Community-Based Argentine Tango Dance Program Is
Associated With Increased Activity Participation Among
Individuals With Parkinson’s Disease
Erin R. Foster, OTD,a,c,dLaura Golden, OTD,aRyan P. Duncan, PT, DPT,b
Gammon M. Earhart, PhD, PTb,c,e
From theaPrograms in Occupational Therapy andbPhysical Therapy and thecDepartments of Neurology,dPsychiatry, andeAnatomy and
Neurobiology, Washington University School of Medicine, St. Louis, MO.
Objective: To determine the effects of a 12-month community-based tango dance program on activity participation among individuals with
Parkinson’s disease (PD).
Design: Randomized controlled trial with assessment at baseline, 3, 6, and 12 months.
Setting: Intervention was administered in the community; assessments were completed in a university laboratory.
Participants: Volunteers with PD (nZ62) enrolled in the study and were randomized to a treatment group; 10 participants did not receive the
allocated intervention, and therefore the final analyzed sample included 52 participants.
Interventions: Participants were randomly assigned to the tango group, which involved 12 months of twice-weekly Argentine tango dance
classes, or to the no intervention control group (nZ26 per group).
Main Outcome Measure: Current, new, and retained participation in instrumental, leisure, and social activities, as measured by the Activity Card
Sort (with the dance activity removed).
Results: Total current participation in the tango group was higher at 3, 6, and 12 months compared with baseline (Ps?.008), while the control
group did not change (Ps?.11). Total activity retention (since onset of PD) in the tango group increased from 77% to 90% (PZ.006) over the
course of the study, whereas the control group remained around 80% (PZ.60). These patterns were similar in the separate activity domains. The
tango group gained a significant number of new social activities (PZ.003), but the control group did not (PZ.71).
Conclusions: Individuals with PD who participated in a community-based Argentine tango class reported increased participation in complex
daily activities, recovery of activities lost since the onset of PD, and engagement in new activities. Incorporating dance into the clinical
management of PD may benefit participation and subsequently quality of life for this population.
Archives of Physical Medicine and Rehabilitation 2013;94:240-9
ª 2013 by the American Congress of Rehabilitation Medicine
Parkinson’s disease (PD) is a neurodegenerative disorder that
affects over 1 million North Americans.1In PD, degeneration of
dopamine-producing neurons in the substantia nigra disrupts basal
ganglia functioning. This results in motor dysfunction, most
prominently tremor, rigidity, akinesia, bradykinesia, and postural
instability. In addition, individuals with PD can experience
a variety of nonmotor problems, such as sensory disturbances,
cognitive impairment, autonomic dysfunction, and psychological
changes.2,3As PD progresses, it can hinder the individual’s ability
to perform activities of daily living (ADL), leading to dependency
on others.4,5As such, PD is associated with reduced quality of
life6-8and significant socioeconomic costs.9
Although loss of independence in ADL (ie, disability) is
thought to occur in the middle or moderate stages of disease
Supported by the National Institutes of Health (grant no. NIH UL1 TR000448); the Parkinson’s
Disease Foundation; the Greater St. Louis American Parkinson Disease Association (APDA); and
the APDACenter for Advanced Parkinson’s Disease Research at Washington University in St. Louis.
No commercial party having a direct financial interest in the results of the research supporting
this article has or will confer a benefit on the authors or on any organization with which the authors
Clinical Trial Registration No.: CT0138856.
An audio podcast accompanies this article.
Listen at www.archives-pmr.org.
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journal homepage: www.archives-pmr.org
Archives of Physical Medicine and Rehabilitation 2013;94:240-9
progression,4emerging research10suggests that PD can negatively
impact participation early in the disease. The International
Classification of Functioning, Disability and Health defines
participation as involvement in life situations and the extent to
which individuals are engaged in a societal context.11Individuals
with early and mild PD, for whom motor dysfunction is not yet
sufficient to cause physical disability, report reduced participation
in instrumental, low physical-demand leisure, and social activities
compared with healthy, age-matched peers.10,12Furthermore,
participation restrictions among individuals with PD are associ-
ated with reduced health-related quality of life.12,13Participation
is positively correlated with functional status and life satisfac-
tion14,15and may be protective against physical and cognitive
decline as people age.16,17These links highlight the importance of
pursuing interventions targeted at improving participation for
those with PD. Dopaminergic medication does not adequately
address many of the factors that contribute to reduced participa-
tion in this population, including impaired mobility, depressive
symptoms, and cognitive dysfunction.10,13,18There is a need for
more comprehensive approaches to manage the complex mani-
festations of PD and their effects on individuals’ participation.
