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Ting LH, Gick B, Kesar TM, Xu J. Ethnokinesiology: towards a neuromechanical understanding of cultural differences in movement. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230485. [PMID: 39155720 DOI: 10.1098/rstb.2023.0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/15/2024] [Accepted: 06/18/2024] [Indexed: 08/20/2024] Open
Abstract
Each individual's movements are sculpted by constant interactions between sensorimotor and sociocultural factors. A theoretical framework grounded in motor control mechanisms articulating how sociocultural and biological signals converge to shape movement is currently missing. Here, we propose a framework for the emerging field of ethnokinesiology aiming to provide a conceptual space and vocabulary to help bring together researchers at this intersection. We offer a first-level schema for generating and testing hypotheses about cultural differences in movement to bridge gaps between the rich observations of cross-cultural movement variations and neurophysiological and biomechanical accounts of movement. We explicitly dissociate two interacting feedback loops that determine culturally relevant movement: one governing sensorimotor tasks regulated by neural signals internal to the body, the other governing ecological tasks generated through actions in the environment producing ecological consequences. A key idea is the emergence of individual-specific and culturally influenced motor concepts in the nervous system, low-dimensional functional mappings between sensorimotor and ecological task spaces. Motor accents arise from perceived differences in motor concept topologies across cultural contexts. We apply the framework to three examples: speech, gait and grasp. Finally, we discuss how ethnokinesiological studies may inform personalized motor skill training and rehabilitation, and challenges moving forward.This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.
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Affiliation(s)
- Lena H Ting
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Bryan Gick
- Department of Linguistics, The University British Columbia, Vancouver, BC V6T 1Z4, Canada
- Haskins Laboratories, Yale University, New Haven, CT 06520, USA
| | - Trisha M Kesar
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Jing Xu
- Department of Kinesiology, The University of Georgia, Athens, GA 30602, USA
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Rice PE, Thumuluri D, Barnstaple R, Fanning J, Laurita-Spanglet J, Soriano CT, Hugenschmidt CE. Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework. J Alzheimers Dis 2024:JAD230741. [PMID: 39031353 DOI: 10.3233/jad-230741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging. Objective To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations. Methods Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life). Results High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified. Conclusions Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.
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Affiliation(s)
- Paige E Rice
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Deepthi Thumuluri
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Christina T Soriano
- Department of Theatre and Dance, Wake Forest University, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Poikonen H, Duberg A, Eriksson M, Eriksson-Crommert M, Lund M, Möller M, Msghina M. "InMotion"-Mixed physical exercise program with creative movement as an intervention for adults with schizophrenia: study protocol for a randomized controlled trial. Front Hum Neurosci 2023; 17:1192729. [PMID: 37476005 PMCID: PMC10354340 DOI: 10.3389/fnhum.2023.1192729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Background Schizophrenia is among the world's top 10 causes of long-term disability with symptoms that lead to major problems in social and occupational functioning, and in self-care. Therefore, it is important to investigate the efficacy of complementary treatment options for conventionally used antipsychotic medication, such as physical training, and psychosocial interventions. Objective To combine aerobic and strength training with cognitive, emotional and social stimulation in one intervention for people with schizophrenia and test the feasibility and effects of this intervention. Methods The study is a mixed-method randomized controlled trial to evaluate the effects of a 12-week intervention for adults with schizophrenia. The treatment group (30 participants) will receive the intervention in addition to standard care and the control group (30 participants) only standard care. The intervention consists of 24 biweekly sessions with a duration of 60 min. The pre-test (weeks from 4 to 2 prior to the intervention) and post-test (week 12) include clinical measure (PANSS), quality of life, social performance, movement quantity, brain function and eye tracking measures. In addition, a treatment subgroup of 12-15 participants and their family member or other next of kin will complete a qualitative interview as a part of their post-test. Two follow-up tests, including clinical, quality of life, brain function and eye tracking will be made at 6 and 12 months from the completion of the intervention to both study groups. The primary outcome is change in negative symptoms. Secondary outcome measures include general and positive symptoms, quality of life, social performance, movement quantity, brain function and eye tracking. Explorative outcome includes patient and family member or other next of kin interview. Results Pilot data was collected by June 2023 and the main data collection will begin in September 2023. The final follow-up is anticipated to be completed by 2026. Conclusion The InMotion study will provide new knowledge on the feasibility, efficacy, and experiences of a novel intervention for adults with schizophrenia. The hypothesis is that regular participation in the intervention will reduce clinical symptoms, normalize physiological measures such as brain activation, and contribute to new active habits for the participants. Trial registration ClinicalTrials.gov, identifier NCT05673941.
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Affiliation(s)
- Hanna Poikonen
- Professorship for Learning Sciences and Higher Education, Department of Humanities, Social and Political Sciences, Swiss Federal Institute of Technology Zurich (ETH Zürich), Zürich, Switzerland
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Martin Eriksson-Crommert
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Majja Lund
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Margareta Möller
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mussie Msghina
- Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Foster Vander Elst O, Foster NHD, Vuust P, Keller PE, Kringelbach ML. The Neuroscience of Dance: A Conceptual Framework and Systematic Review. Neurosci Biobehav Rev 2023; 150:105197. [PMID: 37100162 DOI: 10.1016/j.neubiorev.2023.105197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 04/28/2023]
Abstract
Ancient and culturally universal, dance pervades many areas of life and has multiple benefits. In this article, we provide a conceptual framework and systematic review, as a guide for researching the neuroscience of dance. We identified relevant articles following PRISMA guidelines, and summarised and evaluated all original results. We identified avenues for future research in: the interactive and collective aspects of dance; groove; dance performance; dance observation; and dance therapy. Furthermore, the interactive and collective aspects of dance constitute a vital part of the field but have received almost no attention from a neuroscientific perspective so far. Dance and music engage overlapping brain networks, including common regions involved in perception, action, and emotion. In music and dance, rhythm, melody, and harmony are processed in an active, sustained pleasure cycle giving rise to action, emotion, and learning, led by activity in specific hedonic brain networks. The neuroscience of dance is an exciting field, which may yield information concerning links between psychological processes and behaviour, human flourishing, and the concept of eudaimonia.
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Affiliation(s)
- Olivia Foster Vander Elst
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Denmark; Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK.
| | | | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Denmark
| | - Peter E Keller
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Denmark; The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Morten L Kringelbach
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Denmark; Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, UK; Department of Psychiatry, University of Oxford, UK
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Aldana-Benítez D, Caicedo-Pareja MJ, Sánchez DP, Ordoñez-Mora LT. Dance as a neurorehabilitation strategy: A systematic review. J Bodyw Mov Ther 2023; 35:348-363. [PMID: 37330793 DOI: 10.1016/j.jbmt.2023.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This systematic review aimed to demonstrate the benefits of dance-based therapeutic interventions in rehabilitation processes in patients with neurological disorders. METHODS Searches on the following databases and electronic search engines were conducted: MEDLINE, LILACS, Science Direct, SCOPUS, PeDro, BVS (virtual health library), and Google Scholar. Data extraction was independently performed by two authors. Twenty-five clinical trial-type studies that included dance and established outcome measures were included, and studies in which a musicalized exercise modality was used without the connotation of dance were excluded. RESULTS From the results of multiple studies, the short-term motor benefits of rhythmic auditory stimulation on gait parameters were highlighted. Furthermore, there was scientific evidence demonstrating the benefits of the cognitive and social parameters of group dancing as significant improvements in cognitive flexibility and processing speed were highlighted. Recent studies showed that interventions based on exercise and/or rhythmic choreography can reduce the risk of falls in patients with neurological disorders, thereby improving their quality of life. CONCLUSION These findings suggest that dance is an innovative and effective method that can be included in therapies as it allows for a promising prognosis in motor, cognitive, and social performances of patients with neurological disorders that alter mobility and quality of life.
