The potential benefits of Zumba Gold® in people with mild-to-moderate Parkinson’s: Feasibility and effects of dance styles and number of sessions

The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial

This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.

Heart Rate Responses of Post-Menopausal Women to Zumba Gold® Classes

This study aimed to describe the heart rate (HR) responses of post-menopausal women during Zumba Gold® classes and to investigate the effects of body fat on HR responses. Twenty-three post-menopausal women (68.8 ± 7.2 years old; 160.0 ± 5.2 cm; 66.9 ± 11.1 kg, 36.0 ± 9.9% body fat) participated. Baseline testing assessed participants' anthropometric and fitness characteristics. Then, HR measurements were taken during four of their regular Zumba Gold® classes, and average HR (HRmean), as well as time spent in different HR intensity categories, was calculated. Linear regressions and t-tests were performed to analyse the data. The average HR during Zumba Gold® classes was 70.2% of maximum HR. Women with lower body fat achieved a significantly higher HRmean and spent less time at light to very light intensity and more time at moderate intensity compared to those with higher body fat. Body fat percentage and age were identified as determinants of time spent at moderate intensity. These findings suggest that Zumba Gold® can be an effective exercise option for post-menopausal women aiming to meet the recommended daily exercise guidelines. Understanding the HR responses during Zumba Gold® classes can aid in the development of safe and effective exercise prescriptions for this population.

If Art Were a Drug: Implications for Parkinson's Disease

Parkinson's disease (PD) is a chronic and complex neurodegenerative disorder. Conventional pharmacological or surgical therapies alone are often insufficient at adequately alleviating disability. Moreover, there is an increasing shift toward person-centered care, emphasizing the concept of "living well". In this context, arts-based interventions offer great promise, functioning as platforms for creative expression that could provide novel mechanisms to promote quality of life. Here we present a qualitative review of arts-based interventions for PD, including music, dance, drama, visual arts, and creative writing. For each, we discuss their applications to PD, proposed mechanisms, evidence from prior studies, and upcoming research. We also provide examples of community-based projects. Studies to date have had relatively small sample sizes, but their findings suggest that arts-based interventions have the potential to reduce motor and non-motor symptoms. They may also empower people with PD and thereby address issues of self-esteem, foster personal problem-solving, and augment holistic well-being. However, there is a paucity of research determining optimal dosage and symptom-specific benefits of these therapies. If art were a drug, we would have to perform appropriately powered studies to provide these data before incorporating it into routine patient care. We therefore call for further research with properly designed studies to offer more rigorous and evidence-based support for what we intuitively think is a highly promising approach to support individuals living with PD. Given the possible positive impact on people's lives, arts-based approaches merit further development and, if proven to be effective, systematic inclusion within integrated management plans.

Dual-Task Zumba Gold for Improving the Cognition of People With Mild Cognitive Impairment: A Pilot Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Integrating mental activities with physical exercises (e.g., dual-tasking) may potentially improve cognition in older adults and people with mild cognitive impairment (MCI). This study investigated the preliminary efficacy of a new intervention called dual-task Zumba Gold (DTZ) on people with MCI to guide an adequately-powered full-scale trial.

RESEARCH DESIGN AND METHODS

This is a 2-arm pilot randomized controlled trial with 60 people with MCI assigned to a 12-week DTZ intervention or control group (health education). We hypothesized that DTZ would facilitate significant improvements in global cognition (primary outcome) and other psychological/physical measures at postintervention (T1) and 6-week follow-up (T2). Generalized estimating equations with an intention-to-treat approach were used to evaluate intervention effects. Postintervention qualitative interviews explored the participants' program perceptions.

RESULTS

Fifty-one participants completed the study, with no adverse events reported. DTZ participants showed significant improvements in global cognition (p < .001, d = 0.75-0.78), executive function (p < .001, d = 0.28-0.33), immediate recall (p < .001, d = 0.50-0.54), delayed recall (p = .003, d = 0.66-0.71), quality of life (p = .027, d = 0.59-0.63), and mobility (p = .005, d = 0.53-0.56) at T1 and T2. There were nonsignificant changes in working memory, depressive symptoms, blood pressure, body mass index, and waist circumference. Participants conveyed intervention acceptability, including challenges/barriers, enablers, and future recommendations.

