Available via license: CC BY-NC-ND 4.0
Content may be subject to copyright.
A preview of the PDF is not available
Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review
Abstract and Figures
Purpose
To conduct a systematic review that examined the effect of dance interventions on balance, gait and functional mobility outcomes in adults with neurological conditions other than Parkinson's disease.
Methods
A systematic search of relevant databases was conducted. Data extraction and methodological appraisal were performed by two independent authors.
Results
Nine studies were included (4 pre-post studies with no control group, 3 case reports, and 2 controlled studies) and results of the methodological quality assessment ranged from poor to good. Study groups included stroke, multiple sclerosis, spinal cord injury, and Huntington's disease. Dance interventions varied in frequency, type and duration, and only 1 study reported intensity. Study dropout rates ranged from 20–44%, and 88–100% of dance classes were attended. Only 3 studies mentioned adverse events, of which there were none. A summary of results revealed significant changes in spatiotemporal gait parameters, Berg Balance Scale scores, Timed Up and Go test and six-minute walk test that were similar to or greater than those previously reported in a review of dance for individuals with Parkinson's disease.
Conclusions
There is emerging evidence to support the use of dance as a feasible intervention for adults with neurological conditions. Further investigation of the effects of dance with randomized controlled trials using larger sample sizes and better reporting of the intervention, participant tolerance, and adverse events is warranted.
Figures - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
... However, those authors who have introduced multitasking exercises based on music and rhythm in older adult populations have found that the available cognitive resources are increased, thus improving gait control [48] and balance, as well as producing a reduction in the rate of falls in said population [29]. Furthermore, dance or choreographed workouts with music have been shown to be a therapeutic tool for people with cognitive and motor pathologies such as Parkinson's, cancer, or neurological disorders [49][50][51], as these activities include movements of all parts of the body and appear to improve adherence to sports activities, as well as leading to benefits in cognitive and balance parameters [50,51]. At the same time, activities with music have a strong social and motivational factor that favors the improvement of the well-being of subjects' lives and contributes to the fight against a sedentary lifestyle in people with previous pathologies [52,53]. ...
... However, those authors who have introduced multitasking exercises based on music and rhythm in older adult populations have found that the available cognitive resources are increased, thus improving gait control [48] and balance, as well as producing a reduction in the rate of falls in said population [29]. Furthermore, dance or choreographed workouts with music have been shown to be a therapeutic tool for people with cognitive and motor pathologies such as Parkinson's, cancer, or neurological disorders [49][50][51], as these activities include movements of all parts of the body and appear to improve adherence to sports activities, as well as leading to benefits in cognitive and balance parameters [50,51]. At the same time, activities with music have a strong social and motivational factor that favors the improvement of the well-being of subjects' lives and contributes to the fight against a sedentary lifestyle in people with previous pathologies [52,53]. ...
The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants’ ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called “categorical evocation in associations”. The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η2p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η2p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η2p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music.
... However, those authors who have introduced multitasking exercises based on music and rhythm in older adult populations have found that the available cognitive resources are increased, thus improving gait control 43 and balance, as well as producing a reduction in the rate of falls in said population 17 . Furthermore, dance or choreographed workouts with music have been shown to be a therapeutic tool for people with cognitive and motor pathologies such as Parkinson's, cancer or neurological disorders [44][45][46] , as these activities include movements of all parts of the body and appear to improve adherence to sports activities, as well as leading to benefits in cognitive and balance parameters 45,46 . At the same time, activities with music have a strong social and motivational factor that favors the improvement of the well-being of subjects' lives and contributes to the fight against a sedentary lifestyle in people with previous pathologies 47,48 . ...
... However, those authors who have introduced multitasking exercises based on music and rhythm in older adult populations have found that the available cognitive resources are increased, thus improving gait control 43 and balance, as well as producing a reduction in the rate of falls in said population 17 . Furthermore, dance or choreographed workouts with music have been shown to be a therapeutic tool for people with cognitive and motor pathologies such as Parkinson's, cancer or neurological disorders [44][45][46] , as these activities include movements of all parts of the body and appear to improve adherence to sports activities, as well as leading to benefits in cognitive and balance parameters 45,46 . At the same time, activities with music have a strong social and motivational factor that favors the improvement of the well-being of subjects' lives and contributes to the fight against a sedentary lifestyle in people with previous pathologies 47,48 . ...
