crumrine said.

Published: Tue, Jul 21, 2015