Effects of dance on gait and dual-task gait in Parkinson’s disease

Abstract

Background Gait impairments in Parkinson’s disease (PD) limit independence and quality of life. While dance based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to perform a feasibility study of the effects of a dance intervention, based on the Dance for PD®(DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted.Methods A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke’s score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III) participated in the study. The DG undertook a one-hour DfPD®based class, twice weekly for 12 weeks. The CG had treatment as usual. Gait analysis was performed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions (regular walking; dual-task: verbal-fluency, serial-subtraction). The data was analysed by means of a linear mixed model. ResultsThe DG improved significantly compared to the CG in gait velocity, cadence, step-length, and stride-length when even surface walking, with and without a dual-task. On the uneven surface the DG walked more cautiously during regular walking but had improved gait velocity, cadence and step-length when performing serial-subtractions. Conclusions DfPD®-based classes produced clinically significant improvement on spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted.Trial registration A protocol for this study has been registered retrospectively at Australian New Zealand Clinical Trials Registry on 12.11.2018. Identifier: ACTRN12618001834246.