Weighting for the Beat: Using a Dance Cue to Facilitate Turning in People with Parkinson’s Disease and Freezing of Gait (original) (raw)
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Effects of dance on gait and dual-task gait in Parkinson’s disease
PLOS ONE, 2023
Background Gait impairments in Parkinson's disease (PD) limit independence and quality of life. While dance-based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to assess the effects of a dance intervention, based on the Dance for PD ® (DfPD ®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted. Methods A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke's score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III). The DG undertook a one-hour DfPD®-based class, twice weekly for 12 weeks. The CG had treatment as usual. The spatiotemporal variables of gait were assessed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions: regular walking; dual-task: verbal-fluency (DT VERB), and serial-subtraction (DT SUBT). The data were analysed by means of a linear mixed model. Results At baseline, there was no significant group difference for any spatiotemporal gait variable. The DG improved significantly compared to the CG with and without a dual task when walking on even surface. During regular walking, DG improved in gait velocity (p = 0.017), cadence (p = 0.039), step length (p = 0.040) and stride length (p = 0.041). During DT VERB
Explore (New York, N.Y.)
This study aimed to measure the effects of a dance training program on subjective and objective balance and gait measures in a person with Parkinson's disease. The participant was measured via clinical scales and biomechanical balance and gait analyses pre- and post-16 weeks of dance participation at the University Center for Arts in Medicine. The dance program consisted of 75 minute sessions three days a week. Improved clinical scales included the Schwab and England scale (+10%), falls efficacy scale (-11 points), six-minute walk (+15.54m), and timed up and go (1.38s). Balance measures during three conditions (eyes open, eyes closed, and narrow stance) all demonstrated an increase (24-112%) in center of pressure path length, velocity (anteroposterior and mediolateral), sway area, and approximate entropy (anteroposterior and mediolateral). Spatiotemporal gait parameters improved during forward walking: velocity (+0.12m/s), cadence (+3.89steps/min), double support time (-2.02%), ...
International Journal of Gerontology, 2016
Background: This study aimed to evaluate the effects of cueing on circular walking in patients with Parkinson's disease. Methods: Parkinson's disease patients in the "off" state were asked to walk on a designed route at their preferred speed. The experimental protocol was divided into two sessions. The first session was to be performed with no manual task. During the second session, the participant had to perform a manual task. Each session was measured for each of four conditions performed in the following order: without cues, with a visual cue, with an auditory cue, and with dual cues simultaneously. Temporospatial gait parameters and freezing of gait (FOG) events regarding the cueing-on and cueing-off situations were the main measures of gait performance. Results: Twelve patients with Parkinson's disease were recruited. Demographic and clinical characteristics of the participants were the following [median (interquartile range)]: age 63 years (57e67.3 years), Hoehn and Yahr stage 3.0 (3.0e3.25), and Unified Parkinson's Disease Rating Scale motor subsection off medication 22.5 (20.3e35.5). Walking turns of 180 in combination with a manual task were the most important triggers for FOG. On circular walking either with or without a manual task, visual or dual cues improved festinating gait patterns and increased step length. Visual or dual cues further improved the velocity of walking with a manual task. All types of cueing decreased FOG scores either with or without a manual task. Conclusion: Our study suggests that cueing improves festinating gait and decreases the incidence of FOG. Future studies with much larger sample sizes are warranted to support our findings.
Neurorehabilitation and Neural Repair, 2010
Partnered tango dance can improve balance and gait in individuals with Parkinson’s disease (PD). Partnered dance may allow these individuals to challenge balance more than nonpartnered dance. Alternatively, partnered practice could reduce balance gains because the participant may rely on the partner as a balance aid when challenged. The authors compared the effects of partnered and nonpartnered dance on balance and mobility in 39 people (11 women) with mild-moderate PD (Hoehn and Yahr stages I-III). Participants were randomly assigned to partnered or nonpartnered tango and attended 1-hour classes twice per week, completing 20 lessons within 10 weeks. Balance and gait were evaluated in the weeks immediately before, immediately after, and 1 month after the intervention. Both groups significantly improved on the Berg Balance Scale, comfortable and fast-as-possible walking velocity, and cadence. Improvements were maintained at the 1-month follow-up. The nonpartnered class improved as mu...
