Dancing with Parkinson's - an exploration of teaching and the impact on whole body coordination during turning

Parkinson’s is a common, progressive, neurodegenerative movement disorder of the central nervous system, presenting with particular impairment of the motor system. Despite a growing body of literature recommending the use of dance for the treatment and management of Parkinson’s, the exact impact and effect on turning ability has not been investigated. In addition, the experience of those teaching dance has also received little attention.The purpose of this research study was to explore the experience of teaching ballroom and Latin American dance classes for people with Parkinson’s (PwP) from a qualitative perspective alongside the main aim of investigating effects on turning in PwP from a quantitative perspective.Qualitatively, three dance teachers were approached to participate in semi-structured interviews before and after teaching dance classes for PwP over one year. A thematic analysis was undertaken using a framework approach, informed by the principles of Interpretative Phenomenological Analysis. Two dance teachers participated, with analysis generating four themes: 1) the role of adaptation, 2) the context and 3) practical application of the class and 4) how achievement was measured and the impact of the teacher.Quantitatively, twenty-four PwP were randomly allocated to receive either twenty, one-hour dancing classes over 10-weeks (n=12), or usual care (n=12). Using 3-dimensional movement analysis before and after the intervention period, measures of latency and horizontal movement of the eyes, head, thorax, shoulders, pelvis and feet, centre of mass displacement, and the total time of a 180 degree on-the-spot turn were taken alongside clinical measures.Statistical analysis (4-way ANOVA) demonstrated a significant four-way interaction for head latency (p=0.008), with mean values showing longer latency in the usual care. Similar trends were also shown in pelvis latency (p=0.077), first (p=0.063) and second (p=0.081) foot latency, with mean values suggesting longer pelvis latency and slower foot movement in the usual care group, although all results were affected by prediction and preference of turn direction. Significant between-group differences were also found for pelvis rotation (p=0.036), with the usual care group showing greater rotation. No differences were found in the centre of mass displacement, turn time or clinical measures. As a result of interpretation the main findings suggest a tighter coupling and greater co-ordination of all segments following dance.In conclusion, teachers’ expectations and experiences suggest a multidimensional impact of dance for PwP with importance of socialisation, increased confidence, level of achievement and participation, knowledge of which will support the development of dance classes for PwP.Specifically, body segments (head, pelvis and feet) appear more coordinated in time and sequence following dance in PwP, suggesting a more ‘en bloc’ turning pattern with greater inter-segmental coordination. However, this is influenced by direction of turn preference and prediction, with further research required to comment on the clinical implications