The aim of the study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual-task conditions. Design: Randomized clinical trial. Methods: 20 healthy and physically active older adults (73.255.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE), closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants’ ability to reposition their dominant knee at 45º. Finally, performance on the cognitive task was measured through a subscale of the Barcelona Test called “categorical evocation in associations.” The EG and the CG completed 8-week training programme with two sessions the 30 minutes per week of postural control and proprioception exercises. The EG additionally included music in each session. Results: The results showed significant differences in both group at the postural control tests (RBOE and RBCE) and proprioceptive test post intervention. Conclusion: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music.
... These impairments can lead to falls and injuries [22][23][24][25], which in turn lead to increased disease burden [ 26 ]. While many studies hav e explor ed balanc e deficits and int erventions for these deficits in PD [27][28][29] and AD [ 30 , 31 ], less is known about HD. Directly comparing balance in AD, PD, and HD would allow for better understanding of these neur odegenerativ e diseases and inform future research directions, particularly in HD. ...
Article highlights
Background
Neurodegenerative diseases including Alzheimer, Huntington, and Parkinson disease have overlapping signs and symptoms.
Understanding how overlapping symptoms, like balance impairment, differ in each of these conditions could help guide treatment.
Methods
The Balance Evaluation Systems Test (BESTest) breaks balance down into six subsections, allowing for better identification of specific balance impairments.
Results
Individuals with Parkinson disease have significantly better balance, as measured by the BESTest, than individuals with Alzheimer disease and Huntington disease at a similar early disease stage.
Individuals with Alzheimer disease and Huntington disease had lowest scores on dynamic balance subsections of the BESTest (III, IV and VI).
Individuals with Alzheimer disease and Huntington disease were not significantly different on any of the subsections of the BESTest.
Discussion
Cognitive impairment may contribute to the balance impairments in individuals with Alzheimer disease and Huntington disease.
Conclusions
Future research should focus on how balance changes over time in these diseases, and how cognitive impairment may relate to these changes.
Objectives
To explore participant experience and perceived impacts of an online dance-based long COVID support programme.
Design
Mixed-methods study using thematic analysis of semi-structured interviews and structured observations, and ordinal scale questionnaire responses.
Setting
Online, community-based, with participants in Scotland and England.
Participants
26 people with self-reported long COVID who participated in the final block of 10 sessions were invited to participate in this study. 13 of these consented, 12 female, 7 White British, 10 English as first language, mean(range) age 57yrs (38-77), symptom duration 27months (17 – 35), and live sessions attended 9.2 (4-17). Two dance leaders also participated in the study.
Interventions
An online dance-based long COVID support programme of live sessions, provided in morning and afternoon slots, 30 to 45 minute duration, and online materials to promote wellbeing and self-management strategies, developed by Scottish Ballet, people with long COVID and healthcare professionals. The block of 10 sessions, from which participants were recruited, ran in September-November 2023. Potential participants were required to confirm they were well enough to participate in the programme.
Results
Responses to closed questions regarding self-reported impacts demonstrated perceived physical and mental health improvements, the programme surpassed participant expectations, and participants would recommend the programme. Qualitatively, we identified four themes 1. Improved experience of symptoms; 2. Increased confidence regarding movement and physical activity; 3. Feeling calm and refreshed; 4: Valuing time spent in a safe space. Facilitators of impact related to content, logistics, and delivery. Few barriers were described. Dance leaders’ responses aligned with those of programme participants.
Conclusions
A remotely delivered dance-based intervention for supporting people with long COVID is feasible, with participants consistently reporting that they found it enjoyable and beneficial to their health and wellbeing. Further research to assess impact on clinically validated measures is required.
Strengths and Limitations of the study
- This is the first known study to explore participant experience in a dance-based support programme for people with long COVID.
- The study provides insights into participant perspectives on their experience of movement and ways it might be incorporated into long COVID management.
- Small number of participants limits generalisability of the conclusions.
- Participants were self-selecting both in accessing the program and the evaluation described here.
- Further research is required to assess impact on clinically validated outcome measures.
