What if we could improve walking speed and step length in people with Parkinson’s disease, by inviting them to dance?
Introduction
In this blog I describe a research paper by Haputhanthirige et al. which addresses the question of whether taking part in a series of dance sessions can improve the way that people with Parkinson’s walk
The research paper I’m looking at today is called:
Effects of dance on gait and dual-task gait in Parkinson’s disease
This research paper was published, following peer-review, in PLoS ONE in 2023. A link to the paper, and its full reference, is given below:
Haputhanthirige NKH, Sullivan K, Moyle G, Brauer S, Jeffrey ER, Kerr G (2023) Effects of dance on gait and dual-task gait in Parkinson’s disease. PLoS ONE 18(1): e0280635. https://doi.org/10.1371/journal.pone.0280635
Let’s start by looking at Parkinson’s disease.
According to Parkinson’s UK
“Parkinson’s is a progressive neurological condition. This means that it causes problems in the brain and gets worse over time.
People with Parkinson’s don’t have enough of the chemical dopamine in their brain because some of the nerve cells that make it have died.
Around 145,000 people live with Parkinson’s in the UK. And it’s the fastest growing neurological condition in the world.
There are over 40 symptoms of Parkinson’s. From a tremor or stiffness, to problems with sleep and mental health. Everyone’s experience is different.
The motor symptoms of Parkinson’s can include slowness of movement, falls, dizziness and freezing of gait, where people describe feeling like their feet are ‘glued’ to the ground.
The symptoms of Parkinson’s which are being examined in the current research paper are disturbances to gait – defined as a person’s pattern of walking.
A disturbance in a person’s pattern of walking, in people with Parkinson’s, can be characterised, for example, by reduced walking speed and shorter step length.
In addition, People with Parkinson’s are known to have dual-task walking deficits. This means that people with Parkinson’s can find it difficult to have a conversation while they walk, and they can find it difficult to adjust to walk on uneven surfaces.
This is thought to be because dual-tasking relies on executive function and the ability to divide attention. Executive function describes a set of mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.
Both executive function and the ability to divide attention are thought to be affected by basal ganglia pathology in people with Parkinson’s.
The Researchers recruited 33 people with Parkinson’s.
At the beginning of the research project they carried out a full battery of tests and measured everyone’s pattern of walking.
To measure people’s walking they used motion capture equipment. They placed 41 reflective markers all over the body and then used a 12-camera data capture system to record each person as they walked along a 12-metre walkway.
The researchers also wanted to find out how walking was affected by carrying out a verbal thinking and problem-solving task while people were walking,
So, in one condition they had people count backwards in 7’s from a target number such as 782 (782, 775, 768, 761 etc.) as they walked.
And in another condition they had people name as many words as possible that start with a given letter, such as P (Peter, Piper, Picked, Peck, Pickled, Peppers etc.), as they walked.
Using these technique they could measure people’s walking speed and step length – and a load of other walking measures – while people were just walking or walking while carrying out a verbal executive function problem-solving task.
But what about the dancing?
To test the impact of dancing of people’s patterns of walking the researchers divided the research participants in to two groups.
They put 17 people into a dance group and 16 into a control group. At the beginning of the research project there were no differences in measures of walking between the two groups.
Intervention
For those people in the control group they just carried on with life as normal for 12 weeks.
For those people in the dance group they attended 2 two-hour dance sessions per week for 12 weeks.
The dance sessions were based on the Dance for Parkinson’s Disease approach, developed by the Mark Morris Dance Group.
In the Dance for Parkinson’s Disease classes “participants experience the grace, fluidity, and power of dance in a social, joyful, and supportive environment.” The Dance for Parkinson’s Disease classes strive to increase coordination, balance, flexibility, and strength through music and movement from a broad range of dance styles.
At the end of 12 weeks, the participants were brought back to the lab and completed the same battery of tests as they had 12 weeks earlier.
The big question is this – will those people who completed 12 weeks of dancing show any improvements in their patterns of walking compared with those people in the control group – who didn’t do any dancing?
Here’s what the researchers found.
Walking Speed and Step Length
Looking at how the walking speed and step length for each group changed over time.
The researchers found that the Dance Group improved more than the control group.
For members of the Dance Group, their walking speed became faster and their step length became longer
These improvements in walking speed were found to be clinically significant in terms of minimal clinically important differences MCID.
(MCID) are scores that reflect changes in a clinical intervention that are meaningful for the patient.
The improvements in walking speed and step length even persisted when people had to carry out a secondary cognitive task while they walked, such as counting backwards in 7’s or generating words beginning with a particular letter of the alphabet.
These findings suggest that dancing twice a week for 12 weeks might improve walking speed and step length in people with Parkinson’s
and it might even improve dual-task executive function too.
The authors suggest that the mechanism of improvement in gait and dual task gait could be due to improvement in multiple functional measures such as balance, muscle strength, cognition, disease severity, and fine manual dexterity.
Dance is thought to be a great form of physical activity because it stimulates a wide range of human experiences.
Dance can be social, cognitive, emotional, artistic, aesthetic – as well as physical.
What I have presented here is just a snapshot of the study and results. To get the complete picture I advise you to read the full paper and contact the authors for further information.