Date Presented 04/8/21
People with Parkinson's disease (PD) experience nonmotor symptoms (NMS) such as cognitive impairment, depression, and fatigue, all of which impact daily function. Despite the prevalence and negative impact of NMS, there are limited interventions. Improvisational dance (ID) requires spontaneous integration of cognitive and motor skills in a playful and nonjudgmental environment. This study found improvements in NMS and daily function in people with PD after participating in an ID class.
Primary Author and Speaker: Margaret R. Fleita
Additional Authors and Speakers: Erika Fimple, Nicole Renae Roberts
PURPOSE: Parkinson disease (PD) is a neurodegenerative disease affecting approximately 10 million people. Individuals with PD can experience a variety of non-motor symptom (NMS), including cognitive impairment, depression, anxiety, sleep disorders, and fatigue. These NMS relate to reduced daily function. Despite the prevalence and negative effects of NMS for those with PD, they are poorly recognized and inadequately treated in clinical practice. Dance is emerging as an effective intervention for people with PD. In particular, improvisational dance (ID) requires flexible and spontaneous integration of cognitive and motor skills, similar to how one acts in daily life, and thus may improve NMS and daily function. Evidence supports the motor-related benefits of an ID program designed for people with PD (IMPROVment®). The purpose of this study was to examine its effects on NMS and daily function.
DESIGN: This was a one group pre-test/post-test trial. Participants were recruited from the community in partnership with the Greater St. Louis's Chapter of American Parkinson Disease Association.
METHOD: Seven volunteers with mild-moderate PD (mean age = 68±3.6 years; 57.1% male) participated in IMPROVment® classes, which met once a week for an hour for a 12-week period. Before and after the intervention, participants completed assessments of NMS (NIH Toolbox Cognitive Battery, Alternative Uses Task, Weekly Calendar Planning Activity, Geriatric Depression Scale, PD Anxiety Scale, PD Fatigue Scale, Sleep Disturbance), daily function (PROMIS Satisfaction with Participation scale, Older Americans Resources and Services Scale), and motor symptoms (Unified Parkinson Disease Rating Scale). Immediately before and after each dance class, participants completed four Visual Analog Scales (VAS) assessing happiness, energy level, anxiety, and overall well-being; these scores were averaged across classes for each scale for analysis. Wilcoxon signed rank tests and effect sizes (Cohen's d for repeated measures) were used to compare baseline and post-intervention differences and the averaged before and after class VAS scores.
RESULTS: For the NIH Toolbox Cognitive Battery, participants demonstrated improved processing speed (p = 0.03) and attentional control (p = 0.07). Depression and sleep improved from baseline to post-intervention (p < 0.04), as well as satisfaction with participation in daily activities (p = 0.02). Motor symptoms increased (p = 0.05). There were no significant effects for the other NMS and daily function measures. Improvements were found on all four VAS; on average, all participants felt happier, more energetic, less anxious, and reported overall greater well-being at the end, compared the beginning, of each class (p = 0.02).
CONCLUSION: Individuals with PD that participated in a 12-week IMPROVment® class demonstrated improved performance in some aspects of cognition and reported fewer depressive symptoms, better sleep, and more satisfaction with their participation in daily life. Additionally, IMPROVment® had positive short-term effects on mood, anxiety, energy level, and overall well-being. These results are promising, as they demonstrate that this relatively simple and fun activity may positively impact cognition, other NMS, activity participation and thus, overall function and quality of life for this population. Further investigation in a larger, controlled study is warranted.
References
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