As cases of Parkinson’s Disease rise in Europe, there is an urgency to reduce its burden on those living with Parkinson’s and on health services. Whilst the search for a cure is on-going, and the use of medication is an on-going experiment for many people, the engagement with non-pharmaceutical interventions is imperative. Under this topic, the 2024 Policy Framework to Reduce the Burden of Neurodegenerative Diseases in Europe and Beyond notes the important role that non-pharmaceutical interventions play. In exploring in detail the contribution of arts practices, in particular dancing, this paper argues that they have a potentially impactful role to play as non-pharmaceutical interventions for people with Parkinson’s. This discursive article critically engages with current research discussing what factors are important to be considered for the integration of arts practices – in particular dancing - in a successful implementation of a roadmap for better relieving the burden of Parkinson’s. Key points laid out include: It needs to be recognised that arts practices are heterogenous and do not have treatment goals, but do emphasise what the person brings to a process. The lack of standardisation and goals are to be embraced, rather than criticised for being difficult to measure. The evidence around dancing for people with Parkinson’s is not conclusive, yet largely positively framed. To increase understanding of what quality of life and relief of burden feels like to people with Parkinson’s - and so greater success in implementing arts practices as NPIs in a Europe-wide policy - a broader range of studies from different disciplines need to be used in researching or reviewing this area of work; researchers need to actively listen to what matters to people with Parkinson’s and be critically reflective of their own studies consequently. The Action Plan for non-pharmacological interventions in the Policy Framework is welcomed. Policy implementation needs to happen in consultation with dance organisations operating strategically around Europe, with people with Parkinson’s and with those who are underrepresented in Parkinson’s initiatives and dance activity.
Background: Achondroplasia, the most common form of dwarfism, is a lifelong condition, and impacted persons often face issues of health and wellbeing. For this cohort, the effectiveness of arts-based programs, such as dance or augmented dance sessions, needs to be studied. Methods: For this nonequivalent comparison group quasi-experimental study, the impacts of dance sessions and augmented dance sessions (comprising added spiritual content), both delivered online, on the self-esteem and wellbeing outcomes of young adults with achondroplasia were compared. Results: Participants of the augmented dance sessions reported significant improvements on self-esteem and wellbeing outcomes. The comparison cohort who did the dance sessions alone did not have any significant post-test outcome score changes. Gender, education, and program compliance were significant predictors of post-test outcome score changes of the intervention group. Discriminant analyses suggested that young adult females, those with higher formal education (postgraduate or vocational degrees) and whose program compliance was higher (>50% augmented dance sessions attended and corresponding homework sessions completed), gained most. Conclusions: With an added component of meditation, dance can be a creative community-based intervention that nurses may use in working with young adults with achondroplasia. Augmented dance sessions with added spiritual content are thus impactful for diverse participants.
This chapter explores the use of smart materials in physiotherapy, highlighting their potential to revolutionize patient care and rehabilitation practices. It discusses various types of smart materials, such as shape memory alloys, electroactive polymers, piezoelectric materials, magnetorheological materials, and thermoresponsive polymers, and their unique properties and applications. The chapter also discusses the use of smart materials in assistive devices, wearable technology, rehabilitation, pain management, and tissue healing. The advantages of smart materials include personalization, real-time monitoring capabilities, and non-invasive nature. However, challenges such as cost, integration with existing healthcare systems, and durability concerns need to be addressed. The chapter concludes by exploring future advancements in smart materials, integrating them with other technologies like AI, robotics, and nanotechnology. Ethical considerations and patient acceptance are also emphasized to ensure responsible and patient-centric adoption.
Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual's needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery.
Background:
There were few studies about training effects of wheelchair dance on aerobic fitness in the bedridden individuals with severe cerebral palsy for whom the traditional maximal or submaximal exercise tests were not applicable. As the oxygen pulse (O2P), the oxygen uptake divided by the heart rate, is regarded to be a relative measure of stroke volume and the O2P correlates to peak oxygen uptake, we would be able to assess the training effects of wheelchair dance on aerobic fitness in those individuals measuring O2P.
Aim:
To study training effects of wheelchair dance on aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy.
Design:
Pre-post study design.
Setting:
A laboratory and a community care center.
Population:
Bedridden individuals with athetospastic cerebral palsy rated to Gross Motor Function Classification System (GMFCS) level V (N. = 6).
