Parkinson’s Disease Motor Symptom Progression Slowed with Multisensory Dance Learning over 3-Years: A Preliminary Longitudinal Investigation

Abstract

Parkinson’s disease (PD) is a neurodegenerative disease that has a fast progression of motor dysfunction within the first 5 years of diagnosis, showing an annual motor rate of decline of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) between 5.2 and 8.9 points. We aimed to determine both motor and non-motor PD symptom progression while participating in dance classes once per week over a period of three years. Longitudinal data was assessed for a total of 32 people with PD using MDS-UPDRS scores. Daily motor rate of decline was zero (slope = 0.000146) in PD-Dancers, indicating no motor impairment, whereas the PD-Reference group showed the expected motor decline across three years (p < 0.01). Similarly, non-motor aspects of daily living, motor experiences of daily living, and motor complications showed no significant decline. A significant group (PD-Dancers and PD-Reference) by days interaction showed that PD who train once per week have less motor impairment (M = 18.75) than PD-References who do not train (M = 24.61) over time (p < 0.05). Training is effective at slowing both motor and non-motor PD symptoms over three years as shown in decreased scores of the MDS-UPDRS.

Rhythmic cueing, dance, resistance training, and Parkinson's disease: A systematic review and meta-analysis

“…Studies in dance displayed different methodological characteristics, such as type of dance, duration of intervention, and group comparisons (22). However, recent literature indicates that dance can improve selected motor and non-motor elements, such as gait, cognition, quality of life (QoL), and mood (22,23), as it increases -brainderived neurotrophic factor (BDNF) levels that, inter alia, trigger dopamine's production, an important aspect of PD pathophysiology (22,24,25). In addition, neurophysiological evidence via functional magnetic resonance imaging (fMRI) has shown that dance is associated with enhanced functional connectivity between premotor cortex and basal ganglia, while electroencephalogram (EEG) studies have demonstrated that Tango might alter muscle synergy during balance and walking testing (26).…”

“…In addition, neurophysiological evidence via functional magnetic resonance imaging (fMRI) has shown that dance is associated with enhanced functional connectivity between premotor cortex and basal ganglia, while electroencephalogram (EEG) studies have demonstrated that Tango might alter muscle synergy during balance and walking testing (26). It has been found that dance provides environmental enrichment that positively affects social and emotional states by stimulating diverse sensory functions during dancing, such as audition, vision, proprioception and tactile perception, balance, and vestibular control that might affect several aspects of motor function, mood, and cognitive impairment of PD patients (25). Although the neuroprotective effects of dance in PD have not been adequately examined, it has been proposed that BDNF upregulation and other molecular pathways may underlie the dance-mediated enhancement of neuronal activation in disrupted sensory-motor areas in PD, thereby resulting in the improvement of motor symptoms (25).…”

The Effects of a Dance and Music-Based Intervention on Parkinson’s Patients’ Well-Being: An Interview Study

“…In relation to dance, evidence-based research showed that both dance therapy and dance programs are effective interventions for health-related physical and psychological problems [ 8 ]. This seems particularly appropriate for Parkinson’s patients since if the main PD symptoms are linked to motor functions (e.g., rigidity, postural instability, rest tremor, balance difficulties, lack of coordination, and bradykinesia), numerous non-motor symptoms (such as cognitive dysfunction or mood/affective disorders) contribute to the progression of the overall disability and impaired quality of life, often to a greater extent than motor symptoms [ 9 , 10 , 11 , 12 ].…”

“…Dance interventions provide a pleasurable, cost-effective, and multidimensional experience where dancers have a chance to improve balance, coordination, visual-spatial ability, flexibility, imagery, creativity, rhythm, memorization, learning, social connection, and an overall enhancement in psycho-emotional well-being [ 8 , 9 , 13 ]. The positive effects of dance on the motor, cognitive and emotional dimensions in PD were demonstrated for the first time in a study published in 1989 [ 14 ].…”

“…Specifically, when focusing on the mobility of individuals with PD, dance-based interventions have been reported to enhance walking speed [ 15 ], flexibility [ 16 ], pitch length, gait [ 17 ], balance [ 18 ], stability, coordination, body control [ 19 , 20 ], and to provide a better posture [ 17 , 21 , 22 ], as well as an overall heightened perceptual sensitivity [ 23 ]. The mobility improvement is both immediate (especially on limb rigidity, fine motor skills, and facial expression) [ 24 ] and is also reported as a long-term effect (especially when assessing improvements in balance, walking, activities of daily living, and physical fitness) [ 9 , 25 , 26 , 27 ].…”