Dance Class Intervention Safe for Patients With Parkinson Disease

Camila Pinto, MRS

Data presented at The International Parkinson and Movement Disorders (MDS) Society Virtual Congress 2021, September 17-22, outlined findings from a recent study (NCT04580849), which showed that online dance classes were 100% safe for patients with Parkinson disease (PD).

Investigators, led by Camila Pinto, MRS, PhD-candidate, Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal das Ciências de Saúde de Porto Alegre, Porto Alegre, RS, Brazil, included a total of 28 individuals, divided into 2 groups: 1 comprised of patients with PD (n = 13; age, 70 years; Mini-Mental State Examination [MMSE], 27.83; New Freezing of Gait Questionnaire [NFOG-Q], 11.92; Hoehn and Yahr scale [HY], 2.63) and another comprised of patients without PD (n = 15; age, 70 years; MMSE, 28.79). 

Feasibility of the trial design was determined by investigators, who monitored patients to assess adherence, frequency, and safety (specifically falls) of online dance classes using a scale of 0% to 100%. It was concluded that online dance therapy was safe for both groups, with those in the PD group showing a 100% adherence rate, as well as a frequency of 90% during classes themselves. 

“Dance therapy is one of the several interventions that have shown important benefits on motor and nonmotor symptoms in people with PD,” Pinto et al wrote.¹ “Nowadays, there is a growing necessity for online interventions for those people that are not able to go outside their houses without assistance or take public transportation and those who live in remote places with internet availability.”

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Both before and after the dance intervention, members were evaluated for difference in outcomes, including anxiety and depression via the Hospital Anxiety and Depression Scale (HADS), self-efficacy in performing activities without using balance using the Activities-Specific Balance (ABC) Scale, and functional mobility strength of lower extremity via the Five Times Sit to Stand Test (FTSST). 

When evaluating patients with PD, investigators found that following dance classes, patients had decreased time to perform the FTSST (P = .004) and saw no change in either HADS or ABC outcomes. Members of the control group did not report changes in outcomes following the study. 

To perform the initial assessment, participants joined dance classes through Zoom, followed by a total of 16 synchronic online dance classes, also held through Zoom, over the course of 2 months. Classes were held twice weekly for 60-minute periods. 

Following the COVID-19 pandemic, which necessitated the integration of telehealth, the need to incorporate virtual options for treatment and exercise has surfaced, particularly for patients with PD who live in remote areas. Illustrating this, data presented at MDS 2021 focused on the effects of COVID-19 in this patient population, finding that subgroups of those with PD experienced worsening mental health and poorer quality of life due to a range of stressors associated with the pandemic.

“People with Parkinson disease might be especially vulnerable to distress, for instance, because reduced levels of physical activity have caused worsening of symptoms, or because people with Parkinson disease often have difficulties with flexible adaptations to rapid and drastic changes in daily routines, such as those introduced by the COVID-19 pandemic,” lead author Lisanne Dommershuijsen, MSc, PhD candidate, department of epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands, said in her presentation.²

Physical exercise and activity for this patient population was further discussed in another presentation at MDS 2021, which outlined design protocol of a trial aimed at identifying in noncontact boxing exercise program can improve movement and quality of life for individuals with PD. The trial, FIGHT-PD, has begun screening, with interim results anticipated for the end of 2021, having been delayed by COVID-19.^{3, 4} 

According to poster author David Blacker, MD, neurologist and medical director, Perron Institute for Neurological and Translational Science, preliminary evidence does suggest the potential of noncontact boxing for patients with PD, but existing trials “lack [a] detailed description of component elements and documentation of exercise intensity” and that “there are few data on heart rate targets and rates of perceived exertion; information which is critical for quantifying dose.”³ 

For more coverage of MDS 2021, click here.

REFERENCES

1. Pinto C, Figueiredo C, Mabilia V, et al. Feasibility of dance therapy through synchrony videoconference in Parkinson’s disease and elderly people. Presented at MDS Congress 2021; September 17-22; Virtual. Poster 432.
2. Dommershuijsen L, Heide A, Berg E, et al. Effect of COVID-19 stressors on mental health and quality of life in Parkinson’s disease. Presented at: MDS Congress 2021; September 17-22; Virtual. Poster 1045.
3. Blacker D, Fazio R, Tucak C, Turner M, Rajandran S, Cruickshank T. Feasibility of Instituting Graduated High-Intensity Training (FIGHT-PD); Protocol for a non-contact boxing exercise study. Presented at: MDS Congress 2021; September 17-22; Virtual. Poster 368.
4. Boxing for Parkinson’s study in full swing. News release. Perron Institute. Published 2021. Accessed September 20, 2021. https://www.perroninstitute.org/boxing-for-parkinsons-study-in-full-swing/