Role of Dance in Parkinsonism

Parkinson Disease is a progressive neurodegenerative disease. Common symptoms of PD are resting tremor, bradykinesia, rigidity, mask face, and difficulties with gait. Gait difficulties include short and shuffling steps, festination and/or freezing of gait, difficulty turning or walking backward, and impaired ability to perform dual tasks when walking.  Individuals with PD are also at an increased risk of falls.

Dance address each of the previously mentioned key areas in the following ways, 

• The use of music to accompany dance movement can act as an external cue to facilitate movement.
• The use of specific movement strategies when teaching the dance steps.
• The need to control dynamic balance and respond to perturbations when interacting with other participants facilitates balance exercises.
• Dance helps enhance strength and flexibility. It may also improve cardiovascular functioning if done at a sufficient intensity

 Some of benefits are,

Motor benefits

Dance is shown to benefit individuals with Parkinson's disease by enhancing motor function through stretching, stepping and balance. Individuals who participated in a dance intervention ranging from 90 minutes of dance per week for 8 weeks, to 2 hours, two times per week for 2 years, showed improvements in various outcome measures, when compared to a regular exercise group. The motor improvements could be due to repetition, direction change, and step sequencing that are inherent in dance and transfer into effective, regular gait patterns.Furthermore, basal ganglia may be activated during rhythmic movements, and enhanced by the auditory cues in the music accompanying dance.

Cognitive benefits:

The changing visual and auditory stimuli, unique to dance, facilitate cognitive improvements when compared to regular exercise programs for PD patients. A dance class creates an environment where individuals must control continuously changing patterns of movement to match the instructor. Dance has been shown to reduce time taken to correctly complete the MRT (Mental Rotation Task) as dance aids in imagery formation and judgement. The attention required to anticipate movements, and respond to changes in music or instruction is unique to dance and can enhance the activity of the basal ganglia loops and frontal lobes. This is supported by greater improvement in FAB (frontal assessment battery). When compared to traditional rehabilitation (balance exercises, gait training) there were moderate improvements in cognitive test scores at the 8 week follow up, supporting dance therapy as being able to impact higher cortical functions in the long term.

Mental health benefits:

Mental health benefits for individuals with Parkinson's disease are exclusive to dance when compared to control and regular exercise treatment. Improvement shown in mood, motivation and enjoyment can be related to feelings of unity. There are improved AP (apathy scale) and SDS (self-rating depression scale) scores after dance intervention in patients with PD. It has been suggested that dance therapy can decrease fear of falling through practicing position changes in a controlled environment. Overall, health related quality of life and emotional well-being has been increased through dance for people living with PD.

Other benefits:

When compared to regular exercise and control groups, dance for PD yields greater gains in UPDRS (Unified Parkinson's Disease Rating Scale).  Personal, cultural, and social preference need to be considered to improve adherence to treatment program.