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Affiliation(s)
- Daniel Aldana-Benítez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - María José Caicedo-Pareja
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Diana Patricia Sánchez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Leidy Tatiana Ordoñez-Mora
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
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Meulenberg CJW, Rehfeld K, Jovanović S, Marusic U. Unleashing the potential of dance: a neuroplasticity-based approach bridging from older adults to Parkinson's disease patients. Front Aging Neurosci 2023; 15:1188855. [PMID: 37434737 PMCID: PMC10331838 DOI: 10.3389/fnagi.2023.1188855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that affects >1% of individuals worldwide and is manifested by motor symptoms such as tremor, rigidity, and bradykinesia, as well as non-motor symptoms such as cognitive impairment and depression. Non-pharmacological interventions such as dance therapy are becoming increasingly popular as complementary therapies for PD, in addition to pharmacological treatments that are currently widely available. Dance as a sensorimotor activity stimulates multiple layers of the neural system, including those involved in motor planning and execution, sensory integration, and cognitive processing. Dance interventions in healthy older people have been associated with increased activation of the prefrontal cortex, as well as enhanced functional connectivity between the basal ganglia, cerebellum, and prefrontal cortex. Overall, the evidence suggests that dance interventions can induce neuroplastic changes in healthy older participants, leading to improvements in both motor and cognitive functions. Dance interventions involving patients with PD show better quality of life and improved mobility, whereas the literature on dance-induced neuroplasticity in PD is sparse. Nevertheless, this review argues that similar neuroplastic mechanisms may be at work in patients with PD, provides insight into the potential mechanisms underlying dance efficacy, and highlights the potential of dance therapy as a non-pharmacological intervention in PD. Further research is warranted to determine the optimal dance style, intensity, and duration for maximum therapeutic benefit and to determine the long-term effects of dance intervention on PD progression.
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Affiliation(s)
| | - Kathrin Rehfeld
- Institute for Sport Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Saša Jovanović
- Faculty of Physical Education and Sport, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea–ECM, Maribor, Slovenia
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Cao K, Bay AA, Hajjar I, Wharton W, Goldstein F, Qiu D, Prusin T, McKay JL, Perkins MM, Hackney ME. Rationale and Design of the PARTNER Trial: Partnered Rhythmic Rehabilitation for Enhanced Motor-Cognition in Prodromal Alzheimer's Disease. J Alzheimers Dis 2023; 91:1019-1033. [PMID: 36530084 PMCID: PMC10105523 DOI: 10.3233/jad-220783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Functional decline in Alzheimer's disease (AD) is impacted by impaired ability to integrate and modulate complex cognitive and motor abilities, commonly known as motor-cognitive integration. Impaired motor-cognitive integration occurs in the early stages of AD, prodromal AD (pAD), and may precede other symptoms. Combined motor and cognitive training have been recommended for people with pAD and need to be better researched. Our data suggest that partnered rhythmic rehabilitation (PRR) improves motor-cognitive integration in older adults with cognitive impairment. PRR is an ideal intervention to simultaneously target cardiovascular, social, and motor-cognitive domains important to AD. OBJECTIVE/METHODS We propose to conduct a 1-year Phase II, single-blind randomized controlled trial using PRR in 66 patients with pAD. Participants will be assigned to three months of biweekly sessions, followed by nine months of weekly sessions of PRR or group walking (WALK) with 1 : 1 allocation. Group walking in the control group will allow us to compare physical exercise alone versus the added benefit of the cognitively engaging elements of PRR. RESULTS/CONCLUSION Using an intent-to-treat approach, this innovative pilot study will 1) Determine acceptability, safety, tolerability, and satisfaction with PRR; 2) Compare efficacy of PRR versus WALK for improving motor-cognitive integration and identify the most sensitive endpoint for a Phase III trial from a set of motor-cognitive, volumetric MRI, and cognitive measures. The study will additionally explore potential neural, vascular, and inflammatory mechanisms by which PRR affects pAD to derive effect size of these intermediary measures and aid us in estimating sample size for a future trial.
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Affiliation(s)
- Ke Cao
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Allison A Bay
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ihab Hajjar
- Department of Neurology, University of Texas Southwestern, Dallas, TX, USA
| | | | - Felicia Goldstein
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Deqiang Qiu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Todd Prusin
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - J Lucas McKay
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Bioinformatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Molly M Perkins
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center (GRECC), Atlanta, GA, USA
| | - Madeleine E Hackney
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Emory University School of Nursing, Atlanta, GA, USA.,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Decatur, GA, USA.,Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center (GRECC), Atlanta, GA, USA
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Simpkins C, Yang F. Do dance style and intervention duration matter in improving balance among people with Parkinson's disease? A systematic review with meta-analysis. Parkinsonism Relat Disord 2023; 106:105231. [PMID: 36470708 DOI: 10.1016/j.parkreldis.2022.105231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/25/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Impaired balance is a common symptom that increases fall risk in people with Parkinson's disease (PwPD). Although previous meta-analyses concluded that dance-based interventions could improve balance in PwPD, they have limitations, such as small samples and low rigor. Another overlooked issue is whether the effects of dance-based interventions depend on dance style and training duration. The primary purpose of this meta-analysis was to further examine the efficacy of dance-based interventions in improving balance in PwPD. The secondary goals were to compare the intervention efficacy of different dance styles and durations. METHODS Fourteen randomized controlled trials (RCT) examining the effect of dance-based treatment on improving balance among 612 PwPD were included. Effect size (ES) was calculated as the standardized mean difference. Meta-analyses (one primary analysis and three subgroup analyses) were completed using random-effects models. RESULTS Results showed a medium overall ES of 0.57 (95% confidence interval or CI: [0.29,0.84], p < 0.0001) in favor of dance versus control on improving balance in PwPD. The subgroup analysis of six dance styles revealed various ES ranging 0.40-2.00. Balance was significantly improved with dance compared to control group for 12+ week interventions (ES = 0.72, 95%CI: [0.37,1.08], p < 0.0001). Interventions with 60- and 90-min classes produced similar ES for improving PwPD's balance (60-min ES = 0.54; 90-min ES = 0.68). CONCLUSION Dance-based interventions (particularly of 12+ weeks) could effectively improve balance among PwPD. More high-quality RCT are needed to determine the most beneficial dance styles and session lengths. These findings could inform future studies for designing/deploying effective dance-based balance training and fall prevention programs for PwPD.
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Affiliation(s)
- Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, USA.
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Haputhanthirige NKH, Sullivan K, Moyle G, Brauer S, Jeffrey ER, Kerr G. Effects of dance on gait and dual-task gait in Parkinson's disease. PLoS One 2023; 18:e0280635. [PMID: 36693038 PMCID: PMC9873168 DOI: 10.1371/journal.pone.0280635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 11/09/2022] [Indexed: 01/25/2023] Open
Abstract
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 (DTVERB), and serial-subtraction (DTSUBT). 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 DTVERB significant improvements were noted in gait velocity (p = 0.035), cadence (p = 0.034) and step length (p = 0.039). The DG also exhibited significant improvement compared to the CG during DTSUBT in the measures of gait velocity (p = 0.012), cadence (p = 0.021), step length (p = 0.018), and stride length (p = 0.151). On the uneven surface, improvements were noted when walking while performing serial subtractions only. During regular walking, improvements were noted for the CG but not for the DG. CG has spent less time in double support following the intervention than DG. While DTVERB condition had no significant group differences for any gait parameter (p's >0.05), in the DTSUBT condition, the DG improved significantly compared to the controls on gait velocity (p = 0.048), cadence (p = 0.026), and step length (p = 0.051). CONCLUSIONS DfPD®-based classes produced clinically significant improvement in spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted. TRIAL REGISTRATION A protocol for this study has been registered retrospectively at the Australian New Zealand Clinical Trials Registry. Identifier: ACTRN12618001834246.
