Hackney, M. E., Kantorovich, S., Levin, R., & Gammon, M. (2007). Effects of tango on functional mobility in Parkinson's disease: A preliminary study. Journal of Neurologic Physical Therapy, 31(4), 173-179.
Purpose:
Recent evidence suggests that dance (or movement therapy) can be an effective therapeutic intervention targeting balance and complex gait tasks in elderly individuals. Subjectively, dance appears to be an appropriate and pleasurable therapeutic activity physically, mentally, and emotionally. The purpose of this study was to compare the effects of two movement programs (tango and exercise) in participants with Parkinson's disease (PD).
Participants:
Nineteen subjects diagnosed with idiopathic PD participated in this study.
Method:
Subjects were randomly assigned to one of two groups: tango or exercise. Those in the tango group participated in 20 1-hour progressive Argentine tango dance lessons with a partner for 13 weeks. These lessons included postural stretches, balance exercises, tango-style walking, footwork patterns, and experimentation with timing of steps to music, both with and without a partner. Those in the exercise group participated in structured strength/flexibility exercise classes designed for people with PD and/or elderly individuals for 13 weeks, as well. During the first 40 minutes of the class, participants were seated and performed breathing and stretching exercises, progressing to resistance and dexterity exercises. Participants would then exercise for 10 minutes while standing, using the chair for support. During the last 10 minutes of class, students performed core strengthening and stretching exercises using floor mats (modified in a chair if necessary).
Subjects were assessed prior to the intervention and again the week following the 20th training session. Subjects were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS), Motor Subscale 3. Balance was evaluated using the Berg Balance Scale. Gait velocity was assessed while walking straight along a 5-meter path with and without a concurrent dual task. Mobility was assessed with the Timed Up and Go (TUG). For the gait tasks and the TUG, subjects performed five trials of each task and results were averaged. Subjects also completed a Freezing of Gait questionnaire, a six-item self-report questionnaire in which each item is answered on a 0-to-4 scale.
Results:
There were no significant differences between the tango and exercise groups at baseline on all measures. After 20 sessions, both the tango and exercise groups significantly improved on motor subscale 3 of the UPDRS. The tango group, but not the exercise group, improved on the Berg Balance Scale. There was no significant change in perception of freezing for either the tango or the exercise group; however, both groups showed trends toward a reduction in reported freezing. There were no significant main effects for the TUG; however, those in the tango group showed a trend toward improvement in the TUG test while those in the exercise group did not. Both groups showed slight, non-significant changes in gait velocity and also showed virtually no change in dual-task walking velocity.
Discussion:
Those who participated in the Argentine tango dance group improved on measures of balance and mobility. Those who participated in the exercise class experienced fewer gains. This may reflect the fact that exercises, for most of the class, were performed from a seated position. These preliminary results suggest that the tango is feasible for individuals with PD and may be an appropriate and effective form of group exercise for individuals with PD. Exercise may also provide benefits, though functional mobility changes were less evident in the exercise group than in the tango group. Future studies with larger sample sizes are needed to verify and expand on the observation that tango may be an effective therapeutic intervention to target balance and functional mobility in individuals with PD.