Wednesday, November 30, 2022

Dance As Therapy For Individuals With Parkinson Disease

Improvements In Parkinsons Disease

Why people with Parkinsons are dancing at Stanfords Neuroscience Health Center

Dance typically involves learning sequences of steps and movements in space, in coordination with music. In other words, it requires substantial physical and cognitive engagement and, as such, it should improve not only muscle tone, strength, balance and coordination, but also memory, attention and visuospatial processing.

When comparing relatively long-term dance interventions to conventional fitness training, several studies have found improvements in attention and verbal memory and neuroplasticity in healthy older adults. Researchers also found improvements in memory and cognitive function for older adults with mild cognitive impairment after a 40-week dance program.

In addition, a recent meta-analysis of seven randomized controlled trials comparing the effects of dance therapy to non-dance interventions in Parkinsons disease found that dance was especially beneficial for executive function, the processes that help us plan, organize and regulate our actions.

A Positive Effect On Depression

One of the main reasons people dance is to modify their emotional state typically, they strive to feel more joy and happiness and to reduce stress and anxiety. Since its inception dance therapy, similar to somatic psychotherapies, has emphasized the reciprocal interaction between body and mind, and the ability to regulate emotions via changes in body postures and movements.

The exploration of new movements can evoke novel perceptions and feelings. It may also facilitate seeing a wider range of possibilities in a given situation. Some new or old movement patterns may evoke repressed material and enhance better understanding of oneself and ones environment and history.

One of the most compelling studies supporting this idea examined complex improvised movements, and identified unique sets of movement components that can elicit the feelings of happiness, sadness, fear or anger. The associations between emotions and specific motor components have been used in the past for diagnosis or emotion recognition. This study goes further and proposes specific techniques for modifying emotions.

A recent systematic review of research on dance/movement therapy specifically found it to be effective in the treatment of adults with depression.

Does Dance Really Help With Pd Movement And Memory Issues

The answer is a resounding yes! Research supports that lacing up those shoes for dance/movement therapy can help individuals with PD and other movement disorders.

In a 2019 study comparing the effects of dance for early-stage PD patients, researchers found that memory skills, anxiety and depression, and quality of life were significantly improved for participants in the dance group.

Neurology Now, in their 2010 article Finding New Life through Movement, noted in a series on innovative therapies for neurological disease that dance/movement therapy is embraced by healthcare professionals as a supplement to traditional medical treatment.

Although PD dance classes are trendy these days, their benefits for PD arent newly realized. Back in 1989, dancer and psychologist Beth Kaplan Westbrook, PhD, and Dr. Helen McKibben wrote in the American Journal of Dance Therapy about dance/movement therapy participants with PD and other neurological diseases: When they moved, they began to express themselves nonverbally. Its fascinating that a non-verbal approach can make such a difference.

Parkinsons News Today columnist Lori DePorter, who participated in a Dance for PD class, echoed this experience: It was obvious that our Parkinsons didnt matter. It made each one of us unique and that was reflected in our movements and the art we created.

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Dancing Helps People With Parkinson’s Disease

Could daily tango classes help people with Parkinsons Disease? A recent article, posted on BioRxiv, shows that in a small group of people, these daily lessons improved their motor symptoms. This paper is not yet peer-reviewed, but the positive effects of dancing for people with Parkinsons Disease have been well-studied by many other researchers as well.

Heather MacTavish, left, with Parkinson’s patient Margaret Moylan, 61, right, and volunteers Jocelyn… Thomas, second right, and Charlie Kisch, leads a dance exercise at the World Parkinson’s Conference, Thursday, Feb. 23, 2006, in Washington. Thomas’ mother had Parkinson’s disease.

ASSOCIATED PRESS

Parkinsons Disease affects between seven and ten million people worldwide. In this condition, a gradual breakdown of certain cells in the brain causes a lowering of the normal levels of dopamine. The characteristic tremors and slow movement seen in people with Parkinsons Disease are a direct effect of these lower levels of dopamine, and one of the established and successful forms of treatment is the drug L-DOPA, which helps address the dopamine imbalance. But there are other forms of therapy available as well, and one of them is dance.

As a form of movement therapy, dance addresses several of the problems that come with Parkinsons Disease. It provides regular social interaction for people who have this condition, has a positive effect on their mental well-being, and it improves their movement and balance.

Selection Of Studies Data Extraction And Management

How do dance lessons retrain brain in Parkinson

We followed the Cochrane methods, as described in the Cochrane Handbook for Systematic Reviews of Interventions . A detailed description of our methods is available in Additional File and following is a summary.

Two authors independently screened the titles and/or abstracts for potentially eligible studies, and two authors then independently evaluated the abstract and full texts of the shortlisted articles to determine eligibility. We delineated the study selection process in a PRISMA diagram. Two review authors independently extracted and coded all data from each included study using a data collection form, including design, population, intervention, comparison and outcomes. Disagreements along these steps were resolved via discussion, with the input of a third author if necessary. One review author transferred the data to Review Manager 5.4 software , and a second review author checked the accuracy of data entry.