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Affiliation(s)
- Nadeesha Kalyani Hewa Haputhanthirige
- Movement Neuroscience Group, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, Department of Allied Health Sciences, University of Colombo, Sri Lanka
- * E-mail: (NKHW); (GK)
| | - Karen Sullivan
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gene Moyle
- Faculty of Creative Industries, School of Creative Practice, Queensland University of Technology, Brisbane, Queensland, Australia
- Academic Division, Office of the Deputy Vice-Chancellor (Academic), Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sandy Brauer
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Erica Rose Jeffrey
- Queensland Ballet, South Brisbane, Queensland, Australia
- Dance for Parkinson’s Australia, Brisbane, Queensland, Australia
| | - Graham Kerr
- Movement Neuroscience Group, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- * E-mail: (NKHW); (GK)
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Impact of pathological conditions on postural reflex latency and adaptability following unpredictable perturbations: A systematic review and meta-analysis. Gait Posture 2022; 95:149-159. [PMID: 35500364 DOI: 10.1016/j.gaitpost.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pathological conditions can impair responses to postural perturbations and increase risk of falls. RESEARCH QUESTION To what extent are postural reflexes impaired in people with pathological conditions and can exercise interventions shorten postural reflexes? METHODS MEDLINE, EMBASE, Scopus, SportDiscus and Web of Science were systematically searched for articles comparing muscle activation onset latency in people with pathological conditions to healthy controls following unpredictable perturbations including the effect of exercise interventions (registration: CRD42020170861). RESULTS Fifty-three articles were included for systematic review. Significant delays in muscle activity onset following perturbations were evident in people with multiple sclerosis (n = 7, mean difference [MD]: 22 ms, 95% confidence interval [CI]: 11, 33), stroke (n = 10, MD: 34 ms, 95% CI: 19, 49), diabetes (n = 2, MD: 19 ms, 95% CI: 10, 27), HIV (n = 3, MD: 9 ms, 95% CI: 4, 14), incomplete spinal cord injury (n = 2, MD: 57 ms, 95% CI: 33, 80) and back and knee pain (n = 7, MD: 12 ms, 95% CI: 6, 18), but not in people with Parkinson's disease (n = 10) or cerebellar dysfunction (n = 4). Following exercise interventions, the paretic limb of stroke survivors (n = 3) displayed significantly faster muscle activation onset latency compared to pre-exercise (MD: -13 ms, 95% CI: -24, -4), with no significant changes in Parkinson's disease (n = 3). CONCLUSIONS This systematic review demonstrated that postural reflexes are significantly delayed in people with multiple sclerosis (+22 ms), stroke (+34 ms), diabetes (+19 ms), HIV (+9 ms), incomplete spinal cord injury (+57 ms), back and knee pain (+12 ms); pathological conditions characterized by impaired sensation or neural function. In contrast, timing of postural reflexes was not impaired in people with Parkinson's disease and cerebellar dysfunction, confirming the limited involvement of supraspinal structures. The meta-analysis showed exercise interventions can significantly shorten postural reflex latencies in stroke survivors (-14 ms), but more research is needed to confirm this finding and in people with other pathological conditions.
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Technical Note: Quantifying music-dance synchrony during salsa dancing with a deep learning-based 2D pose estimator. J Biomech 2022; 141:111178. [DOI: 10.1016/j.jbiomech.2022.111178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
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12
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Brown EL, Gannotti ME, Veneri DA. Including Arts in Rehabilitation Enhances Outcomes in the Psychomotor, Cognitive, and Affective Domains: A Scoping Review. Phys Ther 2022; 102:6515752. [PMID: 35084031 DOI: 10.1093/ptj/pzac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/25/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to analyze the published literature regarding the use of art in the context of rehabilitation for consideration in physical therapy. METHODS The CINAHL, PsycArticles, APA PsycInfo, Art Index, Music Index, Cochrane Reviews, and PubMed electronic databases were accessed. Inclusion and exclusion criteria were established and utilized to determine study eligibility. Study details were extracted from each article by researchers using a systematic format. Summation of journal type, participants, dosing and type of intervention, setting and interventionist, outcome domains, and study results were included. RESULTS Out of 1452 studies, 76 were included for extraction. Of these studies, most had outcome measures aligned with the psychomotor and affective domains of learning (n = 66). Very few studies had outcome measures with psychomotor and cognitive domains (n = 2) or psychomotor, affective, and cognitive outcome measures (n = 8). Regarding the arts used, music, dance, or both were used in 77 instances. Fewer studies reported using creative arts therapy, singing, theater, writing, and rhythm (n = 17). Of the 76 studies analyzed, 74 reported a within-group treatment effect. CONCLUSION The arts effectively enhance physical therapist practice; therefore, it is recommended that physical therapists continue to seek collaboration with art professionals and explore the use of arts in practice. IMPACT Findings demonstrate that combining the arts with physical therapist practice amplifies not only psychomotor but affective and cognitive outcomes as well. The arts have applicability across broad populations (eg, chronic pain, neurologic dysfunction, respiratory conditions). This study supports that physical therapist education and practice should embrace the arts as a collaborative modality to promote enhanced psychomotor, affective, and cognitive outcomes.
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Affiliation(s)
- Emma L Brown
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Mary E Gannotti
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Diana A Veneri
- Department of Physical Therapy, Sacred Heart University, Fairfield, Connecticut, USA
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13
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Speranza L, Pulcrano S, Perrone-Capano C, di Porzio U, Volpicelli F. Music affects functional brain connectivity and is effective in the treatment of neurological disorders. Rev Neurosci 2022; 33:789-801. [PMID: 35325516 DOI: 10.1515/revneuro-2021-0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/25/2022] [Indexed: 11/15/2022]
Abstract
In a million years, under the pressure of natural selection, hominins have acquired the abilities for vocal learning, music, and language. Music is a relevant human activity, highly effective in enhancing sociality, is a universal experience common to all known human cultures, although it varies in rhythmic and melodic complexity. It has been part of human life since the beginning of our history, or almost, and it strengthens the mother-baby relation even within the mother's womb. Music engages multiple cognitive functions, and promotes attention, concentration, imagination, creativity, elicits memories and emotions, and stimulates imagination, and harmony of movement. It changes the chemistry of the brain, by inducing the release of neurotransmitters and hormones (dopamine, serotonin, and oxytocin) and activates the reward and prosocial systems. In addition, music is also used to develop new therapies necessary to alleviate severe illness, especially neurological disorders, and brain injuries.
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Affiliation(s)
- Luisa Speranza
- Department of Neuroscience, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Salvatore Pulcrano
- Institute of Genetics and Biophysics, "Adriano Buzzati-Traverso", C.N.R., 80131 Naples, Italy.,Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Carla Perrone-Capano
- Institute of Genetics and Biophysics, "Adriano Buzzati-Traverso", C.N.R., 80131 Naples, Italy.,Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Umberto di Porzio
- Institute of Genetics and Biophysics, "Adriano Buzzati-Traverso", C.N.R., 80131 Naples, Italy
| | - Floriana Volpicelli
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
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14
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Carapellotti AM, Rodger M, Doumas M. Evaluating the effects of dance on motor outcomes, non-motor outcomes, and quality of life in people living with Parkinson's: a feasibility study. Pilot Feasibility Stud 2022; 8:36. [PMID: 35139914 PMCID: PMC8827282 DOI: 10.1186/s40814-022-00982-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community-based dance programs for people living with Parkinson's have grown in popularity over the past two decades. Studies investigating these programs have demonstrated multidimensional benefits in motor, non-motor, and quality of life related outcomes, yet there is a need to focus on the feasibility of larger trials. The primary objective of this study was to assess the feasibility and acceptability of conducting a trial investigating dance and Parkinson's in Northern Ireland. The secondary objectives were to conduct preliminary analyses of the classes' effects and to assess the appropriateness of outcome measures for a randomized controlled trial. METHODS Participants were recruited through the community, Parkinson's UK, and university contacts to participate in a 12-week dance intervention inspired by the Dance for PD® model. Pre- and post-intervention, participants completed the following outcomes: MDS-UPDRS III, TUG, DT-TUG, Sensory Organization Test, MoCA, Trail Making Tests A&B, Digit Symbol Substitution Test, Digit Span, PDQ-39, FOG-Q, PHQ-9, FES-I, and an exit questionnaire (post-test only). Data were analyzed using paired samples t tests or Wilcoxon signed ranked test. RESULTS Ten people living with Parkinson's participated. Running a larger trial was deemed infeasible in this setting due to recruitment issues; conversely, the dance intervention was accepted by participants with all but one completing the study. Functional mobility (TUG), symptoms of depression (PHQ-9), and bodily discomfort showed improvement. All other outcomes did not. The exit questionnaire revealed that the social aspect of classes was important, and improvements in mood or mental state were cited most frequently as perceived benefits. Outcome measures were feasible, with some changes suggested for future trials. CONCLUSIONS This study highlighted the infeasibility of running a larger trial using this design in this setting despite demonstrating the acceptability of implementing a dance program in Northern Ireland for people living with Parkinson's. The results support existing evidence demonstrating that dance may improve functional mobility and symptoms of depression in people living with Parkinson's, though the study design and small sample size prevent the generalizability of results. The findings also support the idea that dancing has the potential to support several aspects of physical, emotional, mental, and social health.
