Dance for Parkinson's disease to improve gait and balance: Clinical assessments vs. objective measures

Dance for Parkinson's disease to improve gait and balance: Clinical assessments vs. objective measures

Objective: To evaluate how the dance classes based on the Dance for Parkinson’s Disease®(DfPD®) model could improve gait and balance in people with Parkinson’s disease (PD) using clinical and objective measures.

Background: Gait and balance deficits lead to poor functional mobility in PD. While dance can improve clinical measures of gait and balance, it remains to be shown if improvements are also seen on objective measures.

Method: Participants with mild to moderate stage PD (Hoehn & Yahr: DG=1.6 ± 0.7, CG=1.5 ± 0.8) with no cognitive impairment (Addenbrooke’s score: DG=93.2±3.6, CG=92.6±4.3) were divided into dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) The DG undertook a one-hour DfPD® based class, twice weekly for 12 weeks while CG had medication and conventional physiotherapy as usual. Assessments were undertaken at pre and post-intervention. Clinical measures of gait and balance included Tinetti test: TT (TT-gait and TT-balance), Timed Up and Go test: TUG, Mini-BEST test: MBT and Berg Balance Scale: BBS. Spatio-temporal parameters of gait were objectively measured using Vicon 3-D motion analysis system for regular and dual-task (serial-subtraction- DTSUBT) walking. The data were analysed by using the linear mixed model.

Results: The DG participants had a higher attendance rate (92.89%) and no adverse events. The groups did not differ significantly on any measure at baseline. Based on p values and effect size (ES) of the change scores the DG significantly improved, relative to the CG, on the TT-Gait (ES=1.17, p=0.002), TT-Balance (ES=1.19, p=0.002), TT-Total (ES=1.52, p=0.001),TUG (ES=-0.76, p=0.038), DT-TUG(ES=-1.23, p=0.001), MBT (ES=2.07, p=0.001) and BBS (ES=2.20, p=0.001). Objective measures of gait for regular walking also improved significantly: gait velocity [ES = 0.98, p = 0.02], cadence [ES = 0.08, p = 0.02], step length [ES=0.81, p = 0.03], and stride length [ES = 0.84, p = 0.03]. The DG also exhibited significant improvement during DTSUBT in the measures of gait velocity (ES=1.03, p=0.012), cadence (ES=0.90, p=0.021), step length (ES=0.02, p=0.018) and stride length (ES=0.01, p=0.151) compared to the CG.

Conclusion: We conclude that DfPD® model could be a useful supplementary intervention that will improve gait and balance in PD which was confirmed by both the clinical and objective measures of balance and gait.

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