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New Possibilities For Feeling And Perceiving

It is clear that dance has a powerful effect on the human body and psyche.

DMT from its inception emphasized that the body is inseparable from, and in constant reciprocal interaction with, the mind. As such, sensations, perceptions, emotions and thinking affect our body and the way we move. By observing the body we can deduce mental states.

Conversely, our posture and our movements have the power to transform our mental states, to evoke repressed memories, to release spontaneity and creativity, to reorganize our brains. New ways of moving and dancing may produce new ways of feeling and perceiving the world.

This is one of the most exciting and profound aspects of DMT and it is shocking that the body, movement and dance have been almost entirely ignored by mainstream psychotherapy. It is time to change that!

Indications For Use Of Dance As Therapy In Pd

To date, published studies of dance for individuals with PD have included mainly individuals in Hoehn & Yahr stages I-III. Some have suggested that early intervention may be a key to improving and preserving function among those with PD, and as such dance may be indicated even for those who have been diagnosed with PD but are not experiencing falls or balance difficulties. Those with more advanced disease also may benefit from dance, but inclusion criteria have often included a stipulation that the individual must be able to walk 3m with or without an assistive device but without physical assistance from another person.34,35,43 Those whose disease has advance sufficiently to warrant treatment with deep brain stimulation are also likely appropriate candidates for dance interventions. There is no reason to suspect that those who have had DBS would respond very differently than those without DBS. In fact, our most recent tango study has included individuals with DBS and we have noted no differences in the responses of these individuals compared to those without DBS .

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How Do I Find A Therapist Or Program

Dance/movement therapists and programs are all over the country. To find one nearest you, go to The American Dance Therapy Associations website at www.adta.org. You can find a list of resources and a directory of therapists in your area. The toll-free Parkinsons Foundation Helpline can also help connect you to information and resources: 1-800-4PD-INFO .

Dance/movement therapy is often a wonderful complementary or adjunct therapy for individuals affected by movement disorders. Some dance/movement therapy sessions may be covered by private health insurance, which can make it an affordable and accessible option for treatment of symptoms and maintenance of quality of life.

Erica Hornthal, LCPC, BC-DMT, is CEO of Chicago Dance Therapy. She is a clinical counselor and board-certified dance therapist who specializes in working with individuals living with movement and cognitive disorders. Additionally, Erica works with people of all ages and abilities to connect the mind and body to promote self-awareness, self-expression, healthy attachments, compassion and improved quality of life.

Tango Versus Mixed Dances

Dance Helps Parkinson’s Patients Harness Therapeutic Power of Movement

There were no significant differences between groups in all outcomes estimates under this comparison, including Timed Up and Go Test, Functional Gait Assessment, Freezing Gait Questionnaire, Berg Balance Scale, disease severity , and quality of life . The certainty of evidence is low for all outcomes included in this comparison, due to serious concerns on the risk-of-bias of the included study and imprecision .

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Benefits Of Dance In General

There are many different types of dancing. Some is more social, such as line dancing, folk dancing or ballroom dancing. Dance fitness, such as Zumba, is another type of dance that is aimed specifically at building functional fitness. There are also dance therapy programs, often aimed at specific types of health issues.

According to a literature review done by researchers out of the University of Hawaii in 2017, dance has some specific health benefits, including:2

  • improves muscular strength and endurance
  • promotes better balance
  • improves other aspects of functional fitness

This review also showed significant positive changes in cognitive ability. There was a 21-year study of senior citizens, 75 and older, funded by the National Institute on Aging. It was conducted by the Albert Einstein College of Medicine in New York City and published in the New England Journal of Medicine in 2003.6 The study looked at a number of leisure activities, but found that dancing was the only one to offer significant protection from the risk of dementia.

Plus, let’s not forget that dancing to music that resonates with you can just be plain fun, no matter your age or gender.

Comparison : Dance Versus Physiotherapy

Irish Dance vs. physiotherapy

Based on one study in this comparison , dancers appeared to have lower severity of disease in the motor examination subscale of the MDS-UPDRS subscale 3 , improved balance as measured by the Berg Balance Scale and better ratings in the Freezing of Gait Questionnaire . However, there were no significant differences in the risks of fall of any cause between groups either during the time of intervention or during the entire study period , as well as the quality of life .

The certainty of evidence is low for all outcomes included in this comparison, due to serious concerns on the risk-of-bias of the included study and imprecision .

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Benefits Of Exercise For People With Pd

Exercise is good for all of us, whether we’re perfectly healthy, at risk for certain health issues or already suffering from a chronic illness. But for people with PD, exercise can be especially beneficial. In fact, the Parkinson’s Foundation states that exercise is “a vital component to maintaining balance, mobility and daily living activities, along with a potential neuroprotective effect.”