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Affiliation(s)
- Anna M Carapellotti
- School of Psychology, Queen's University Belfast, 18-30 Malone Road, Belfast, BT9 5BN, UK.
| | - Matthew Rodger
- School of Psychology, Queen's University Belfast, 18-30 Malone Road, Belfast, BT9 5BN, UK
| | - Michail Doumas
- School of Psychology, Queen's University Belfast, 18-30 Malone Road, Belfast, BT9 5BN, UK
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15
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Rabinovich DB, Garretto NS, Arakaki T, DeSouza JFX. A high dose tango intervention for people with Parkinson's disease (PwPD). ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Emmanouilidis S, Hackney ME, Slade SC, Heng H, Jazayeri D, Morris ME. Dance Is an Accessible Physical Activity for People with Parkinson's Disease. PARKINSON'S DISEASE 2021; 2021:7516504. [PMID: 34721836 PMCID: PMC8556098 DOI: 10.1155/2021/7516504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/16/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- Sara Emmanouilidis
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Madeleine E. Hackney
- Emory University School of Medicine, Department of Medicine, Division of Geriatrics and Gerontology, Atlanta, USA
- Atlanta Veterans Affairs Centre for Visual & Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Susan C Slade
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Hazel Heng
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Dana Jazayeri
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Meg E. Morris
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
- Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
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17
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Abnormal center of mass feedback responses during balance: A potential biomarker of falls in Parkinson's disease. PLoS One 2021; 16:e0252119. [PMID: 34043678 PMCID: PMC8158870 DOI: 10.1371/journal.pone.0252119] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/10/2021] [Indexed: 02/01/2023] Open
Abstract
Although Parkinson disease (PD) causes profound balance impairments, we know very little about how PD impacts the sensorimotor networks we rely on for automatically maintaining balance control. In young healthy people and animals, muscles are activated in a precise temporal and spatial organization when the center of body mass (CoM) is unexpectedly moved that is largely automatic and determined by feedback of CoM motion. Here, we show that PD alters the sensitivity of the sensorimotor feedback transformation. Importantly, sensorimotor feedback transformations for balance in PD remain temporally precise, but become spatially diffuse by recruiting additional muscle activity in antagonist muscles during balance responses. The abnormal antagonist muscle activity remains precisely time-locked to sensorimotor feedback signals encoding undesirable motion of the body in space. Further, among people with PD, the sensitivity of abnormal antagonist muscle activity to CoM motion varies directly with the number of recent falls. Our work shows that in people with PD, sensorimotor feedback transformations for balance are intact but disinhibited in antagonist muscles, likely contributing to balance deficits and falls.
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18
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Hackney ME, Bay AA, Jackson JM, Nocera JR, Krishnamurthy V, Crosson B, Evatt ML, Langley J, Cui X, McKay JL, Huddleston DE. Rationale and Design of the PAIRED Trial: Partnered Dance Aerobic Exercise as a Neuroprotective, Motor, and Cognitive Intervention in Parkinson's Disease. Front Neurol 2020; 11:943. [PMID: 33162925 PMCID: PMC7581698 DOI: 10.3389/fneur.2020.00943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD), an intractable condition impairing motor and cognitive function, is imperfectly treated by drugs and surgery. Two priority issues for many people with PD are OFF-time and cognitive impairment. Even under best medical management, three-fourths of people with PD experience “OFF-time” related to medication-related motor fluctuations, which severely impacts both quality of life and cognition. Cognitive deficits are found even in newly diagnosed people with PD and are often intractable. Our data suggest that partnered dance aerobic exercise (PDAE) reduces OFF-time on the Movement Disorders Society Unified Parkinson Disease Rating Scale-IV (MDS-UPDRS-IV) and ameliorates other disease features, which motivate the PAIRED trial. PDAE provides AE during an improvisational, cognitively engaging rehabilitative physical activity. Although exercise benefits motor and cognitive symptoms and may be neuroprotective for PD, studies using robust biomarkers of neuroprotection in humans are rare. We propose to perform a randomized, controlled trial in individuals with diagnosed mild–moderate PD to compare the efficacy of PDAE vs. walking aerobic exercise (WALK) for OFF-time, cognition, and neuroprotection. We will assess neuroprotection with neuromelanin-sensitive MRI (NM-MRI) and iron-sensitive (R2*) MRI sequences to quantify neuromelanin loss and iron accumulation in substantia nigra pars compacta (SNc). We will use these biomarkers, neuromelanin loss, and iron accumulation, as tools to chart the course of neurodegeneration in patients with PD who have undergone long-term (16 months) intervention. We will randomly assign 102 individuals with mild–moderate PD to 16 months of PDAE or WALK. The 16-month intervention period will consist of Training (3 months of biweekly sessions) and Maintenance (13 months of weekly sessions) phases. We will assess participants at baseline, 3 months (immediately post-Training), and 16 months (immediately post-Maintenance) for OFF-time and behaviorally and physiologically measured cognition. We will acquire NM-MRI and R2* imaging data at baseline and 16 months to assess neuroprotection. We will (1) examine effects of Training and Maintenance phases of PDAE vs. WALK on OFF-time, (2) compare PDAE vs. WALK at 3 and 16 months on behavioral and functional MRI (fMRI) measures of spatial cognition, and (3) compare PDAE vs. WALK for effects on rates of neurodegeneration.
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Affiliation(s)
- Madeleine E Hackney
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Emory University School of Nursing, Atlanta, GA, United States.,Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA, United States
| | - Allison A Bay
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Jordan M Jackson
- Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Joe R Nocera
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA, United States.,Emory University School of Medicine Department of Neurology, Atlanta, GA, United States
| | - Venkatagiri Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Division of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Emory University School of Medicine Department of Neurology, Atlanta, GA, United States
| | - Bruce Crosson
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Emory University School of Medicine Department of Neurology, Atlanta, GA, United States.,Georgia State University Department of Psychology, Atlanta, GA, United States.,Health and Rehabilitation Science, University of Queensland, Brisbane, QLD, Australia
| | - Marian L Evatt
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Emory University School of Medicine Department of Neurology, Atlanta, GA, United States
| | - Jason Langley
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA, United States.,Emory University School of Medicine Department of Neurology, Atlanta, GA, United States.,Center for Advanced Neuroimaging, University of California, Riverside, Riverside, CA, United States
| | - Xiangqin Cui
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, United States.,Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - J Lucas McKay
- Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, United States
| | - Daniel E Huddleston
- Emory University School of Medicine Department of Neurology, Atlanta, GA, United States
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19
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Berti A, Pini M, Ferrarello F. Argentine tango in the care of Parkinson's disease: A systematic review and analysis of the intervention. Complement Ther Med 2020; 52:102474. [PMID: 32951724 DOI: 10.1016/j.ctim.2020.102474] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To analyse the content of the interventions reported in studies investigating the applicability and efficacy of Argentine tango in participants with Idiopathic Parkinson Disease. METHODS Independent reviewers searched databases (PubMed, CINAHL, EMBASE, PsycINFO, and PEDro) from their inception to November 2019. Eligible studies were randomised, controlled and uncontrolled clinical trials, and case reports. MAIN OUTCOME MEASURE The Template for Intervention Description and Replication guidelines and checklist were used to assess quality and quantity of the content of Argentine tango interventions' description. RESULTS We found 21 papers investigating the applicability and efficacy of Argentine tango in participants with Idiopathic Parkinson Disease. Completeness of the reporting of intervention was satisfying. The intervention is intended to affect a variety of aspects of functioning relevant to individuals with Idiopathic Parkinson Disease. Detailed information on the intervention's procedure and dosing is usually provided. The delivery of the Tango dance program was predominantly extensive; however, the intervention has been provided with various approaches and showed to be very adaptable. Attrition- and adherence- rates described are acceptable. The Adapted Tango dance program is the earliest and most researched modality of tango intervention in participants with Idiopathic Parkinson Disease. CONCLUSIONS Argentine tango is appropriately described in the studies investigating the applicability and efficacy of the intervention in participants with Idiopathic Parkinson Disease. However, the reporting could be ameliorated.
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Affiliation(s)
- A Berti
- Private Practice, Pistoia, Italy.
| | - M Pini
- School of Physiotherapy, University of Florence, Florence, Italy.
| | - F Ferrarello
- SOC Attività di Riabilitazione Funzionale, Azienda USL Toscana Centro, Via Cavour 118/120, 59100 Prato, Italy.
