Dance and Parkinson's Disease: Research,

Practice, and Patient Experience

Naomi Goodman, MPH

Nancy Mazonson, MS OTR/L

Marjie Sokoll, M.Ed

Jewish Family & Children’s Service

Parkinson’s Family Support Program

"Your programs continue to be a cornerstone inspiration of our life with this disease.

Thank you."

Our Programs: Monthly Education, Networking and Support Group

“I want you to know that coming to your group with my husband makes us feel taken care of.”

Community Wellness

“We’ve learned incredibly helpful things in this group, and I’ve had a great time. I’m now more motivated to keep active.”

Adult Child Support Group

“As the daughter of someone with Parkinson’s Disease, I’m learning to have patience.”

Our Services

• Information and referral– Community resources– Mental health counseling– Home health– Nutrition– Geriatric care management

• Free home safety evaluation

Why Dance? The Research on Exercise

• Patients with PD improve their physical performance and activities of daily living through exercise, specifically improved axial rotation, functional reach, flexibility, balance, muscle strength, short-step gait, and mobility. Crizzle, AM , Newhouse, IJ. Clin J Sport Med. 2006 Sep;16(5):422-5.

• Evidence supported exercise as being beneficial to physical functioning, health-related quality of life, strength, balance and gait speed for people with PD.Goodwin, VA, Richards, SH, Taylor, RS, Taylor, AH, Campbell, JL. Mov Disord. 2008 Apr 15;23(5):631-40

And Dance in Particular…• Rhythmic auditory stimulation (RAS)-

metronome-pulse patterns embedded into the on/off beat structure of rhythmically accentuated music.

• Patients trained with RAS significantly improved their gait velocity by 25%, stride length by 12%, step cadence by 10%,compared to self-paced subjects and no-training subjects.Hausdorff JM, Lowenthal J, Herman T, Gruendlinger L, Peretz C, Giladi N. Eur J Neurosci. 2007 Oct;26(8):2369-75.

And Dance in Particular

• After 20 Tango sessions, people with PD showed significant improvements in overall Unified Parkinson's Disease Rating Scale (UPDRS) score and significant improvements on the Berg Balance Scale. Hackney ME, Kantorovich S, Levin R, Earhart GM. Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA.

Tango and PD

• Is it tango? Is it dance in general?

• We have the UNOFFICIAL answer!

Qualitative Evidence • The Ed Rudman Story

Models of PD Dance

• Mark Morris

Qualitative EvidenceBob Dawson

“Dance as therapy.

Dance for flexibility, strength, endurance.

Dance for joy.

Dance in defiance of the disease.

Dance for a cure.

Dance to bother the scientists.

Dance to raise a question.”

Clinical Features of Dance- An OT Perspective

• Address common PD symptoms such as:

– Rigidity/stiffness with

poor trunk rotation

– Decreased balance

– Limited range of

motion

– Stooped posture

Clinical Features of Dance- An OT Perspective (Cont)

– Address common PD symptoms such as:– Shuffling gait– Slowness of movement– Loss of smooth, coordinated movements– Stiff facial expression– Muffled speech

So what does a class look like…

Welcome and Introductions• “… We learn there is 'no right way', to explore our

own response in movement. [This class] encourages free movement, reassuring people who felt self-conscious or unsure or embarrassed.”-JP

• “We start with a greeting ritual of names, connecting us, showing us  each one's particular movement gesture. We are learning the language of movement.”-JP

Yoga Warm Up

“What I love is that this is low stress, with no mirrors, so I don’t feel conspicuous. Here, you can let all of your worries drop….”-LA

Chair Routines (Free Form)

Floor Work

“When I dance, I potentiate my movements. I now listen to disco music at home. I turn on the tape in my bedroom and dance away. When I am done, my whole body feels stretched. It feels so good, that I like to aim to do it every day.”-AF

Choreographed Routine

“The other night I had to get up and I was feeling very stiff. I looked out the window and saw the big full moon. I smiled and started picking apples (one of the dance routines), which made me feel much better.”-GA

Partner Work

(Photo by: Michele McDonald/Globe Staff)

“It’s a joy to have fun doing something physical together again with my spouse.”-CA

Break• Hydrate

• “You offer something simple to drink, a cookie, and serve us!”

• Determine pacing for second half of class.

• Connect with each other and staff

Group Routine

Cool Down and Stretching

“I find dancing relaxing. I haven’t felt that I could exercise for more than three years. My arms and muscles were tightening. Dancing is a great workout.”

Meditation

“Dancing is so helpful, and so hopeful. I love being here with others who are doing what they can to help themselves.”

Closing

“I had been searching for something and coming here, we have found it! Finally, I have found people who ‘get’ what having and dealing with Parkinson’s are all about.”

“We end with a ritual of gratitude, connecting us.”-JP

Support

“This is a caring community with the input of others and the camaraderie. Sharing dancing and sharing knowledge with others is good for the soul. It’s so much better than going it alone.”

Support

Harbouring “P” by Rosamond Rosenmeier

“Something is happening in me,Something interior and realSomething not me, but present in

everything I do.“P” is the name I have given this

ghostly invader…..” 

Support

“A primary function of music is collective and communal….People sing together and dance together in every culture, and one can imagine them having done so around the first fires, a hundred thousand years ago.”

 

Dr. Oliver Sacks, Musicophila: Tales of Music and the Brain

Support

“Hope is the elevating feeling we experience when we see – in the mind’s eye – a path to a better future.”

 

Dr. Jerome Groopman, The Anatomy of Hope: How People Prevail in the Face of Illness

 

Your Turn!

• Now, what’s a class really like?

• Let’s try it!

Our mission: To improve quality of life for families affected by

Parkinson’s diseaseFor information, contact:Nancy Mazonson MS, OTR/LProgram CoordinatorJF&CS1430 Main St.Waltham, MA 02451781 693 5069nmazonson@jfcsboston.org