# **BIG Parkinson’s Exercise: Floor‑to‑Ceiling Reach** ## **Purpose** This exercise trains amplitude — moving *bigger*, *longer*, and *taller* — to counteract the small, shuffling, and reduced‑range movements common in Parkinson’s. It improves posture, mobility, balance, and confidence in daily reaching tasks. --- ## **Setup** - Stand tall with feet hip‑width apart. - Keep a soft bend in the knees. - Engage your core and lengthen your spine. - Arms rest comfortably at your sides. --- ## **How to Perform** 1. **Start Low** - Reach both hands down toward the floor in front of your shins. - Bend at the hips with a long spine — avoid rounding your back. - Let your arms stretch fully toward the ground. 2. **Explode Up BIG** - Drive through your legs and stand tall. - Sweep your arms overhead in a wide, powerful arc. - Open your chest and reach your fingertips toward the ceiling as high as you can. 3. **Hold the Top** - Pause for **1–2 seconds** at full height. - Think “tall, open, BIG.” 4. **Return with Control** - Lower your arms and hinge back down toward the floor. - Keep the movement smooth and intentional. 5. **Repeat** - Perform **8–12 repetitions**, focusing on amplitude and posture rather than speed. --- ## **Key Cues** - “Make the movement BIG and purposeful.” - “Reach long, not fast.” - “Open the chest and stand tall.” - “Lead with the hips when going down; lead with the chest when coming up.” --- ## **Common Mistakes** - Rounding the back instead of hinging at the hips - Rushing through the movement - Keeping the arms narrow instead of wide and expressive - Letting the head drop forward --- ## **Options & Modifications** - **Chair‑Supported Version:** Hold the back of a chair with one hand for balance. - **Seated Version:** Start seated, reach toward the floor, then reach overhead while sitting tall. - **Reduced Range:** If touching the floor isn’t comfortable, reach toward the knees or shins instead. --- ## **When to Use This Exercise** - As part of an LSVT BIG‑style amplitude routine - Warm‑ups for mobility and posture - Daily practice to reinforce “bigger” movement patterns

# **BIG Exercise: Sit‑to‑Stand** ## **Purpose** This functional BIG movement trains amplitude, posture, and power during one of the most important daily tasks: rising from a chair. It reinforces upright posture, confident weight shift, and full‑body coordination for people with Parkinson’s. --- ## **Setup** - Sit tall at the front edge of a sturdy chair. - Feet are hip‑width apart and planted firmly under the knees. - Hands rest lightly on your thighs (avoid pushing off if possible). - Chest lifted, shoulders relaxed, eyes forward. --- ## **How to Perform** 1. **Prepare BIG** - Lean your torso slightly forward with a long spine. - Shift your weight toward your feet. - Think “tall and ready.” 2. **Stand Up BIG** - Drive through your legs and rise to standing in one strong, purposeful motion. - Swing your arms upward into a wide, expressive BIG reach. - Open the chest and stand as tall as possible. 3. **Pause at the Top** - Hold for **1–2 seconds**, feeling tall, open, and balanced. 4. **Return to Sit with Control** - Lower your arms. - Hinge at the hips and slowly guide yourself back to the chair. - Keep your chest lifted and control the descent until you’re seated. 5. **Repeat** - Perform **8–12 repetitions**, focusing on amplitude and posture rather than speed. --- ## **Key Cues** - “Stand up BIG — bigger than feels natural.” - “Shift forward, then drive through your legs.” - “Arms wide, chest open, tall posture.” - “Control the sit — don’t collapse.” --- ## **Common Mistakes** - Using momentum instead of purposeful movement - Collapsing the chest or rounding the back - Pushing heavily off the thighs or chair - Sitting down too quickly without control --- ## **Options & Modifications** - **Assisted Version:** Use hands lightly on the chair or thighs for support. - **Chair Height Adjustment:** Use a higher chair or add cushions if needed for safety. - **Reduced Range:** Perform partial stands if full standing is not yet accessible. - **Advanced BIG Version:** Add a wide step or BIG arm sweep at the top. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Warm‑ups for lower‑body strength and posture - Daily practice to reinforce confident, BIG functional movement patterns