Here are a few specific benefits of exercise for people who have Parkinson’s disease:

  • Reduced motor symptoms
  • Less gait disturbances

Exercise can also help PD patients be more active participants in their care. That can help alleviate some of the non-motor symptoms and improve quality of life overall.1

Dance For Parkinsons Disease Versus Tango

Dance Returns The

There were no significant differences between groups in all outcomes estimates under this comparison, including disease severity , Timed Up and Go Test, six-minute walk test, forward velocity and quality of life . The certainty of evidence is low for all outcomes included in this comparison, due to serious concerns on the risk-of-bias of the included study and imprecision .

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Lucille Visits Northern Ballet In Leeds With Her Husband Melvyn Who Has Parkinsons

Melvyn was diagnosed in 2011, and has lots of different symptoms including unsteadiness of movement, anxiety and speech problems.

We joined the Northern Ballet Dance for Parkinsons class in 2018, after a friend recommended it. At the time, Melvyn was quite housebound and was difficult for him to get out. But, we went, and were very glad we did.

We enjoyed the first class, although we didnt stay for too long afterwards for a chat, as Melvyns anxiety was quite bad. But now we like to socialise after the class as often as we can.

Each session is specific for people affected by Parkinsons, and is very cleverly thought out by the teachers. A lot of the dances start off seated, and we will all use our facial muscles and arms to really loosen up before everyone stands. You can see the difference it makes, as it gives people the confidence to move more freely and eases stiffness. Well always do it to music, like the Nutcracker, which gives you a feel good factor too. And it gives both of us the chance to do something we can do together, and genuinely enjoy.

If youre not sure, you should definitely give it a go.

Benefits Of Dance For Individuals With Pd

There are limited numbers of studies to date that examine the benefits of dance for individuals with PD. One of the earliest such studies compared a 6-week period of dance/movement therapy to a traditional exercise program. 29 The authors observed improvements in movement initiation in the dance group but not in the exercise group. Another early study examining the benefits of dance therapy for individuals with neurological deficits described improvements in balance, gait, and cognitive performance with a twice weekly, 5-month intervention.30 Within a few years of this study, the Mark Morris Dance Group and the Brooklyn Parkinson Group collaborated to develop âDance for PDâ, a dance/movement class. This class continues to be offered on a weekly basis and a recent study of this class suggests that it positively impacts quality of life.31 While these studies have all focused on dance/movement therapy using free-form movement and often dancing without a partner, another line of research has examined the benefits of partnered dance, with a specific emphasis on Argentine tango.

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Assessment Of Heterogeneity Meta

We used the I2 statistic to quantify the degree of heterogeneity in the results , with a cut-off of 50% and above considered as substantial heterogeneity. We pooled data and performed meta-analysis where appropriate, using a random-effect model in the RevMan 5.4 software . We reported our results using mean difference and risk ratio for continuous and dichotomous outcomes respectively with their 95% confidence intervals . We performed certainty of evidence using the GRADE approach for all the outcomes and highlighted some major outcomes using one Summary of findings table for each comparison . Further details on our methodology, including how we addressed heterogeneity, undertook meta-analysis and performed GRADE certainty-of-evidence rating are available in Additional File .

We performed our meta-analysis by entering all data into the Review Manager software version 5.4, where the effect size calculations were automatically performed, using the inverse variance approach with the following core formula in calculating weighted average: \ }_}^)}\), and with additional incorporation of the random effect model using DerSimonian and Laird method , which includes the following additional formula to calculate the prediction interval that takes into account of the variance between studies: \ .

Benefits Of Dance For People With Pd

Parkinson’s Dance Therapy: Dancing gives relief to patients in Cape Town

In the past couple of decades, more and more research has been done studying how different forms of dance might be helpful in treating PD. In fact, the Dance for PD website lists 38 scientific research studies on this topic. Research shows that dance can be especially beneficial for those with mild to moderate PD.3,4

Dance appears to be very helpful in improving gait and balance in Parkinson’s patients. It also can provide social stimulation and support, which can be helpful in reducing depression and improving quality of life. Plus, dance stimulates cognitive functioning, an area that PD patients often struggle with.

It should also be noted that dance always involves music. This combination of movement to music can be powerful.

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Understanding The Body In Motion

Dance/movement therapy goes beyond simply dancing. DMT uses dance and movement to promote insight, integration and well-being, as well as to diminish undesirable symptoms in various clinical populations.

Unlike mainstream talk therapies, DMT uses the entire body to approach the client primarily on a non-verbal and creative level. The body in motion is both the medium and the message. DMT recognizes the moving body as the centre of the human experience, and that body and mind are in constant reciprocal interaction.

Just like with more traditional psychotherapies, DMT can be applied in a wide range of ways. It may involve talking, different types of music or no music at all. It can be done in groups, with individuals or with couples. Therapists sometimes dance with their clients and at other times observe.

A group therapy session may involve a warm-up and check-in as to where we are at emotionally, mentally and physically. It may be followed by the development of a theme, which emerges spontaneously or has been prepared by a therapist . It ends with grounding and closure .

All of this is done with our bodies in motion or stillness, but some verbal sharing, journaling, drawing and other elements may be added.

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