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20
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Carapellotti AM, Stevenson R, Doumas M. The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson's disease: A systematic review and meta-analysis. PLoS One 2020; 15:e0236820. [PMID: 32756578 PMCID: PMC7406058 DOI: 10.1371/journal.pone.0236820] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022] Open
Abstract
Dance may help individuals living with Parkinson's disease (PD) improve motor and non-motor symptoms that impact quality of life (QOL). The primary aim of this systematic review of randomized controlled trials (RCTs) was to evaluate the efficacy of dance in improving motor and non-motor symptoms of PD and QOL. The secondary aims of this review were to evaluate the methodological quality of included studies by assessing risk of bias across nine categories and to inform the direction of future research. Peer-reviewed RCTs that included people living with PD at all disease stages and ages and measured the effects of a dance intervention longer than one day were included. Sixteen RCTs involving 636 participants with mild to moderate PD were eligible for inclusion in the qualitative synthesis and nine in the meta-analysis. Overall, the reviewed evidence demonstrated that dance can improve motor impairments, specifically balance and motor symptom severity in individuals with mild to moderate PD, and that more research is needed to determine its effects on non-motor symptoms and QOL. RCTs that use a mixed-methods approach and include larger sample sizes will be beneficial in fully characterizing effects and in determining which program elements are most important in bringing about positive, clinically meaningful changes in people with PD.
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Affiliation(s)
| | - Rebecca Stevenson
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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21
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Kalyani HH, Sullivan KA, Moyle GM, Brauer SG, Jeffrey ER, Kerr GK. Dance improves symptoms, functional mobility and fine manual dexterity in people with Parkinson disease: a quasi-experimental controlled efficacy study. Eur J Phys Rehabil Med 2020; 56:563-574. [PMID: 32383572 DOI: 10.23736/s1973-9087.20.06069-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Clinically, individuals diagnosed with Parkinson disease (PD) present several symptoms that impact on their functional independence and quality of life. While there is accumulating evidence supporting dance as an effective symptom management option, few studies have objectively assessed these benefits, particularly related to the Dance for Parkinson's Disease<sup>®</sup> (DfPD<sup>®</sup>) program. AIM The aim of this study was to explore the effects of DfPD<sup>®</sup>-based dance classes on disease-related symptoms, fine-manual dexterity and functional mobility in people with PD. DESIGN A quasi-experimental controlled efficacy study, with pre and post testing of two parallel groups (dance versus control). SETTING Community. POPULATION Thirty-three participants with PD allocated to one of two groups: dance group (DG; N.=17; age=65.8±11.7 years) or control group (CG: N.=16; age=67.0±7.7 years). They were cognitively intact (Addenbrooke's Score: DG=93.2±3.6, CG=92.6±4.3) and in early-stage of disease (Hoehn & Yahr: DG=1.6±0.7, CG=1.5±0.8). METHODS The DG undertook a one-hour DfPD<sup>®</sup>-based class, twice weekly for 12 weeks. The CG had treatment as usual. Both groups were assessed at baseline and after 12 weeks on disease-related symptom severity (MDS-Unified Parkinson Disease Rating Scale: MDS-UPDRS), fine-manual dexterity (Perdue Peg Board), measures of functional mobility (Timed Up & Go: single & dual task, Tinetti, Berg, Mini-BESTest) and self-rated balance and gait questionnaires (Activities Balance Confidence Scale: ABC-S; Gait and Falls: G&F-Q; Freezing of Gait: FOG). RESULTS Compared to the CG, there was significantly greater improvement in the DG pre-post change scores on measures of symptom severity MDS-UPDRS, dexterity, six measures of functional mobility, and the ABC-S, G&F-Q, FOG questionnaires. CONCLUSIONS DfPD<sup>®</sup>-based dance classes improved disease-related symptom severity, fine-manual dexterity, and functional mobility. Feasibility of the approach for a large scale RCT was also confirmed. CLINICAL REHABILITATION IMPACT DfPD<sup>®</sup> could be an effective supportive therapy for the management of symptoms and functional abilities in PD.
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Affiliation(s)
- Hewa H Kalyani
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia - .,School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia - .,Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka -
| | - Karen A Sullivan
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Gene M Moyle
- School of Creative Practice, Faculty of Creative Industries, Queensland University of Technology, Brisbane, Australia
| | - Sandra G Brauer
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Erica R Jeffrey
- Queensland Ballet, South Brisbane, Australia.,Dance for Parkinson's Australia, Brisbane, Australia
| | - Graham K Kerr
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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22
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Kalyani HHN, Sullivan K, Moyle G, Brauer S, Jeffrey ER, Roeder L, Berndt S, Kerr G. Effects of Dance on Gait, Cognition, and Dual-Tasking in Parkinson's Disease: A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSONS DISEASE 2020; 9:335-349. [PMID: 30958312 DOI: 10.3233/jpd-181516] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Dance-based interventions have been proposed for the management of Parkinson's disease (PD) symptoms. This review critically appraises and synthesises the research on the effects of dance interventions on gait, cognition and dual-tasking in PD, through a meta-analysis of peer-reviewed literature from seven databases. Eligible studies included people with PD, used a parallel-group or cohort design with a dance-based intervention, reported outcome measures of gait, cognition or dual-tasking, and were published in English up until September 2017. Of the initial 1079 articles, 677 articles were reviewed for eligibility, and 25 articles were retained. Only 12 articles had sufficient common assessment items for meta-analysis. Two independent reviewers extracted the data and assessed the risk of bias of each study using the Cochrane risk-of-bias tool. Based on pre-post change scores, gait speed, Timed Up and Go (TUG) test performance, freezing of gait questionnaire, and six-minute walk test times significantly improved after a dance intervention compared to controls. Global cognition assessed with Montreal Cognitive Assessment, and cognitive dual-tasking measured using dual-task TUG, also exhibited greater improvement in dance groups. There was limited evidence to determine the most effective intensity, frequency, duration of dance interventions or the most beneficial music. Findings must be interpreted cautiously because of the lack of randomised control trials, and the moderate to high risk of bias of studies. However, the results of papers with level-I and level-II.1 evidence suggest that dance may have the potential to ameliorate PD symptoms, particularly gait, global cognition and cognitive dual-tasking.
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Affiliation(s)
- H H N Kalyani
- Movement Neuroscience, Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen Sullivan
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gene Moyle
- School of Creative Practice, Faculty of Creative Industries, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sandy Brauer
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Erica Rose Jeffrey
- Queensland Ballet, South Brisbane, Queensland, Australia.,Dance for Parkinson's Australia, Brisbane, Queensland, Australia
| | - Luisa Roeder
- Movement Neuroscience, Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Sara Berndt
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Graham Kerr
- Movement Neuroscience, Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Bong SM, McKay JL, Factor SA, Ting LH. Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment. Gait Posture 2020; 76:44-50. [PMID: 31731133 PMCID: PMC7015810 DOI: 10.1016/j.gaitpost.2019.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/09/2019] [Accepted: 10/22/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions. RESEARCH QUESTION We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to neurotypical older adults (NOA), and (2) whether balance ability, as assessed by the MiniBESTest, was associated with poor directional acuity in either group. METHODS Participants were exposed to pairs of support-surface translation perturbations in a two-alternative forced choice testing paradigm developed previously in a young healthy population. The first perturbation of each pair that was to be judged by participants was directly backward, and the second perturbation deviated from the left or right from the backward direction by 1°-44°. Participants reported whether the perturbations in each pair were in the "same" or "different" direction. Judgements from 24 to 67 perturbation pairs were used to calculate directional acuity thresholds corresponding to "just-noticeable differences" in perturbation direction. Linear mixed models determined associations between directional thresholds and clinical variables including MDS-UPDRS-III score, age, and MiniBESTest score. RESULTS 20 PD (64 ± 7 y, 12 male, ≥12 h since last intake of antiparkinsonian medications) and 12 NOA (64 ± 8, 6 male) were assessed. Directional thresholds were higher (worse) among PD participants (17.6 ± 5.9° vs. 12.8 ± 3.3°, P < 0.01). Linear mixed models further showed that higher thresholds were associated with MDS-UPDRS-III score (P < 0.01), and were associated with poorer balance ability among PD participants (P < 0.01), but not among NOA participants (P = 0.40). SIGNIFICANCE Perception of whole-body motion is impaired in PD and may contribute to impaired balance and falls.
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Affiliation(s)
- Sistania M. Bong
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - J. Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - Stewart A. Factor
- Jean & Paul Amos PD & Movement Disorders Program,
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia,
USA
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA.,Division of Physical Therapy, Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Georgia, USA,Corresponding author Lena H. Ting PhD, Wallace H.
