http://journal.frontiersin.org/article/10.3389/fneur.2015.00122/full?
- College of Science, Health and Engineering, School of Allied Health, La Trobe University, Bundoora, VIC, Australia
Background: Individuals living with Parkinson’s disease (PD) can experience a range of movement disorders that affect mobility and balance and increase the risk of falls. Low health-related quality of life, depression, and anxiety are more common in people with PD than age-matched comparisons. Therapeutic dance is a form of physical activity believed to facilitate movement and therapy uptake. As well as being enjoyable, dancing is thought to improve mobility, balance, and well-being in some people living with PD. The primary objective of this study was to evaluate the feasibility and safety of a 4-week Argentine tango dance program for people with PD.
Methods: Six community dwelling individuals with mild to moderate PD were recruited from Parkinson’s support groups, movement disorder clinics, and the PD association in Australia. To minimize falls risk, participants were required to be <75 years of age and physically independent (Hoehn and Yahr stages I–III). They were also required to speak English. Participants attended a 1-hour dance class at a dance studio twice per week for 4 weeks. A professional dance instructor led and choreographed the Argentine tango dance classes. Physiotherapists were present to assist participants during the class and served as dance partners as necessary. The primary outcome was feasibility, which was determined by measures of recruitment, adherence, attrition, safety (falls, near misses and adverse events), and resource requirements. Secondary measures included the Beck Depression Inventory and the Euroqol-5D, administered at baseline and post intervention. Therapy outcomes pre- and post-intervention were analyzed descriptively as medians and interquartile ranges and using Wilcoxon matched pair signed-rank tests.
Results: The Argentine tango dance intervention was shown to be safe, with no adverse events. Adherence to the dance program was 89%. Depression scores improved after intervention (p = 0.04). Some challenges were associated with the need to quickly recruit participants and physiotherapists to act as dance partners during classes and to monitor participants.
Conclusion: The 4-week, twice weekly Argentine tango dancing program was shown to be feasible and safe for people with mild-to-moderately severe PD.
Introduction
Idiopathic Parkinson’s disease (PD) is a progressive neurological disorder associated with reduced mobility, falls, and reduced quality of life (QOL) (1). International guidelines endorse exercise therapy to retrain balance and preserve physical capacity for individuals living with PD (2). Meta-analyses have also shown exercise therapy to have positive effects with regards to physical functioning, balance, and health-related QOL (3, 4). Despite the potential benefits of movement rehabilitation, long-term adherence to traditional exercise programs can be problematic (5). A systematic review evaluating exercise adherence in PD reported that reduced motivation was a common reason for reduced participation (6). This demonstrates a need for community-based physical activity programs that facilitate uptake and enjoyment (7).
Emerging evidence suggests that therapeutic dance may be an appropriate and enjoyable form of physical activity for some individuals with PD (8). Dance may address some of the physical impairments in PD through teaching movement strategies, challenging balance, and improving physical fitness (9, 10). The musical rhythm could become an auditory cue to engage cortical control of movement, which in turn might potentially enhance motor learning (11). Preliminary trials suggest dance can facilitate improvements in gait, balance, and motor impairment in comparison to exercise (12), physiotherapy (13), and control conditions (8, 14–16). It has been proposed that therapeutic dance may also facilitate QOL and well-being through enabling movement expression and building social connections (17).
The Argentine Tango dance genre is arguably one of the most suitable dance forms for people with PD (8, 14, 15). It has been proposed to target the movement impairments of PD with strong musical rhythms that trigger movement and enable greater amounts of physical activity. Compared to other dance genres, the choreography can be designed to train specific movement strategies such as walking backwards and turning (18). Furthermore, as a partnered form of dance, tango may facilitate interpersonal connections that positively affect QOL and mood (18).
While a growing number of pilot studies have explored the effects of dance on movement disorders in PD, there is a paucity of feasibility data and recommendations that allow researchers to design future protocols (19). Comprehensive exploration of the safety of specific dance genres is still required given that individuals with PD have a propensity to fall (20). This research also focused on QOL and depression outcomes, as there is little published literature on the effects of therapeutic dance on perceived QOL and mood for adults with PD.
The primary purpose of the current study was to evaluate the feasibility and safety of an Argentine tango dance intervention and to provide recommendations for future research. The specific aims were to: (i) determine if 4 weeks of twice weekly Argentine tango dance classes were feasible and safe for people with PD, allowing the development of recommendations for a future research protocol and (ii) measure the within-group change for depressive symptoms and health-related quality of life (HRQOL) following participation in the dance classes.
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