One adjunct to medical treatment that is beneficial for PD
patients is exercise. Exercise has been found to improve physical
function, mobility, cognition, and health-related quality of life
among individuals with PD.19-21Unfortunately, more than half of
all American seniors do not engage in the recommended amount
of exercise, and those with PD engage in 15% less exercise than
their healthy peers.22Because of this, the identification of alter-
native forms of exercise that are at least as effective as traditional
exercise programs but foster better adherence is needed.
Individuals with PD report that social support and social
interaction positively influence their exercise adherence, with one
of the most salient motivators being spousal participation.23,24
Dance is a form of partnered exercise that provides social
engagement and, importantly, has been found to have a higher
adherence rate than other forms of exercise among individuals with
PD.25At the end of a study comparing traditional exercise to
dance,26nearly half of the participants in the dance group chose to
continue to participate in the dance classes, while no participants
from the traditional exercise class continued their form of exercise.
chose to attend the dance classes after the study was complete.
In addition to promoting better adherence, dance may improve
on the beneficial physical effects of traditional exercise. In the
study previously described,25the dance group showed significant
improvements in balance, whereas the traditional exercise group
did not. Argentine tango was found to be a particularly effective
form of dance, resulting in larger improvements in balance,
mobility, movement initiation, and attention to movement control
compared with other forms of dance (waltz and foxtrot).27The
positive effects of Argentine tango on physical function (eg, motor
dysfunction severity, balance, gait) and progression of motor
symptoms were recently confirmed in a randomized controlled
trial of a long-term community-based tango dancing program.28
The benefits of tango dancing may extend beyond physical
improvements to stimulate broader participation in life activities
and roles for those with PD.29For example, partnered exercise
thereby increasing opportunities for social participation outside of
the formal program.23Interventions for improving participation
among individuals with PD have previously been unexplored. The
purpose of this study was to determine whether the community-
based tango dance program that reduced disease severity and
improved physical function in a group of PD patients28affected
activity participation. We hypothesized that PD participants who
engaged in the dance program would report increased activity
participation over the course of the study relative to a control group
of participants with PD who did not engage in the dance program.
Participants were recruited from the clinical research database of
the Washington University School of Medicine (WUSM) Move-
ment Disorders Center, the WUSM Research Participant Registry,
neurologists in the St. Louis area, and advertisements in the news-
letter of the Greater St. Louis Chapter American Parkinson Disease
Association. All participants were diagnosed with idiopathic PD
using published clinical diagnostic criteria,30were classified as
from levodopa. Participants had to be able to walk independently
for 3 meters with or without an assistive device. Individuals
were excluded if they had a history of neurologic deficit other than
PD, serious medical problem(s), evidence of abnormality other
than PD-related changes on brain imaging, or history or evidence
of musculoskeletal or psychological problems. This study was
approved by the institution’s human research protection office, and
all participants provided written informed consent.
This was a single-blind randomized controlled trial. On enroll-
ment, participants were randomly assigned to the tango or control
group. The protocol for the tango intervention was based on prior
investigations of the effects of Argentine tango for individuals
with PD.32Tango participants attended 1-hour dance classes 2
times per week for 12 months. Dance classes were taught by an
experienced dance instructor who was trained and supervised by
the principal investigator (G.M.E.) to ensure appropriateness and
safety for individuals with PD. The classes consisted of progres-
sive Argentine tango lessons in which participants learned a new
step in each class. This form of dance involved flexible, impro-
visational step patterns composed of small step elements, spon-
Individuals with PD were paired with individuals who did not
have PD. These dance partners were caregivers (eg, spouses,
family members) who accompanied PD participants to the classes
and healthy young volunteers recruited from health-related grad-
uate and undergraduate departments at Washington University in
St. Louis (volunteers received special training on fall prevention
and safety). All individuals, regardless of sex, were asked to dance
in both the leader and follower roles to ensure that everyone spent
similar amounts of time moving forward and backward. In addi-
tion, participants changed partners every 10 minutes, a practice
List of abbreviations:
ACS Activity Card Sort
ADL activities of daily living
PD Parkinson’s disease
UPDRS Unified Parkinson’s Disease Rating Scale
WUSM Washington University School of Medicine
Tango and participation in Parkinson’s disease 241
commonly used in dance classes to facilitate learning. Control
participants were asked to continue the normative life routine that
they had engaged in before enrolling in the study.