Methods:
The O2P was compared between during the rest, the waltz, and the jive at the baseline, the 3rd, the 6th, and the 12th month of the intervention of wheelchair dance 6 to 15 minutes at a time, 2 days a week or more.
Results:
Paired student t test showed that O2P during the waltz and the jive was significantly increased compared with that during the rest at the 6th and the 12th month, and O2P during the jive was also significantly increased compared with that during the rest at the 3rd, the 6th, and the 12th month of the intervention period.
Conclusion and clinical rehabilitation impact:
This is the first study that shows wheelchair dance may possibly increase aerobic fitness in bedridden individuals with severe athetospastic cerebral palsty rated GMFCS level V. Future studies with a larger sample will be warranted to prove the claim.
BACKGROUND: Lhe aim of this study was to investigate whether wheelchair dance was the exercise or the physical activity that could affect aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy. METHODS: Six bedridden individuals with severe athetospastic cerebral palsy participated in this study. Oxygen uptake (VO2) and heart rate (HR) were measured during dance styles of waltz and jive while being seated in a wheelchair. VO2 and HR were compared during rest, waltz, and jive using one-way ANOVA. RESULLS: While no significant difference was observed in VO2 during the rest, Waltz, and Jive (F=2.463, P=0.07), HR during the rest, Waltz, and Jive was significantly different (F=4.196, P=0.04). Lukey HSD revealed significant difference between the rest and Jive (P=0.03) CONCLUSIONS: During jive, there was equivalent to light intensity exercise and was not sufficient to have a training effect on aerobic fitness. Further investigations regarding the potential effectiveness of frequent wheelchair dance in improving aerobic fitness of bedridden individuals with severe athetospastic cerebral palsy are warranted.
Recently, dance has become a therapeutic and rehabilitative intervention for individuals with Parkinson’s disease (PD). Compared with traditional gait training or other rehabilitative interventions, dance appears to be a safe, fun, and an alternative way to achieve functional changes and improvements in mobility, gait, balance, and quality of life. This paper reviews literature regarding dance and PD in terms of enrollment size, dosage and frequency of intervention, class size, comparison or control groups, outcome measures, and effect size. A search was conducted on PubMed, Web of Sciences, Cochrane Library, and Google Scholar using the terms “dance” and “Parkinson’s disease.” Ten papers were included in this review: seven of which examined walking speed, nine that included measures of balance, one study that examined upper extremity function, eight studies that measured disability rating, and one study that examined falls. Only five studies had control groups, three of which were active control groups. Various studies have clinical design issues such as inclusion of a control group, outcome measures or the way in which the intervention was administered. Essential outcome measures to include are safety, tolerability, quality of life, and falls. These measures determine information on treatment effects, adverse event rates, and dropout rates.
The aims of this pilot were to examine dance as a feasible intervention for persons with multiple sclerosis (MS), specifically to examine issues of tolerability and its longitudinal effects on participants. Dance is an enjoyable physical activity that has been investigated in other neurodegenerative populations but has yet to be studied in MS.
A 4-week, two 60-min classes per week, pilot salsa dance intervention was administered to eight individuals with MS. The outcomes measured were effects on gait, balance, self-efficacy, motivation, physical activity and MS symptoms. They were administered at baseline, immediately post-intervention and at 3- and 6-month follow-ups.
Statistically significant pre-post intervention gains were found for the Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), Activities-specific Balance Confidence Scale and Godin Leisure Time Questionnaire. Significant improvements were also found for the TUG, DGI and MS Walking Scale between baseline and 3-month follow-up assessments. Participants did not report any problems with fatigue or intolerability with the 60-min suggestions, further supporting the feasibility for the concept of a dance intervention.
This study suggests that dance for persons with MS may have promise for improving physical activity, gait and balance. Implications for Rehabilitation Although structured dance has reported benefits in elderly populations and in individuals with cardiovascular and neurological impairments, there is virtually nothing known regarding dance in the MS population. This pilot salsa dance study shows that structured dance demonstrates promise of being well-tolerated, safe and effective at promoting physical activity in people with MS without increased fatigue. A 12-week study has been initiated to test the robustness of initial observations and further examine factors influencing participants' physical activity adherence and behavioral change.
