Using dance as a therapeutic strategy may benefit patients with Parkinson’s disease by improving their motor function, results of a pilot study suggest.
The study, “ ‘Dance Therapy’ as a psychotherapeutic movement intervention in Parkinson’s disease,” was published in Complementary Therapies in Medicine.
Parkinson’s disease is mainly recognized by its progressive motor symptoms including tremor, muscle rigidity, and impaired gait and balance. Several non-motor symptoms are also experienced by patients, including cognitive impairment, fatigue, mood disorders, and sleep disturbances, all of which can be disabling and lead to a significant decrease in quality of life.
Anti-parkinsonian therapies focus on easing and managing the motor symptoms of the disease, but their use can be limited by the presence of non-motor issues. In addition, effective treatments for non-motor symptoms are not always available.
Given the complex symptom-treatment landscape of the disease, there is increased interest from both patients and caregivers in pursuing mind-body interventions, such as dance therapy, which have the potential to simultaneously address both the motor and non-motor symptoms of the disease.
Dance requires the practice of fluid movements and postures while maintaining full body control, which can address many of the motor symptoms associated with Parkinson’s. In addition, dance can improve patients’ emotional, cognitive, and social well-being as a result of listening to music and interacting with other people, potentially reducing the common non-motor symptoms of Parkinson’s.
Dance therapy differs from traditional dance classes because it not only focuses on the aesthetic and recreational features of the activity, but also includes the biopsychological status of the subject.
According to the American Dance Therapy Association, “dance/movement therapy is the psychotherapeutic use of movement to promote emotional, social, cognitive and physical integration of the individual.”
A team led by researchers at Northwestern University in Illinois evaluated the benefits of dance therapy in nine Parkinson’s patients, and compared it with the effects of support group therapy in four patients, who served as the control group.
Patients enrolled in the dance group had a mean age of 66.4 and mean Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor score of 27.6 points. The control group was older, with a mean age of 75.5, and had worse motor scores, a mean of 40.8 points. The UPDRS is a comprehensive 50-question assessment of both motor and non-motor symptoms associated with Parkinson’s.
Dance therapy sessions lasted 60 minutes and were conducted once a week, over 10 weeks. The exercises were tailored on an individual basis to incorporate different levels of functional capacity. The sessions focused on an understanding of how movement influences mood and mental health; enhanced balance, gait, and coordination; and expression of thoughts, feelings, and emotions through movement and dance.
The certified dance therapist who conducted the dance therapy sessions also led the support group, “which involved education about how movement influences mood and mental health, ways to incorporate movement and dance into daily life, and exploration of feelings and emotions in a supportive group environment,” according to the researchers.
Seven of the nine patients in the dance group and all participants in the control group completed the study, attending at least 70 percent of the classes. Only one participant in the dance therapy group developed mild low back pain, but it was unclear whether this was due to the dance intervention.
After completing the 10-week intervention, participants were questioned about their satisfaction with the program.
In general, patients in the dance group enjoyed the therapy sessions, with seven patients reporting benefits from them, while the other two felt neutral. Six patients in the dance group and two in the support group noted they would attend similar classes in the future and would recommend the program to other Parkinson’s patients. Only one patient in the control group did not enjoy or benefit from the classes, conveying disappointment at not having been included in the dance therapy group.
An evaluation of symptoms after the completion of the study revealed a 2.37-point reduction in motor disability scores on the MDS-UPDRS III in the dance therapy group compared with the control group. Patients who received dance therapy also improved their ability to perform daily living activities, with a 0.36-point difference in MDS-UPDRS II scores relative to the control group. Some positive changes in non-motor symptoms such as fatigue and cognition were also reported, but these were not significant.
“Dance may be effective in targeting motor symptoms of Parkinson’s disease because it incorporates the stretching and strengthening of muscles, and increases flexibility throughout the body, which may help maintain balance in people with Parkinson’s,” the researchers wrote.
“Another possibility is that practice of dance may activate areas of the brain that normally show reduced activation in Parkinson’s,” they added.
Because this study only included a small number of patients, researchers were not able to fully determine the complete impact of these interventions in disease manifestations.
Additional studies in a larger patient population over longer periods of time are necessary to further explore the potential of dance therapy, in particular its ability to improve motor function in Parkinson’s patients.
“This is the first study of dance therapy as a psychotherapeutic movement intervention in Parkinson’s disease,” the authors noted. In general, its results support “the feasibility of a dance therapy intervention [in this population],” the said.