Control and tango participants were evaluated at baseline and then
at 3, 6, and 12 months postbaseline. All assessments were con-
ducted while participants were off their regular antiparkinsonian
WUSM program in physical therapy. The full evaluation consisted
of a variety of measures to characterize physical function and
mobility, including the Unified Parkinson’s Disease Rating Scale
(UPDRS) sections 1 to 333(for a complete description of study
measures, see Duncan and Earhart28). The Beck Depression
Inventory-II34,35was administered to assess depressive symptoms.
Participation, the primary outcome for this analysis, was measured
using the Activity Card Sort (ACS).36The ACS is a standardized
assessment that measures perceived level of participation in daily
life activities as well as changes in participation in relation to
certain events (eg, the onset of disease or disability, beginning
a new treatment regimen) or over specified periods of time (eg, in
the past 5y). It consists of 89 cards containing pictures of people
involved in activities that fall into 1 of 4 domains: (1) instrumental
activities (20 items; eg, grocery shopping, doing laundry, house-
hold maintenance), (2) low-demand leisure activities (35 items; eg,
cooking as a hobby, playing table games, reading, watching movies
or television), (3) high-demand leisure activities (17 items; eg,
swimming, woodworking, hiking, fishing, gardening), and (4)
social activities (17 items; eg, traveling, eating at a restaurant,
volunteer work, spending timewith friends). Participants sorted the
cards into 1 of 5 categories with the corresponding numerical point
values: continue to do since illness (at preillness level) Z 1, do less
since illness Z 0.5, given up because of illness Z 0, new activity
since illness Z 1, or not done prior to illness Z 0. PD was the
illness to which the categories referred. As per published scoring
criteria,36current participation scores were calculated by summing
the point values for the activities sorted into the continue to do, do
less, and new activity categories. Activities sorted into the continue
todo, do less, andgiven up categories each also received 1 point for
previous participation. Activity retention since PD onset was
calculated by dividing current by previous participation scores.
These calculations were completed for all activities (total) and for
the separate activity domains (instrumental, low-demand leisure,
high-demand leisure, social). The ACS includes dancing as a social
activity; however, this item was removed from analysis, therefore it
would not inflate the tango participants’ scores. In the present
study, total current and previous scores could range from 0 to 88,
and separate activity domain scores could range as follows:
instrumental, 0 to 20; low-demand leisure, 0 to 35; high-demand
leisure, 0 to 17; and social, 0 to 16. Higher scores indicate partic-
ipation in more activities. Activity retention scores could be above
0%, with higher scores indicating proportionately more activities
retained since the onset of PD. The ACS has strong psychometric
properties in community-dwelling samples of healthy adults14,36,37
and those with various neurologic conditions (ie, Alzheimer
disease, multiple sclerosis, stroke),37including good internal
consistency, test-retest reliability, and construct validity. The ACS
demonstrated sensitivity to change in a sample of individuals with
stroke in response to a community rehabilitation program.38
Descriptive statistics were calculated for all variables. Group
characteristics at baseline were compared using independent
samples t tests, Wilcoxon signed-rank tests for ordinal scales (eg,
Hoehn and Yahr stage), and chi-square tests for categorical data
(eg, sex). Longitudinal analyses were conducted using mixed-
model 2?4 analyses of variance with group (tango, control) as
the between-subjects factor and time (baseline, 3, 6, and 12mo) as
the within-subjects factor. Planned pairwise comparisons were
used to characterize change over time within each group. An
intent-to-treat analysis was employed including all participants
who completed the baseline and 3-month evaluation and carrying
forward the last recorded data for those who dropped out after this
point. A significance level of .05 was used in all statistical anal-
yses, and P<.10 designating trends.
Sixty-two individuals with idiopathic PD (30 control, 32 tango)
enrolled in this study, were randomized to treatment groups, and
completed the baseline evaluation. Fifty-two participants (26
control, 26 tango) completed the 3-month evaluation and were
included in the current analysis (fig 1). Sample characteristics are
presented in table 1. There were no differences between the tango
and control groups at baseline with regards to sex, age, duration
and severity of PD, or depressive symptoms (all P?.25).