DISCUSSION AND IMPLICATIONS

DTZ is a potentially feasible intervention for people with MCI that may improve cognition, quality of life, and mobility. A full-scale trial is recommended for confirmatory evaluation.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04788238.

Mix-and-Match or Mismatch? Exploring the Perspectives of Older Adults About Zumba Dance and Its Potential Utilization for Dual-Task Training

Despite the popularity of Zumba dancing, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, also known as dual tasking, is an evolving strategy to facilitate activities for older adults. This study investigated the perceptions of persons aged ≥55 years on Zumba and its potential to be incorporated into a dual-task program. We conducted a descriptive-qualitative study involving 44 Filipino older adults. Using content analysis, four themes were identified: moving toward match or mismatch, balancing benefits with burdens, dual tasking as innovative yet potentially challenging, and overcoming barriers with enablers. Although Zumba was perceived as an inclusive and beneficial activity, individual and contextual limitations could hinder its suitability. Moreover, dual tasking in Zumba was considered an innovative approach, although challenges should be addressed to promote its feasibility. Several strategies could enable the design and implementation of age-appropriate Zumba and dual-tasking programs for older adults.

Dance Is an Accessible Physical Activity for People with Parkinson's Disease

OBJECTIVE

To evaluate the outcomes of face-to-face, digital, and virtual modes of dancing for people living with Parkinson's disease (PD).

DESIGN

Systematic review informed by Cochrane and PRIMSA guidelines. Data Sources. Seven electronic databases were searched: AMED, Cochrane, PEDro, CINHAL, PsycINFO, EMBASE, and MEDLINE.

METHODS

Eligible studies were randomised controlled trials (RCT) and other trials with quantitative data. The PEDro scale evaluated risk of bias for RCTs. Joanna Briggs Institute instruments were used to critically appraise non-RCTs. The primary outcome was the feasibility of dance interventions, and the secondary outcomes included gait, balance, quality of life, and disability.

RESULTS

The search yielded 8,327 articles after duplicates were removed and 38 met the inclusion criteria. Seven were at high risk of bias, 20 had moderate risk of bias, and 11 had low risk of bias. There was moderately strong evidence that dance therapy was beneficial for balance, gait, quality of life, and disability. There was good adherence to digital delivery of dance interventions and, for people with PD, online dance was easy to access.

CONCLUSION

Dancing is an accessible form of exercise that can benefit mobility and quality of life in people with PD. The COVID-19 pandemic and this review have drawn attention to the benefits of access to digital modes of physical activity for people living with chronic neurological conditions.

Pilot testing of Dual-task Zumba Gold (DTZ) for community-dwelling people with mild cognitive impairment: A mixed-methods study

Dual-tasking (e.g., enrichment of physical activities with mental exercises) is an innovative strategy to enhance older adults' cognition. Meanwhile, Zumba is a popular dance program, but research is limited about its utility on older people or those with mild cognitive impairment (MCI). This study assessed the feasibility of a new intervention called dual-task Zumba Gold (DTZ) for people with MCI. A mixed-methods feasibility study involving ten people aged ≥55 years with MCI was conducted from December 2020 to March 2021. Nine participants completed the study (90%) with high intervention acceptability. Program adherence (90.3%) and implementation fidelity (92.2%) were high. Participants also expressed the program's benefits, challenges, and facilitators. Moreover, pilot test results suggested improvements in global cognition (Z=-2.680; p=0.007), quality of life (Z=-2.688; p=0.008), and mobility (Z=-2.333; p=0.020). Hence, DTZ is feasible and acceptable for people with MCI, offering potential multidomain effects. Future randomized controlled studies should confirm these outcomes.

Binary dance rhythm or Quaternary dance rhythm which has the greatest effect on non-motor symptoms of individuals with Parkinson's disease?

This study aimed to compare the effect of a binary and quaternary rhythm protocol on cognition, mental activity, daily life, and quality of life among individuals with Parkinson's Disease. A two-arm randomized clinical trial with 31 individuals diagnosed with Parkinson's disease, who were allocated to the binary group or quaternary group. Both groups underwent a 12-week intervention. The following variables were analyzed: personal and clinical information; MoCA; UPDRSI and II; PDQ-39. Both intervention groups improved cognition, mental activity, activities of daily living, and quality of life. In addition, there were intergroup differences in total UPDRSII, writing, and hygiene where the quaternary group was superior to the binary group. It concludes that the binary and quaternary rhythm positively influenced and presented similar effects on the complementary treatment of individuals with Parkinson's disease on the studied variables. Thus, it is believed that both interventions are possible and feasible for the health professionals involved in the area.