Effects of dance on balance and gait in severe Parkinson disease: A case study
Disability & Rehabilitation, 2010
Purpose:Dance may improve functional mobility in individuals with mild - moderate Parkinson disease (PD), yet dance effects in severe PD remain unexamined. This study's purpose was to evaluate the feasibility and effects of partnered tango classes on balance, endurance and quality of life in an individual with severe PD.Design:Over 10 weeks, the participant attended 20, 1-hour tango classes for individuals with PD. Balance, walking, and quality of life were evaluated before and after the intervention and at a one-month follow-up in this single case design. Caregiver burden was also assessed at all time points.Results:The participant improved on the Berg balance scale, 6 minute walk test, and functional reach. He reported increased balance confidence and improved quality of life as measured by the Parkinson Disease Questionnaire-39 summary index. Gains were maintained at the one-month follow-up. Caregiver burden increased from baseline immediately post-intervention and at follow-up.Conclusion:Twenty partnered tango lessons improved balance, endurance, balance confidence, and quality of life in a participant with severe PD. This is the first report of the use of dance as rehabilitation for an individual with advanced disease who primarily used a wheelchair for transportation.
Improvement of freezing of gait in patients with Parkinson's disease by imagining bicycling
Case reports in neurology, 2014
Freezing of gait (FOG) is one of the factors that reduce the quality of life in patients with Parkinson's disease (PD). Imagining bicycling before gait start provided improvement in FOG in 2 PD patients. Imagining and mimicking bicycling after the initiation of gait allowed the rhythmic gait to continue without interruption. We suggest that imagining and mimicking bicycling, which are nonexternal cues, could serve as a helpful therapeutic approach for the intractable freezing and interruption of gait of PD patients.
Objectives This study examined if people with Parkinson’s and freezing of gait pathology (FoG) could be trained to increase preparatory weight-shift amplitude, and facilitate step initiation during FoG. Methods Thirty-five people with Parkinson’s and FoG attempted to initiate forward stepping either during a FoG event (n=17, FoG-F) or following a voluntary stop (n=18, FoG-NF) in a Baseline condition and two conditions where an increased weight-shift amplitude was trained via: i) Explicit verbal instruction, and ii) Implicit movement analogies. Results At Baseline , weight-shift amplitudes were smaller during: i) unsuccessful, compared to successful step initiations (FoG-F group), and ii) successful step initiations in the FoG-F group compared to FoG-NF. Both Verbal and Analogy training resulted in significant increases in weight-shift amplitude in both groups, and a corresponding pronounced reduction in unsuccessful attempts to initiate stepping (FoG-F group). Conclusions Hypometric...
Parkinsonism & Related Disorders, 2020
Freezing of gait (FoG) is one of the most disabling gait disorders in Parkinson's disease (PD), reflecting motor and cognitive impairments, mainly related to dopamine deficiency. Recent studies investigating kinematic and kinetic factors affecting gait in these patients showed a postural instability characterized by disturbed weight-shifting, inappropriate anticipatory postural adjustment, worse reactive postural control, and a difficulty executing complex motor tasks (i.e. sit-to-walk). These symptoms are difficult to alleviate and not very responsive to Levodopa. For this reason, additional therapeutic actions based on specific therapeutic protocols may help patients with their daily lives. We conducted a randomized control trial aimed to test if two clinical protocols for PD patients with FoG were effective to improve postural control. Methods: Rehabilitation protocols, conceived to improve gait, were based on learning motor exercises with the Action Observation plus Sonification (AOS) technique, or by the use of external sensory cues. We collected biomechanical data (Center of Mass COM, Center of Pressure COP, and moving timings), using the sit-to-walk task as a measure of motor and gait performance. Results: Kinetic and kinematic data showed that when treatment effects consolidate, patients treated with AOS protocol are more efficient in merging subsequent motor tasks (sit-to-stand and gait initiation), and diminished the total moving time and the area of the COP positions. Conclusion: We demonstrated for the first time that PD patients with FoG treated with an AOS protocol aimed at relearning appropriate gait patterns increased balance control and re-acquired more efficient postural control.
Impaired step-length setting prior to turning in Parkinson's disease patients with freezing of gait
Movement disorders : official journal of the Movement Disorder Society, 2018
Impaired stride-length setting is implicated in the development of freezing of gait (FOG) in PD, with reduced mean step-length superimposed on a successively reduced step-length (sequence effect) leading to freezing episodes. 1 The majority of PD patients note FOG during gait initiation and/or turning. 2 While the first three steps on gait initiation were shorter in FOG subjects, 3 successively reduced step-length prior to turning has not been directly demonstrated. Our goal was to determine if prior to a turn, step-length setting was differentially affected in PD FOG patients.