There were no group differences in current participation at base-
line for total activities or for the separate activity domains (all
P?.15). There was an effect of time (F3,48Z2.78, PZ.04) and
a trend for a time by group interaction in total current participation
(F3,48Z2.55, PZ.06) (fig 2). Planned comparisons indicated that
there was a main effect of time in the tango group (F3,48Z4.05,
PZ.01) but not the control group (F3,48Z.96, PZ.42). Specifi-
cally, the total current participation of the tango group was higher
at 3, 6, and 12 months compared with baseline (all P?.008), while
the control group did not change (all P?.11). Analysis of the
separate activity domains (fig 3) showed a similar pattern for low-
demand leisure activities, such that there was a main effect of time
for the tango group (F3,48Z4.75, PZ.006) but not for the control
group (F3,48Z1.36, PZ.27). Low-demand leisure participation
was higher in the tango group at 3, 6, and 12 months compared
with baseline (all P?.03), while the control group did not change
(all P?.50). There were no significant effects for high-demand
leisure, instrumental, or social activities (all P?.11).
Activity retention since PD onset
There was a main effect of time for total activity retention
(F3,48Z3.70, PZ.02). The time by group interaction did not reach
significance (PZ.15); however, as with total current participation,
planned comparisons revealed a significant effect of time within
the tango group (F3,48Z4.68, PZ.006) but not the control group
(F3,48Z.631, PZ.60) (fig 4). Over the course of the study, the
percentage of pre-PD activities engaged in by the tango group
242 E.R. Foster et al
increased from 77% to 90%, whereas the control group remained
around 80%. Analysis of the separate activity domains (fig 5)
revealed significant effects of time on instrumental and low-
demand leisure activity retention in the tango group (Fs?3.7,
Ps?.02) but not the control group (Fs<.47, Ps?.70). Percentage
of pre-PD instrumental activities increased from 76% at baseline
to 87% at 3 months, before declining to 81% at 12 months in the
tango group, but remained around 80% in the control group.
Percentage of pre-PD low-demand leisure activities increased
from 79% to 106% in the tango group but remained at 84% in the
control group. This indicates that the tango participants reported
engaging in more low-demand leisure activities at the end of the
study compared with before the onset of PD. There was an effect
of time for social activity retention (F1,50Z13.75, PZ.001).
Percentage of pre-PD social activities in the tango group
increased from 85% at baseline to 94% and 102% at 3 and 6
months, respectively, before declining to 89% at 12 months
(F3,48Z4.83, PZ.005). After an initial increase from 85% at
baseline to 90% at 3 months in the control group, there was
a decline to 82% at 12 months (F3,48Z2.61, PZ.06). There were
no significant effects for high-demand leisure activity retention
pants retained through 3 months were included in the final analyzed sample; last observations from those who dropped out after 3 months were
carried forward for intent-to-treat analysis.
Consolidated Standards of Reporting Trials flow diagram illustrating participant recruitment, randomization, and attrition. All partici-
Tango and participation in Parkinson’s disease243
There was a main effect of time on new activity participation
(F3,48Z9.83, P<.001), such that both groups reported more new
activities at 3, 6, and 12 months compared with baseline (all
P?.001) (fig 6). On average, the tango group reported 2.6?3.9
new activities at each time point and the control group reported
1.4?3.6 at each time point. The effect of time was significant for
each activity domain (Fs?5.46, Ps<.01) (fig 7). However, for new
social activities, it was qualified by a time by group interaction
(F3,48Z4.26, PZ.03), such that there was a significant effect of
time in the tango group (F3,48Z5.38, PZ.003) but not the control
group (F3,48Z.47, PZ.71). The tango group gained a significant
number of new social activities from baseline to 3, 6, and 12
months (mean ? SD, 0.5?1.1; Ps<.001), but the control group
did not (mean ? SD, 0.15?0.48; Ps?.31).