Coulter Department of Biomedical Engineering, Emory University and the Georgia
Institute of Technology, 1760 Haygood Drive, Suite W200, Atlanta, Georgia,
30322, USA,
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24
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Bek J, Arakaki AI, Lawrence A, Sullivan M, Ganapathy G, Poliakoff E. Dance and Parkinson's: A review and exploration of the role of cognitive representations of action. Neurosci Biobehav Rev 2019; 109:16-28. [PMID: 31846651 DOI: 10.1016/j.neubiorev.2019.12.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/30/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
- Judith Bek
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Aline I Arakaki
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Adam Lawrence
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Matthew Sullivan
- School of Science and the Environment, E432 John Dalton Building, Manchester Metropolitan University, Oxford Road, Manchester, M16 5BH, United Kingdom.
| | - Gayathri Ganapathy
- Equilibrium International, 6 Stretton Avenue, Manchester, M20 6HE, United Kingdom.
| | - Ellen Poliakoff
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
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25
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Chang MC, Chun MH. The effect of balance training with Tetra-ataxiometric posturography on balance function in patients with parkinsonism. NeuroRehabilitation 2019; 45:379-384. [PMID: 31796700 DOI: 10.3233/nre-192850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Balance impairment is a major clinical concern in patients with parkinsonism. Balance training with tetra-ataxiometric posturography (Tetrax) is known to improve balance function through visual biofeedback effects. OBJECTIVE In this study, we evaluated the effects of balance training with Tetrax in patients with parkinsonism. METHODS Patients with parkinsonism (idiopathic Parkinson's disease, multiple systemic atrophy, and multiple systemic atrophy) who were able to stand with or without an assistive device were recruited for the study. Twenty patients with parkinsonism were randomly assigned to one of the following two groups: (1) the Tetrax group, in which patients received Tetrax biofeedback balance training for 30 min/day for 2 weeks (10 sessions); and (2) the control group, in which patients received conventional balance training for 30 min/day for 2 weeks (10 sessions). One day before and after training, we measured patients' balance parameters using the Berg balance scale (BBS) and fall index (FI). RESULTS The BBS and FI scores of the Tetrax group showed significant improvements after compared to before training. However, the scores in the control group were not significantly changed after vs. before conventional balance training. CONCLUSIONS For patients with parkinsonism, Tetrax biofeedback balance training had a positive effect on balance function.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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26
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Abstract
Parkinson's disease (PD) and other synucleinopathies, namely dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), are common degenerative neurological disorders that share synuclein pathology. Although certain cardinal features of parkinsonism, including bradykinesia and rigidity, respond well to levodopa, axial features, such as gait and balance impairment, are less reliably responsive to dopaminergic therapy and surgical interventions. Consequently, falls are common in PD and other synucleinopathies and are a major contributor toward injury and loss of independence. This underscores the need for appropriate fall risk assessment and implementation of preventative measures in all patients with parkinsonism. The aim of this review is therefore to explore modifiable and non-modifiable risk factors for falls in synucleinopathies. We next review and evaluate the evidence for pharmacological, nonpharmacological, and surgical approaches for fall prevention, and emphasize individualized and multifaceted approaches.
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27
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McKay JL, Hackney ME, Factor SA, Ting LH. Lower Limb Rigidity Is Associated with Frequent Falls in Parkinson's Disease. Mov Disord Clin Pract 2019; 6:446-451. [PMID: 31392245 PMCID: PMC6660233 DOI: 10.1002/mdc3.12784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/03/2019] [Accepted: 05/12/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The role of muscle rigidity as an etiological factor of falls in Parkinson's disease (PD) is poorly understood. Our objective was to determine whether lower leg rigidity was differentially associated with frequent falls in PD compared to upper limb, neck, and total rigidity measures. METHODS We examined the associations between Unified Parkinson's Disease Rating Scale-Part III (motor) rigidity subscores and the history of monthly or more frequent falls in 216 individuals with PD (age, 66 ± 10 years; 36% female; disease duration, 7 ± 5 years) with logistic regression. RESULTS A total of 35 individuals were frequent fallers. Significant associations were identified between lower limb rigidity and frequent falls (P = 0.01) after controlling for age, sex, PD duration, total Unified Parkinson's Disease Rating Scale- Part III score, and presence of freezing of gait. No significant associations (P ≥ 0.14) were identified for total, arm, or neck rigidity. CONCLUSION Lower limb rigidity is related to frequent falls in people with PD. Further investigation may be warranted into how parkinsonian rigidity could cause falls.
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Affiliation(s)
- J. Lucas McKay
- The Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia TechAtlantaGeorgiaUSA
| | - Madeleine E. Hackney
- Department of Medicine, Division of General Medicine and GeriatricsEmory University School of MedicineAtlantaGeorgiaUSA
- Rehabilitation R&D CenterAtlanta Veterans Affairs Medical CenterAtlantaGeorgiaUSA
| | - Stewart A. Factor
- Department of NeurologyEmory University School of MedicineAtlantaGeorgiaUSA
| | - Lena H. Ting
- The Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia TechAtlantaGeorgiaUSA
- Department of Rehabilitation Medicine, Division of Physical TherapyEmory University School of MedicineAtlantaGeorgiaUSA
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28
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Payne AM, Ting LH, Hajcak G. Do sensorimotor perturbations to standing balance elicit an error-related negativity? Psychophysiology 2019; 56:e13359. [PMID: 30820966 DOI: 10.1111/psyp.13359] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/14/2019] [Accepted: 02/08/2019] [Indexed: 12/29/2022]
Abstract
Detecting and correcting errors is essential to successful action. Studies on response monitoring have examined scalp ERPs following the commission of motor slips in speeded-response tasks, focusing on a frontocentral negativity (i.e., error-related negativity or ERN). Sensorimotor neurophysiologists investigating cortical monitoring of reactive balance recovery behavior observe a strikingly similar pattern of scalp ERPs following externally imposed postural errors, including a brief frontocentral negativity that has been referred to as the balance N1. We integrate and review relevant literature from these discrepant fields to suggest shared underlying mechanisms and potential benefits of collaboration across fields. Unlike the cognitive tasks leveraged to study the ERN, balance perturbations afford precise experimental control of postural errors to elicit balance N1s that are an order of magnitude larger than the ERN and drive robust and well-characterized adaptation of behavior within an experimental session. Many factors that modulate the ERN, including motivation, perceived consequences, perceptual salience, expectation, development, and aging, are likewise known to modulate the balance N1. We propose that the ERN and balance N1 reflect common neural activity for detecting errors. Collaboration across fields could help clarify the functional significance of the ERN and poorly understood interactions between motor and cognitive impairments.
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Affiliation(s)
- Aiden M Payne
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, Georgia
| | - Lena H Ting
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, Georgia.,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, Georgia
| | - Greg Hajcak
- Departments of Psychology and Biomedical Sciences, Florida State University, Tallahassee, Florida
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29
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Lang KC, Hackney ME, Ting LH, McKay JL. Antagonist muscle activity during reactive balance responses is elevated in Parkinson's disease and in balance impairment. PLoS One 2019; 14:e0211137. [PMID: 30682098 PMCID: PMC6347183 DOI: 10.1371/journal.pone.0211137] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/08/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Abnormal antagonist leg muscle activity could indicate increased muscle co-contraction and clarify mechanisms of balance impairments in Parkinson's disease (PD). Prior studies in carefully selected patients showed PD patients demonstrate earlier, longer, and larger antagonist muscle activation during reactive balance responses to perturbations. RESEARCH QUESTION Here, we tested whether antagonist leg muscle activity was abnormal in a group of PD patients who were not selected for phenotype and most of whom had volunteered for exercise-based rehabilitation. METHODS We compared antagonist activation during reactive balance responses to multidirectional support-surface translation perturbations in 31 patients with mild-moderate PD (age 68±9; H&Y 1-3; UPDRS-III 32±10) and 13 matched individuals (age 65±9). We quantified modulation of muscle activity (i.e., the ability to activate and inhibit muscles appropriately according to the perturbation direction) using modulation indices (MI) derived from minimum and maximum EMG activation levels observed across perturbation directions. RESULTS Antagonist leg muscle activity was abnormal in unselected PD patients compared to controls. Linear mixed models identified significant associations between impaired modulation and PD (P<0.05) and PD severity (P<0.01); models assessing the entire sample without referencing PD status identified associations with balance ability (P<0.05), but not age (P = 0.10). SIGNIFICANCE Antagonist activity is increased during reactive balance responses in PD patients who are not selected on phenotype and are candidates for exercise-based rehabilitation. This activity may be a mechanism of balance impairment in PD and a potential rehabilitation target or outcome measure.