Recreational Dance Practice Modulates Lymphocyte Profile and Function in Diabetic Women

This study aimed to investigate the impact of a 16-week dance-based aerobic exercise program on lymphocyte function in healthy and type 2 diabetes mellitus (T2DM) women. We enrolled 23 women: 11 with T2DM and 12 non-diabetic controls. Initially, we performed anthropometry and body composition measurements, afterwards, plasma levels of C-reactive protein, lipids, and glucose were determined. We used flow cytometry to measure the CD25 and CD28 expression in circulating lymphocytes, T-regulatory (Treg) cell percentage, lymphocyte proliferation, and cytokines released by cultured lymphocytes. The T2DM group had a lower proportion of CD28+ cells and a higher percentage of Treg lymphocytes and proliferative capacity at the baseline compared with the control group. After 16 weeks of the program, differences in lymphocytes between the T2DM and the control groups disappeared. The dance program promoted IL-10 increase in both groups. We found decreased IL-4, IL-2, and IL-6 secretion in lymphocytes from the control group and increased IL-17 secretion and IL-10/IL-17 ratio in the T2DM group after the program. The program promoted marked changes in lymphocytes in diabetic women, leading to a balance between the different profiles.

Can Samba and Forró Brazilian rhythmic dance be more effective than walking in improving functional mobility and spatiotemporal gait parameters in patients with Parkinson's disease?

Background

Parkinson’s disease (PD) causes motor and nonmotor disorders in patients. Unlike aerobic training, potential adaptations from the practice of dance are less understood in PD, particularly compared with better known exercise modes. This study aimed to verify and compare the effects of a Brazilian dance program, inspired by Samba and Forrró rhythms, and a walking program on functional mobility and spatiotemporal gait parameters in patients with PD.

Methods

Eighteen participants with PD were divided into a dance group (DG) and a walking group (WG) and were assessed before and after an intervention period of 24 1-h sessions, performed twice per week for 12 weeks. The timed-up-and-go test (TUG) and walking kinematics at self-selected speed (SSS) and fast speed (FS) were determined. The generalized estimating equation method was used to compare the DG and WG pre- and post-intervention and to evaluate the group*time interaction (α <  0.05).

Results

Both groups demonstrated a significant improvement in TUG test at SSS (p = 0.02; effect size [ES] = 0.42) and FS (p = 0.02; ES = 0.24). In general, spatiotemporal parameters remained unchanged, except at SSS, in which the DG increased the stride frequency (p = 0.011; ES = 0.72). At FS, the swing time demonstrated a significant group*time interaction (p <  0.001; ES = 1.10), in which the two groups exhibited different behaviors: DG decreased (p = 0.015) and WG increased (p = 0.012).

Conclusions

Functional mobility improved similarly in both groups. The results suggest that a 12-week program of Brazilian dance was sufficient to produce improvements in functional mobility and gait in individuals with PD.

Trial registration

This study is registered with the International Clinical Trial Registry under number NCT03370315. Registered December 28, 2017 - Retrospectively registered.

Impact of Zumba on Cognition and Quality of Life is Independent of APOE4 Carrier Status in Cognitively Unimpaired Older Women: A 6-Month Randomized Controlled Pilot Study

OBJECTIVE

To investigate the association of a 6-month Zumba intervention with cognition and quality of life among older cognitively unimpaired apolipoprotein ∊4 (APOE4) carrier and noncarrier women.

METHODS

Fifty-three women were randomly assigned to either twice-weekly Zumba group classes or maintenance of habitual exercise (control group) for 6 months. At baseline, 3, and 6 months, all participants underwent neuropsychological, physical activity, and quality-of-life assessments.

RESULTS

Overall, neuropsychological test scores and level of physical activity did not differ between intervention and control groups at any time. However, compared to the control group, quality of life was higher at 3 months, and visuospatial working memory and response inhibition improved more in the intervention group by 6 months. Apolipoprotein ∊4 status did not affect the results.

DISCUSSION

Zumba may strengthen performance on visuospatial working memory among cognitively unimpaired older women but this needs to be tested in a larger clinical trial.