The purpose of this study was to examine the effects of
a community-based Argentine tango dance program on activity
participation among individuals with PD. Volunteers with PD
were randomized to participate in 12 months of Argentine tango
classes (tango group) or to continue their daily routine as usual
(control group). As hypothesized, participants in the tango group
reported increased activity participation over the course of the
study. Moreover, they recovered a significant proportion of the
activities they had lost since the onset of PD. Activity participa-
tion among individuals in the control group remained rela-
Our results extend previous work28and suggest that in addition
to improving physical function among individuals with PD,
socially engaging and functional skill-based exercise promotes
participation in instrumental, leisure, and social activities. The
changes in participation observed in the tango group appear to be
driven by a combination of increased engagement in prior activ-
ities done less or given up since the onset of PD, as well as
engagement in novel activities. The only activity domain for
which participation did not increase in the tango group relative to
the control group was high-demand leisure. Tango participants
were required to attend the dance classes and, as such, were
engaging in a high-demand leisure activity that was not captured
by our outcome measure (because this item was removed);
however, they did not report participating in additional exercise
activities outside of the dance classes. There are a number of
potential reasons for this, including lack of opportunities or access
to exercise or being satisfied with the level of exercise offered by
the dance classes. Regardless, by engaging in more instrumental,
low-demand leisure and social activities, participants in the tango
group did boost their overall level of physical activity, which
simply requires bodily movement that increases energy expendi-
ture above the basal level and can include occupational, house-
hold, transportation, and leisure activities.39
Of the separate activity domains, low-demand leisure showed
the most consistent improvements, with tango participants
engaging in more of these types of activities by the end of the
study than they had before the onset of PD. This outcome is
significant, as participation in low-demand leisure activities has
been associated with improved mental health in older adults.14It
is important to note that while the activities in this domain are not
as physically demanding as those in the high-demand leisure
domain, many place significant demand on mobility (eg, going to
the museum, recreational shopping) or other functions affected by
PD, such as cognition and fine motor coordination (eg, games,
puzzles, needlecrafts). Some also involve social interaction. Thus,
rather than representing the adoption of a more sedentary life-
style, increased low-demand leisure participation may reflect
a higher level of daily challenge and engagement for individuals
There are a number of ways in which Argentine tango could
positively influence activity participation in PD. As a form of
physical exercise, it benefits PD-related mobility impairments and
may even slow disease progression (for a discussion of these
effects, refer to Duncan and Earhart28), which could result in
improved capacity for daily performance and participation.
Importantly, progressive tango classes have features that may
additively benefit participation compared with traditional exercise.
For example, tango requires working memory, control of attention,
and multitasking to integrate newly learned and previously learned
dance elements, stay in rhythm with the music, and maneuver
around others on the dance floor. Leading requires self-initiated
movements and motor planning, while following requires
reading and responding appropriately to the leader’s body cues.25
at baseline (nZ52)
Demographic and clinical characteristics for each group
Characteristics Control GroupTango Group
Male/female ratio (n)
Hoehn and Yahr stage (n)
Years since diagnosis
NOTE. Values represent means ? SD or as otherwise indicated.
Abbreviation: BDI-II, Beck Depression Inventory II.
and 12-month evaluations for the tango and control groups. Values are
means ? SEs. Horizontal lines indicate a significant difference within
the tango group between the time points spanned by the line.
244E.R. Foster et al
These cognitive challenges may further improve capacity for daily
performance and result in increases in, or maintenance of,
The social interaction, social support, and social influences that
emerged from the tango classes likely also had positive effects on
participation. The group setting provided an opportunity for social
modeling, the establishment and reinforcement of social norms
regarding health-promoting behavior, and the development of
social networks.40In fact, participants in the tango group reported
engaging in social activities together outside of class, including
attending a play, the symphony, and a social dance. On an indi-
vidual level, the presence of a partner may have helped those with
PD to feel more comfortable challenging themselves in the
complexity and difficulty of movements,27thereby providing the
opportunity for mastery experiences, a primary source of self-
efficacy.41Improvements in self-efficacy that occurred during the
tango classes could have translated to daily life, cultivating the
desire to go out and engage in more or new activities, retry
activities that had been given up, or devote the necessary effort
and persistence required to maintain one’s current level of activity.
There was no control for attention and social interaction across
groups; therefore, it is possible that the changes in participation
observed in the tango group were because of nonspecific effects of
socializing. However, studies in older adults have shown that
Current participation scores on the ACS for each activity domain at baseline, 3-, 6-, and 12-month evaluations for the tango and control
12-month evaluations for the tango and control groups. Activity
retention scores represent the proportion of pre-PD activities currently
engaged in, calculated as current participation/previous participation.
within the tango group between the time points spanned by the line.