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Affiliation(s)
- Kimberly C. Lang
- Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, Georgia, United States of America
| | - Madeleine E. Hackney
- Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Rehabilitation R&D Center, Atlanta VA Medical Center, Atlanta, Georgia, United States of America
| | - Lena H. Ting
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, Georgia, United States of America
- The Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Tech, Atlanta, Georgia, United States of America
| | - J. Lucas McKay
- The Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Tech, Atlanta, Georgia, United States of America
- * E-mail:
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30
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Pereira APS, Marinho V, Gupta D, Magalhães F, Ayres C, Teixeira S. Music Therapy and Dance as Gait Rehabilitation in Patients With Parkinson Disease: A Review of Evidence. J Geriatr Psychiatry Neurol 2019; 32:49-56. [PMID: 30558462 DOI: 10.1177/0891988718819858] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Ana Paula S Pereira
- 1 Department of Physical Therapy, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Marinho
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Daya Gupta
- 4 Department of Biology, Camden County College, Blackwood, NJ, USA
| | - Francisco Magalhães
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Carla Ayres
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Silmar Teixeira
- 1 Department of Physical Therapy, Federal University of Piauí, Parnaíba, Brazil.,2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
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31
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Bekkers EMJ, Van Rossom S, Heremans E, Dockx K, Devan S, Verschueren SMP, Nieuwboer A. Adaptations to Postural Perturbations in Patients With Freezing of Gait. Front Neurol 2018; 9:540. [PMID: 30065694 PMCID: PMC6056632 DOI: 10.3389/fneur.2018.00540] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Freezing of gait (FOG) is a powerful determinant of falls in Parkinson's disease (PD). Automatic postural reactions serve as a protective strategy to prevent falling after perturbations. However, differences in automatic postural reactions between patients with and without FOG in response to perturbation are at present unclear. Therefore, the present study aimed to compare the response patterns and neuromuscular control between PD patients with and without FOG and healthy controls (HCs) after postural perturbations. Methods: 28 PD patients (15 FOG+, 13 FOG−) and 22 HCs were included. Participants stood on a moveable platform while random perturbations were imposed. The first anterior platform translation was retained for analysis. Center of pressure (CoP) and center of mass (CoM) trajectories and trunk, knee and ankle angles were compared between the three groups using the Statistical Parametric Mapping technique, allowing to capture changes in time. In addition, muscle activation of lower leg muscles was measured using EMG. Results: At baseline, FOG+ stood with more trunk flexion than HCs (p = 0.005), a result not found in FOG−. Following a perturbation, FOG+ reacted with increased trunk extension (p = 0.004) in comparison to HCs, a pattern not observed in FOG−. The CoM showed greater backward displacement in FOG− and FOG+ (p = 0.008, p = 0.027). Both FOG+ and FOG− showed increased co-activation of agonist and antagonist muscles compared to HCs (p = 0.010), with no differences between FOG+ and FOG−. Conclusions: Automatic postural reactions after a sudden perturbation are similar between PD subgroups with and without FOG but different from HCs. Reactive postural control, largely regulated by brain stem centers, seems to be modulated by different mechanisms than those governing freezing of gait. Greater differences in initial stance position, enhanced by joint stiffening, could however underlie maladaptive postural responses and increase susceptibility for balance loss in FOG+ compared to FOG−.
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Affiliation(s)
- Esther M J Bekkers
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Sam Van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Elke Heremans
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Kim Dockx
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Surendar Devan
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Sabine M P Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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32
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McKay JL, Lang KC, Ting LH, Hackney ME. Impaired set shifting is associated with previous falls in individuals with and without Parkinson's disease. Gait Posture 2018; 62:220-226. [PMID: 29571090 PMCID: PMC5960619 DOI: 10.1016/j.gaitpost.2018.02.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/11/2018] [Accepted: 02/22/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with Parkinson's disease (PD) are at increased risk for falls, which lead to substantial morbidity and mortality. Understanding the motor and non-motor impairments associated with falls in PD is critical to informing prevention strategies. In addition to motor symptoms, individuals with PD exhibit non-motor deficits, including impaired set shifting, an aspect of executive function related to cognitive flexibility that can be measured quickly with the Trailmaking Test. RESEARCH QUESTION To determine whether impaired set shifting is associated with fall history in people with and without PD. METHODS We examined associations between set shifting, PD status, and fall history (≥1 falls in the previous 6 months) in data from PD patients (n = 65) with and without freezing of gait (FOG) and community-dwelling neurologically-normal older adults (NON-PD) (n = 73) who had participated in our rehabilitation studies. RESULTS Impaired set shifting was associated with previous falls after controlling for age, sex, overall cognitive function, PD status, FOG, and PD disease duration (OR = 1.29 [1.03-1.60]; P = 0.02). Consistent with literature, PD and FOG were also independently associated with increased fall prevalence (PD OR = 4.15 [95% CI 1.65-10.44], P < 0.01; FOG OR = 3.63 [1.22-10.80], P = 0.02). Although the strongest associations between set shifting and falling were observed among PD without FOG (OR = 2.11) compared to HOA (OR = 1.14) and PD with FOG (OR = 1.46), no statistically-significant differences were observed across groups. SIGNIFICANCE Impaired set shifting is associated with previous falls in older adults with and without PD. Set shifting may be useful to include in fall risk assessments, particularly when global cognitive measures are within reference limits.
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Affiliation(s)
- J. Lucas McKay
- Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, Atlanta, GA, USA,Corresponding author: J. Lucas McKay, PhD MSCR, Room W-202, Health Sciences Research Building, 1760 Haygood Dr NE, Atlanta, GA 30322, , (404) 550-5157 (voice), (404) 727-9873 (fax)
| | - Kimberly C. Lang
- Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
| | - Lena H. Ting
- Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, Atlanta, GA, USA
| | - Madeleine E. Hackney
- Emory University School of Medicine, Department of Medicine, Atlanta, GA, USA,Atlanta VA Medical Center, Atlanta, GA, USA
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33
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Fullard ME, Thibault DP, Hill A, Fox J, Bhatti DE, Burack MA, Dahodwala N, Haberfeld E, Kern DS, Klepitskava OS, Urrea-Mendoza E, Myers P, Nutt J, Rafferty MR, Schwalb JM, Shulman LM, Willis AW. Utilization of rehabilitation therapy services in Parkinson disease in the United States. Neurology 2017; 89:1162-1169. [PMID: 28835397 PMCID: PMC5595277 DOI: 10.1212/wnl.0000000000004355] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/21/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine rehabilitation therapy utilization for Parkinson disease (PD). METHODS We identified 174,643 Medicare beneficiaries with a diagnosis of PD in 2007 and followed them through 2009. The main outcome measures were annual receipt of physical therapy (PT), occupational therapy (OT), or speech therapy (ST). RESULTS Outpatient rehabilitation fee-for-service use was low. In 2007, only 14.2% of individuals with PD had claims for PT or OT, and 14.6% for ST. Asian Americans were the highest users of PT/OT (18.4%) and ST (18.4%), followed by Caucasians (PT/OT 14.4%, ST 14.8%). African Americans had the lowest utilization (PT/OT 7.8%, ST 8.2%). Using logistic regression models that accounted for repeated measures, we found that African American patients (adjusted odds ratio [AOR] 0.63 for PT/OT, AOR 0.63 for ST) and Hispanic patients (AOR 0.97 for PT/OT, AOR 0.91 for ST) were less likely to have received therapies compared to Caucasian patients. Patients with PD with at least one neurologist visit per year were 43% more likely to have a claim for PT evaluation as compared to patients without neurologist care (AOR 1.43, 1.30-1.48), and this relationship was similar for OT evaluation, PT/OT treatment, and ST. Geographically, Western states had the greatest use of rehabilitation therapies, but provider supply did not correlate with utilization. CONCLUSIONS This claims-based analysis suggests that rehabilitation therapy utilization among older patients with PD in the United States is lower than reported for countries with comparable health care infrastructure. Neurologist care is associated with rehabilitation therapy use; provider supply is not.