Dance and Parkinson's: A review and exploration of the role of cognitive representations of action

Parkinson's disease (PD) is a neurodegenerative condition that causes both sensorimotor and non-motor impairments, and there is a clear need for non-medical approaches to improve quality of life. Dance is an increasingly popular activity among people with PD, which demonstrates potential therapeutic benefits. However, findings to date have been inconsistent, and little is known about the mechanisms underlying benefits of dance in PD. In this review, we provide an overview of research into dance for people with PD. The majority of quantitative evidence is in the sensorimotor domain, but cognitive, psychological and social effects have also been reported. We consider the role of cognitive representations of action within dance through observation, imitation and imagery, which may contribute to both sensorimotor and non-motor outcomes for people with PD. Moreover, we discuss how these processes may be enhanced through dance to provide further benefits in everyday life. Finally, we propose avenues for future research to increase understanding of action representation in dance for PD, which has the potential to inform practice and maximize benefits.

Sardinian Folk Dance for Individuals with Parkinson's Disease: A Randomized Controlled Pilot Trial

OBJECTIVES

Among different exercise models proposed for individuals with Parkinson's disease (IwPD), the popularity of traditional forms of dance is increasing. The aim of this study was to evaluate the effects of Sardinian folk dance (Ballu Sardu, BS) on functional performance and motor and nonmotor symptoms in IwPD.

DESIGN

Single-blind, randomized controlled pilot trial.

SETTINGS

Outpatient health clinic.

SUBJECTS AND INTERVENTIONS

Twenty IwPD (13M, 7F; 67.4 ± 6.1 years) were randomly assigned to BS (n = 10) or usual care (n = 10). The dance program consisted of two sessions/week, 90-min/class, for 12 weeks.

OUTCOME MEASURES

Motor and nonmotor symptoms, as well as functional performance, were evaluated using different questionnaires and tests such as the Unified Parkinson's Disease Rating Scale Part-III (UPDRS-III), 6-min walking test (6MWT), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) test, Five Times Sit-to-Stand Test (FTSST), Back Scratch Test (BST), Sit-and-Reach Test (SRT), instrumented gait analysis, Parkinson's Disease Fatigue Scale (PFS-16), Beck Depression Inventory, Starkstein Apathy Scale (SAS), and Montreal Cognitive Assessment (MOCA) scale.

RESULTS

Repeated-measures analysis of variance revealed significant Time × Group interactions for UPDRS-III and functional variables such as the 6MWT, BBS, FTSST, TUG (all, p < 0.001), BST (p = 0.04), and gait analysis parameters (stride length, p = 0.031; gait speed, p = 0.049; and gait fatigue index (GFI), p = 0.005). For nonmotor symptoms, significant Time × Group interactions for depression (p < 0.001), apathy (p = 0.016), and MOCA scores (p = 0.012) were observed. Of note, for GFI and SAS, the BS group only showed a trend toward improvement, while the condition of the controls worsened significantly. No between-group differences were observed for SRT and PFS-16.

CONCLUSIONS

BS is an enjoyable activity, which has been proved to be superior to usual care alone in inducing changes in different motor and nonmotor symptoms associated with PD. Results show that BS can be considered a safe tool for contrasting impairments observed in IwPD due to the intrinsic nature of the neurodegenerative disease.

Music Therapy and Dance as Gait Rehabilitation in Patients With Parkinson Disease: A Review of Evidence

AIM

This review aims to demonstrate the efficiency of music and dance for gait improvement and symptom alleviation in Parkinson disease.

METHODOLOGY

Studies that analyzed sound stimuli and dance in gait improvement in Parkinson disease were searched through PubMed, Scopus, Doaj, MEDLINE, and ScienceDirect databases from November 2017 to April 2018 and repeated in September 2018.

RESULTS AND DISCUSSION

Forty-five studies met the inclusion criteria to synthesize the findings on dance and music performance as a treatment for classical symptoms of Parkinson disease. Five reviews and 40 experimental papers have shown that rhythmic stimulation and dance provide the motor, cognitive, and quality of life benefits for participants with Parkinson disease. Thus, sound stimuli and dance offer satisfactory effects for gait, improving cognitive abilities such as motor control and adjustment and spatial memory. In addition, these new treatment modalities stimulate the elderly population to practice physical exercise, generating well-being and helping self-esteem.

CONCLUSION

Dance and music therapy interventions are noninvasive, simple treatment options, which promote gait and cognition.