Tango and participation in Parkinson’s disease245
exercise outcomes are more strongly predicted by the social
cognitive factors associated with exercise, such as improved self-
efficacy, rather than by social interaction alone.42Thus, we propose
that the improvements in participation in the tango group are larger
than what would occur from socialization alone. Future studies
should incorporate a social control group and measure social
cognitive factors to provide stronger support for this conclusion.
Our attrition rate was relatively high compared with previous
exercise studies in PD.43,44Attrition may have been a function
of the research study rather than of the intervention itself.
Participation in the study required completion of 4 separate off-
medication evaluations that were conducted at a different loca-
tion than where the dance classes were held. This feature likely
added a level of burden or discomfort that would not be present
in a community-based dance program alone. Importantly, the
tango participants who completed the entire study were actively
engaged in the intervention, as evidenced by an average of nearly
80% attendance to all classes. This adherence rate is good
compared with other 12-month exercise trials in older adults.45
Furthermore, most of these participants (13 of 16) chose to
continue attending the dance classes after the study was over.
Thus, dance appears to be an enjoyable and highly motivating
form of physical activity for some people with PD. Formalized
follow-up, perhaps using the ACS with the dancing item rein-
corporated, would provide support for this notion and help to
determine longer-term effects of the intervention. Consistent with
the notion that a one-size-fits-all approach to promoting exercise
will not be efficacious, but instead, that exercise recommenda-
tions should be tailored to individuals’ needs, desires, and
these findings suggest the need for continued
Values are means ? SEs. Horizontal lines indicate a significant difference within the tango group between the time points spanned by the line.
12-month evaluations for the tango and control groups. Values are
means ? SEs. Both groups reported more new activities at 3-, 6-, and
12-months compared with baseline.
Total new activity scores on the ACS at baseline, 3-, 6-, and
246 E.R. Foster et al
identification of alternative, effective forms of exercise for the
diverse population of individuals with PD.
While the ACS provides a broad picture of a person’s
perceived participation in complex daily activities, it may not have
fully captured all changes in participation in our sample. For
example, it allows for the measurement of new activities but does
not include a do more category, and therefore cannot account for
increased participation in existing activities. In addition, the ACS
does not provide information regarding factors such as length of
time spent engaged in activities, the relative importance of
activities to people, satisfaction with participation, or difficulty
a complex and multidimensional construct. The present study has
provided initial support for the efficacy of community-based
dance for improving participation among individuals with PD.
Future work can investigate the nature of changes in participation
that are occurring, as well as the relative importance of the various
facets of participation to overall health and well-being in PD.
We found that engagement in a community-based Argentine tango
dance class was associated with increased activity participation
among individuals with PD. To our knowledge, this is the first
study to test the effect of any intervention on activity participation
in this population. Rehabilitation research in PD primarily focuses
on motor impairment and physical disability, measuring outcomes
at the level of functional mobility and self-care ADL. Given its
importance for health and well-being,14,16,47optimal participation
in all the activities and roles of daily life should be the ultimate
goal of rehabilitation for PD and should be a primary outcome in
intervention studies. Our findings suggest that dance, a socially
engaging form of exercise, should be included in the clinical
management of PD. Future work should examine longer-term
effects of the intervention and investigate the potential biologic
and psychosocial mechanisms underlying the benefits of dance for
individuals with PD.
Exercise; Parkinson disease; Quality of life; Rehabilitation; Social
Gammon M. Earhart, PhD, PT, Associate Professor of Physical
Therapy, Anatomy and Neurobiology, and Neurology, Washington
University School of Medicine, Program in Physical Therapy,
Values are means ? SEs.
New activity scores on the ACS for each activity domain at baseline, 3-, 6-, and 12-month evaluations for the tango and control groups.
Tango and participation in Parkinson’s disease247
Campus Box 8502, 4444 Forest Park Blvd, St Louis, MO 63108.
E-mail address: firstname.lastname@example.org.
We thank Ruth Porter, DPT, and John Michael Rotello for tango
instruction. We also thank Vanessa Heil-Chapdelaine, DPT for
assistance with data management.
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