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Affiliation(s)
- Michelle E Fullard
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore.
| | - Dylan P Thibault
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Andrew Hill
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Joellyn Fox
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Danish E Bhatti
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Michelle A Burack
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Nabila Dahodwala
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Elizabeth Haberfeld
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Drew S Kern
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Olga S Klepitskava
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Enrique Urrea-Mendoza
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Phillip Myers
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Jay Nutt
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Miriam R Rafferty
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Jason M Schwalb
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Lisa M Shulman
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
| | - Allison W Willis
- From the Departments of Neurology (M.E.F., D.P.T., A.H., N.D., A.W.W.) and Biostatistics and Epidemiology (D.P.T., A.H., A.W.W.), University of Pennsylvania School of Medicine; Dan Aaron Parkinson's Rehabilitation Center (J.F.), Leonard Davis Institute of Health Economics (A.W.W.), and Center for Clinical Epidemiology and Biostatistics (A.W.W.), University of Pennsylvania, Philadelphia; Department of Neurobiological Sciences (D.E.B.), University of Nebraska Medical Center, Omaha; Department of Neurology (M.A.B.), University of Rochester, NY; Department of Neurology (E.H.), Temple University, Philadelphia, PA; Department of Neurology (D.S.K., O.S.K.), University of Colorado, Aurora; Greenville Health System (E.-U.M.), SC; Parkinson's Disease Foundation Advocate Group (P.M.), Lakeport, CA; Department of Neurology (J.N.), Oregon Health Sciences University, Portland; Center for Education in Health Sciences (M.R.R.), Northwestern University, Evanston, IL; Department of Neurosurgery (J.M.S.), Henry Ford Medical Group, Detroit, MI; Department of Neurology (L.M.S.), University of Maryland School of Medicine, Baltimore
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Tillmann AC, Andrade A, Swarowsky A, Guimarães ACDA. Brazilian Samba Protocol for Individuals With Parkinson's Disease: A Clinical Non-Randomized Study. JMIR Res Protoc 2017; 6:e129. [PMID: 28676466 PMCID: PMC5516099 DOI: 10.2196/resprot.6489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/24/2016] [Accepted: 03/28/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the 10 most populated countries in the world, Parkinson's disease (PD) affects more than 5 million individuals. Despite optimal treatment options already developed for the disease, concomitant involvement of other areas of health care plays an important role in complementing the treatment. From this perspective, dancing can be viewed as a non-drug alternative that can reduce falls by improving some motor skills, such as mobility, balance, gait, and posture, and can also improve the overall quality of life. Brazilian samba promotes improvement in motor and non-motor symptoms in individuals with PD, providing a new treatment option for this population. OBJECTIVE The main objective of this quasi-experimental study is to provide a 12-week samba protocol (2x/week) for individuals with PD and to compare its effects with the group without intervention. The hypothesis is that the Brazilian samba protocol will promote improvement in primary (motor) and secondary (non-motor) outcomes in individuals with PD. METHODS The sample will be selected at random from individuals diagnosed with PD in the city of Florianopolis (SC, Brazil). Sample size calculation was performed with the G*Power 3.1.9.2 software, with 0.447 effect size, at 5% significance level, power of 0.9, and test and sample loss of 20%. This yielded 60 individuals divided between the intervention and control groups. The questionnaires will be filled out before and after the dance intervention. The data collection for the control group will be held simultaneously to the intervention group. The classes will last for 1 hour, twice a week in the evening for 12 weeks, and all classes will be divided into warm-up, main part, and relaxation. Two-way analysis of variance with repeated measures and Sidak post-hoc comparison test will be used for a comparative analysis of the final results of the control group with the experimental group and of the within-group changes between pre- and postintervention period. RESULTS We expect to complete follow-up in September 2017. CONCLUSIONS The major inspiration for this study was to encourage the creation of new rehabilitation programs that do not emphasize doctor involvement. This is a unique protocol for PD and we believe it can be an important tool to alleviate the motor and non-motor symptoms of individuals with PD. Dance is a simple activity depending on little equipment and few financial resources, facilitating its implementation and improving the cost-benefit relationship. In addition, activities that have a cultural aspect for the population in question, and which are pleasant, enable the participants to commit long term. This can enhance patient's compliance with the therapy, which is often a problem for many rehabilitation programs.
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Affiliation(s)
- Ana Cristina Tillmann
- Health Sciences Centre (CEFID), Research Laboratory in Leisure and Physical Activity (LAPLAF), University of Santa Catarina State, Florianópolis, Brazil
| | - Alexandro Andrade
- Health Sciences Centre (CEFID), University of Santa Catarina State, Florianopolis, Brazil
| | - Alessandra Swarowsky
- Health Sciences Centre (CEFID), University of Santa Catarina State, Florianopolis, Brazil
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Allen JL, McKay JL, Sawers A, Hackney ME, Ting LH. Increased neuromuscular consistency in gait and balance after partnered, dance-based rehabilitation in Parkinson's disease. J Neurophysiol 2017; 118:363-373. [PMID: 28381488 DOI: 10.1152/jn.00813.2016] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 03/07/2017] [Accepted: 04/05/2017] [Indexed: 11/22/2022] Open
Abstract
Here we examined changes in muscle coordination associated with improved motor performance after partnered, dance-based rehabilitation in individuals with mild to moderate idiopathic Parkinson's disease. Using motor module (a.k.a. muscle synergy) analysis, we identified changes in the modular control of overground walking and standing reactive balance that accompanied clinically meaningful improvements in behavioral measures of balance, gait, and disease symptoms after 3 wk of daily Adapted Tango classes. In contrast to previous studies that revealed a positive association between motor module number and motor performance, none of the six participants in this pilot study increased motor module number despite improvements in behavioral measures of balance and gait performance. Instead, motor modules were more consistently recruited and distinctly organized immediately after rehabilitation, suggesting more reliable motor output. Furthermore, the pool of motor modules shared between walking and reactive balance increased after rehabilitation, suggesting greater generalizability of motor module function across tasks. Our work is the first to show that motor module distinctness, consistency, and generalizability are more sensitive to improvements in gait and balance function after short-term rehabilitation than motor module number. Moreover, as similar differences in motor module distinctness, consistency, and generalizability have been demonstrated previously in healthy young adults with and without long-term motor training, our work suggests commonalities in the structure of muscle coordination associated with differences in motor performance across the spectrum from motor impairment to expertise.NEW & NOTEWORTHY We demonstrate changes in neuromuscular control of gait and balance in individuals with Parkinson's disease after short-term, dance-based rehabilitation. Our work is the first to show that motor module distinctness, consistency, and generalizability across gait and balance are more sensitive than motor module number to improvements in motor performance following short-term rehabilitation. Our results indicate commonalities in muscle coordination improvements associated with motor skill reacquisition due to rehabilitation and motor skill acquisition in healthy individuals.
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Affiliation(s)
- Jessica L Allen
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia
| | - J Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia
| | - Andrew Sawers
- Department of Kinesiology, University of Illinois at Chicago, Chicago, Illinois
| | - Madeleine E Hackney
- Atlanta Department of Veterans Affairs Center of Excellence for Visual and Neurocognitive Rehabilitation, Atlanta, Georgia.,Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; and
| | - Lena H Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia; .,Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia
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Godi M, Giardini M, Nardone A, Turcato AM, Caligari M, Pisano F, Schieppati M. Curved Walking Rehabilitation with a Rotating Treadmill in Patients with Parkinson's Disease: A Proof of Concept. Front Neurol 2017; 8:53. [PMID: 28293213 PMCID: PMC5329030 DOI: 10.3389/fneur.2017.00053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 12/20/2022] Open
Abstract
Training subjects to step-in-place eyes open on a rotating platform while maintaining a fixed body orientation in space [podokinetic stimulation (PKS)] produces a posteffect consisting in inadvertent turning around while stepping-in-place eyes closed [podokinetic after-rotation (PKAR)]. Since the rationale for rehabilitation of curved walking in Parkinson's disease is not fully known, we tested the hypothesis that repeated PKS favors the production of curved walking in these patients, who are uneasy with turning, even when straight walking is little affected. Fifteen patients participated in 10 training sessions distributed in 3 weeks. Both counterclockwise and clockwise PKS were randomly administered in each session. PKS velocity and duration were gradually increased over sessions. The velocity and duration of the following PKAR were assessed. All patients showed PKAR, which increased progressively in peak velocity and duration. In addition, before and at the end of the treatment, all patients walked overground along linear and circular trajectories. Post-training, the velocity of walking bouts increased, more so for the circular than the linear trajectory. Cadence was not affected. This study has shown that parkinsonian patients learn to produce turning while stepping when faced with appropriate training and that this capacity translates into improved overground curved walking.
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Affiliation(s)
- Marco Godi
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marica Giardini
- Department of Translational Medicine, University of Eastern Piedmont , Novara , Italy
| | - Antonio Nardone
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy; Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Laboratorio di Comunicazione e Domotica, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno, Veruno, Italy
| | - Anna Maria Turcato
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marco Caligari
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Laboratorio di Comunicazione e Domotica, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Fabrizio Pisano
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Neurological Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Centro Studi Attività Motorie, Pavia, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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