Feasibility of a Brazilian samba protocol for patients with Parkinson's disease: a clinical non-randomized study

The effect of dance on mental health and quality of life of people with Parkinson's disease: A systematic review and three-level meta-analysis

OBJECTIVES

Parkinson's disease (PD) is a neurodegenerative disease that affects millions of individuals worldwide. Dance has emerged as a comprehensive intervention for enhancing well-being in this population. This meta-analysis aimed to assess the effectiveness of dance on mental health and quality of life among individuals with PD.

METHODS

Three databases were searched in December 2022. Research papers comparing the effects of dance with a non-dance control on the quality of life or mental health of individuals with PD were included. Two authors independently screened the studies, extracted data, and assessed methodological quality of eligible studies. To address the interdependence of effect sizes within studies, the three-level meta-analysis approach was employed to analyze the data.

RESULTS

Thirteen trials involving a total of 496 participants were included, with 11 being subjected to statistical analysis. The results indicated that dance had a positive impact on mental health (g = 0.43, 95 % CI = [0.11, 0.75]) and quality of life (g = 0.46, 95 % CI = [-0.04, 0.95]) when compared to passive control groups. Moderator analyses revealed that non-partnered dance and dance interventions with lower total dosages were particularly beneficial for mental health.

CONCLUSION

Dance interventions are an effective lifestyle activity for enhancing mental health and quality of life in individuals with PD. A theoretical framework is proposed to explain the impact of dance on well-being from neurological, social, physical, and psychological perspectives.

Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis

INTRODUCTION

Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence.

METHODS

Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE.

RESULTS

Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls.

CONCLUSIONS

There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found.

PROSPERO REGISTRATION

CRD42022382908.

The effects of Brazilian dance, deep-water exercise and nordic walking, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD

BACKGROUND

Motor and non-motor symptoms affect functional autonomy, mobility and daily life activities in People with Parkinson's Disease (PwPD). Brazilian Dance (BD), Deep-water exercise (DWE), and Nordic Walking (NW) are well-accepted, low-cost, and safe non-pharmacological strategies for untrained PwPD. However, no previous studies have investigated and compared the effects of these interventions on trained PwPD.

OBJECTIVE

To describe and compare the effects of BD, DWE and NW, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD.

METHODS

Eighty-three trained PwPD were randomly assigned into three groups: BD (n = 31), DWE (n = 21) and NW (n = 31), that participated in one of the interventions for 12 weeks. We applied Timed up and go at two speeds (self-selected and fast); 6-min and 10-meter walk test; Sit-to-Stand and handgrip test; Unified Parkinson Disease Rating Scale - III; Falls Efficacy Scale; Montreal Cognitive Assessment questionnaire; and Parkinson's Disease Questionnaire-39. The main (group and time) and interaction effects were analyzed using GEE analysis (p<0.05).

RESULTS

Statistical differences were found between groups in the handgrip test (p<0.01), the time (p = 0.04), and interaction group*time (p< 0.01) in the Sit-to-stand test. While BD improved the Sit-to-stand test performance (ES=1.00; large effect size), DWE and NW remained unchanged (ES=0.16 and ES=0.14; low effect size).

CONCLUSION

BD, DWE, and NW maintained most of the functional-motor and non-motor symptoms in trained PwPD. BD was shown to be more effective at improving strength in the lower limbs, when compared to NW and DWE.

Exercise Made Accessible: the Merits of Community-Based Programs for Persons with Parkinson's Disease

PURPOSE OF REVIEW

Many studies have identified positive effects of physiotherapy and exercise for persons with Parkinson's disease (PD). Most work has thus far focused on the therapeutic modality of exercise as used within physiotherapy programs. Stimulated by these positive findings, there is now a strong move to take exercise out of the clinical setting and to deliver the interventions in the community. Although the goals and effects of many such community-based exercise programs overlap with those of physiotherapy, it has also become more clear that both exercise modalities also differ in various ways. Here, we aim to comprehensively review the evidence for community-based exercise in PD.

RECENT FINDINGS

Many different types of community-based exercise for people with PD are emerging and they are increasingly being studied. There is a great heterogeneity considering the types of exercise, study designs, and outcome measures used in research on this subject. While this review is positive regarding the feasibility and potential effects of community-based exercise, it is also evident that the general quality of these studies needs improvement. By focusing on community-based exercise, we hope to generate more knowledge on the effects of a wide range of different exercise modalities that can be beneficial for people with PD. This knowledge may help people with PD to select the type and setting of exercise activity that matches best with their personal abilities and preferences. As such, these insights will contribute to an improved self-management of PD.