# **BIG Exercise: Side‑to‑Side Reach** ## **Purpose** This movement trains lateral amplitude — reaching wide, opening the ribcage, and shifting weight with confidence. It supports balance, gait, trunk mobility, and the ability to turn or reach sideways during daily tasks. --- ## **Setup** - Stand tall with feet slightly wider than hip‑width. - Keep knees softly bent and core lightly engaged. - Arms rest at your sides, palms relaxed. --- ## **How to Perform** 1. **Shift and Reach BIG** - Shift your weight onto your **right** leg. - Reach your **left** arm out to the side in a long, sweeping arc. - Open your chest and stretch your fingertips as far as you comfortably can. 2. **Pause at Full Width** - Hold the extended position for **1–2 seconds**. - Think “wide, open, BIG.” 3. **Return to Center** - Bring your arm back down with control. - Shift your weight evenly between both feet. 4. **Repeat to the Other Side** - Shift onto your **left** leg. - Reach your **right** arm out in the same wide, expressive motion. - Pause briefly at full extension. 5. **Continue Alternating** - Perform **8–12 BIG reaches per side**, focusing on amplitude and posture. --- ## **Key Cues** - “Reach WIDE — bigger than feels natural.” - “Shift your weight with purpose.” - “Open the ribs and chest.” - “Move smoothly, not quickly.” --- ## **Common Mistakes** - Leaning forward instead of staying tall - Keeping the reach small or timid - Letting the head drop instead of staying aligned - Rushing through the pauses --- ## **Options & Modifications** - **Chair‑Supported Version:** Place one hand on a chair for balance while reaching with the opposite arm. - **Seated Version:** Sit tall and reach side‑to‑side with a wide arc, focusing on ribcage expansion. - **Reduced Range:** Reach to a comfortable width if balance or mobility is limited. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Warm‑ups for trunk mobility and balance - Daily practice to reinforce “bigger” lateral movement patterns

# **BIG Exercise 7: Rock and Reach** ## **Purpose** This exercise trains whole‑body amplitude by combining a rhythmic weight shift (“rock”) with a powerful overhead reach. It improves balance, trunk mobility, posture, and the ability to transition weight confidently during walking and daily tasks. --- ## **Setup** - Stand tall with feet slightly wider than hip‑width. - Keep a soft bend in the knees. - Arms rest at your sides. - Engage your core and lengthen your spine. --- ## **How to Perform** 1. **Rock to One Side** - Shift your weight onto your **right** leg. - Allow your hips and torso to lean slightly in that direction while staying tall. 2. **Reach BIG Overhead** - As you rock right, sweep your **left** arm up and overhead in a wide, expressive arc. - Reach long through your fingertips, opening the ribs and chest. 3. **Pause at Full Height** - Hold the reach for **1–2 seconds**. - Think “tall, open, BIG.” 4. **Return to Center** - Lower your arm with control. - Shift your weight back to the middle. 5. **Repeat to the Other Side** - Rock onto your **left** leg. - Reach your **right** arm overhead in the same BIG, sweeping motion. - Pause briefly at full extension. 6. **Continue Alternating** - Perform **8–12 BIG reaches per side**, focusing on amplitude and smooth transitions. --- ## **Key Cues** - “Rock with purpose — reach with power.” - “Make the reach BIG, not fast.” - “Open the ribs and lengthen the spine.” - “Shift your weight confidently from side to side.” --- ## **Common Mistakes** - Leaning forward instead of staying tall - Keeping the reach small or narrow - Rushing through the pauses - Letting the head drop instead of staying aligned --- ## **Options & Modifications** - **Chair‑Supported Version:** Hold the back of a chair with one hand while reaching with the opposite arm. - **Seated Version:** Sit tall and rock side‑to‑side through the ribcage, reaching overhead with amplitude. - **Reduced Range:** Use a smaller reach if balance is limited, focusing on posture and control. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Warm‑ups for trunk mobility and balance - Daily practice to reinforce confident lateral weight shifting

# **BIG Exercise 6: Forward Rock and Reach** ## **Purpose** This exercise trains forward weight shifting with amplitude, helping clients improve gait initiation, posture, balance, and confidence when stepping or reaching forward in daily life. --- ## **Setup** - Stand tall with feet hip‑width apart. - Keep a soft bend in the knees. - Arms rest comfortably at your sides. - Engage your core and lengthen your spine. --- ## **How to Perform** 1. **Rock Forward** - Shift your weight toward the balls of your feet. - Keep your heels lightly grounded and your spine long. - Allow your torso to lean forward slightly without collapsing the chest. 2. **Reach BIG** - As you rock forward, sweep both arms forward and slightly upward in a wide, powerful arc. - Open the chest and reach long through your fingertips. - Think “forward, tall, BIG.” 3. **Pause at Full Extension** - Hold the reach for **1–2 seconds**. - Maintain balance and tall posture. 4. **Return to Center** - Lower your arms with control. - Shift your weight back to the middle of your feet. - Reset your posture before the next repetition. 5. **Repeat** - Perform **8–12 BIG forward rocks**, focusing on amplitude and smooth transitions. --- ## **Key Cues** - “Shift forward with purpose — reach BIG.” - “Keep the chest lifted and the spine long.” - “Reach forward, not down.” - “Move with intention, not speed.” --- ## **Common Mistakes** - Leaning too far forward and losing balance - Rounding the back instead of staying tall - Keeping the reach small or timid - Rushing through the pause at full extension --- ## **Options & Modifications** - **Chair‑Supported Version:** Stand behind a chair and hold lightly with one hand while reaching with the other. - **Seated Version:** Sit tall, rock forward through the hips, and reach forward with amplitude. - **Reduced Range:** Use a smaller forward shift if balance is limited, focusing on posture and control. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Warm‑ups for gait training and posture - Daily practice to reinforce confident forward movement patterns