A meta-analysis of exercise intervention and the effect on Parkinson's Disease symptoms

Parkinson's disease (PD) is a progressive neurodegenerative disease that is distinguished by tremors at rest, bradykinesia, hypokinesia, and postural instability, resulting in a progressive decline in performance of everyday activities. The non-motor symptoms that occur can include pain, depression, cognitive dysfunction, sleep issues, and anxiety (among others). Functionality is tremendously impaired by physical as well as non-motor symptoms. Recent treatment has begun to incorporate non-conventional interventions that are more functional and tailored to the patients with PD. The purpose of this meta-analysis was to determine the effectiveness of exercise interventions at alleviating PD symptoms, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS). Additionally, this review qualitatively explored whether endurance-based or non-endurance based exercise interventions were more beneficial at alleviating PD symptoms. Two reviewers screened the title and abstract records (n = 668) found in the initial search. Subsequently the reviewers completed full-text screening of the remaining articles for inclusion.. Following this, a total of 25 articles were considered to be eligible and included in the review and data was extracted for meta-analysis. The interventions lasted from 4 to 26 weeks. Results indicated a positive overall effect of therapeutic exercise on patients with PD, where the overall d-index was 0.155. Qualitatively no difference was observed between aerobic and non-aerobic forms of exercise.

Effects of a structured dance program in Parkinson's disease. A Greek pilot study

INTRODUCTION

Dance for Parkinson's Disease® (DfPD®) is a structured dance program that has never been evaluated in Greek PD population. This study assesses for the first time the efficacy, safety and feasibility of DfPD® program in Greek PD patients.

MATERIAL AND METHODS

A total of 16 early-to-mid-stage PD patients (50% men, aged 56 ± 12) underwent a total of 16 60-min classes of adjusted to Greek music and dance culture DfPD®, twice weekly, over 8 weeks. Assessments were performed at baseline and at the end of the study period and included quality of life (PDQ-8), depressive symptoms (BDI-II), fatigue (PFS-16), cognitive functions (MoCA), balance (BBS) and body mass index (BMI). Safety (possible falls, injuries, muscle soreness or excessive fatigue) and feasibility (technical and financial parameters, willingness for participation and continuation, recruitment rates) were also assessed.

RESULTS

Statistically significant improvements were found in quality of life (29 ± 47%, p = 0,020), depressive symptoms (26 ± 52%, p = 0,046), fatigue (13 ± 20%, p = 0,021), cognitive functions (17 ± 23%, p = 0,010), balance (5 ± 4%, p = 0,003) and BMI (2 ± 2%, p = 0,010). No adverse events, high adherence (93,75%) and low attrition (12,5%) rates were reported.

CONCLUSION

A twice weekly 60-min DfPD® class for 8 weeks is a safe and feasible non-pharmacological complementary therapeutic intervention for Greek PD patients and may improve their quality of life, depressive symptoms, fatigue, cognitive functions, balance, and BMI. Further research on this intervention is warranted.

Eficacia de los programas de musicoterapia: un metanálisis cualitativo

Resumen El aumento de enfermedades transmisibles justifica la necesidad de verificar la eficacia no farmacológica de los tratamientos alternativos. La música promueve las interacciones sociales y el trabajo en grupo, ayuda en varios aspectos del aprendizaje humano, la emoción y la memoria, y puede convertirse en una herramienta terapéutica complementaria. El objetivo de este estudio fue analizar la evidencia de la eficacia de la musicoterapia como tratamiento no farmacológico mediante un diseño descriptivo retrospectivo utilizando como parámetros de búsqueda: “musicoterapia” o “programas musicales” y “salud” en las bases de datos Scopus y Web of Science. Entre los principales resultados, destacamos que los programas de intervención que utilizan la música como tratamiento coadyuvante no farmacológico en enfermedades no transmisibles ofrecen resultados positivos y significativos sobre la mejora de las patologías en las que interviene. A partir de estos resultados, sería importante ampliar la formación de los profesionales de la salud en la aplicación de técnicas basadas en el arte y específicamente en la musicoterapia.