# **BIG Exercise 5: Backward Step and Reach** ## **Purpose** This exercise trains amplitude during backward stepping — a key skill for balance recovery, posture, and safe movement in daily life. It improves coordination, trunk extension, and confidence when moving in reverse. --- ## **Setup** - Stand tall with feet hip‑width apart. - Keep a soft bend in the knees. - Arms rest at your sides. - Engage your core and lift your chest. --- ## **How to Perform** 1. **Prepare BIG** - Stand tall and focus your gaze forward. - Shift your weight slightly onto your **left** leg to free the right leg for movement. 2. **Step Back BIG** - Take a **large, purposeful** step backward with your **right** foot. - Land softly on the ball of the foot, then lower the heel. 3. **Reach BIG** - As you step back, sweep your **right** arm up and slightly behind you in a wide, expressive arc. - Open the chest and lengthen through the fingertips. - Think “tall, open, BIG.” 4. **Pause at Full Extension** - Hold the reach for **1–2 seconds** to reinforce amplitude and balance. 5. **Return to Start** - Bring your arm down with control. - Step your right foot forward to return to the starting position. - Reset your posture. 6. **Repeat on the Other Side** - Shift weight onto your **right** leg. - Step back BIG with your **left** foot and reach with your **left** arm. 7. **Continue Alternating** - Perform **8–12 BIG backward steps per side**, focusing on smooth, confident movement. --- ## **Key Cues** - “Step back BIG — bigger than feels natural.” - “Reach tall and open through the chest.” - “Control the return to center.” - “Move with purpose, not speed.” --- ## **Common Mistakes** - Taking small, hesitant steps - Leaning forward instead of staying tall - Reaching too low or too narrow - Rushing through the pause at full extension --- ## **Options & Modifications** - **Chair‑Supported Version:** Hold the back of a chair with one hand while stepping back with the opposite leg. - **Reduced Range:** Use a smaller backward step if balance is limited. - **Seated Prep Version:** Practice the arm reach alone while seated to build amplitude confidence. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Balance and gait training sessions - Daily practice to reinforce confident backward movement patterns

# **BIG Exercise 4: Sideways Step and Reach** ## **Purpose** This exercise trains lateral amplitude — taking a BIG sideways step while opening the chest and reaching wide. It improves balance, trunk mobility, weight shifting, and confidence during side‑stepping tasks in daily life. --- ## **Setup** - Stand tall with feet hip‑width apart. - Keep a soft bend in the knees. - Arms rest comfortably at your sides. - Engage your core and lengthen your spine. --- ## **How to Perform** 1. **Prepare BIG** - Stand tall and focus your gaze forward. - Shift your weight slightly onto your **left** leg to free the right leg for movement. 2. **Step Out BIG** - Take a **large, purposeful** step to the **right**. - Land with the foot fully planted and knees softly bent. 3. **Reach BIG** - As you step out, sweep your **right** arm up and out to the side in a wide, expressive arc. - Open the ribs and chest, reaching long through your fingertips. - Think “wide, open, BIG.” 4. **Pause at Full Width** - Hold the reach for **1–2 seconds** to reinforce amplitude and balance. 5. **Return to Start** - Bring your arm down with control. - Step your right foot back to the starting position. - Reset your posture. 6. **Repeat on the Other Side** - Shift weight onto your **right** leg. - Step out BIG to the **left** and reach with your **left** arm. 7. **Continue Alternating** - Perform **8–12 BIG sideways steps per side**, focusing on smooth, confident movement. --- ## **Key Cues** - “Step WIDE — bigger than feels natural.” - “Reach long and open through the chest.” - “Shift your weight with purpose.” - “Move smoothly, not quickly.” --- ## **Common Mistakes** - Taking small, hesitant steps - Leaning forward instead of staying tall - Reaching too low or too narrow - Rushing through the pause at full extension --- ## **Options & Modifications** - **Chair‑Supported Version:** Hold the back of a chair with one hand while stepping sideways with the opposite leg. - **Reduced Range:** Use a smaller step if balance is limited, focusing on posture and control. - **Seated Prep Version:** Practice the arm reach alone while seated to build amplitude confidence. --- ## **When to Use This Exercise** - As part of an LSVT BIG amplitude routine - Warm‑ups for lateral mobility and balance - Daily practice to reinforce confident side‑stepping patterns