Dance Aerobics for Parkinson's Disease

(PDAE in PD Trial)

Overseen By Laura Britan Lang, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Must be taking: Antiparkinsonian medications

Must not be taking: Antipsychotics, Beta-blockers

Disqualifiers: Major depression, Stroke, Cardiac disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 16 months

82 Participants Needed

Trial Summary

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify if you need to stop taking your current medications. However, you must show clear symptomatic benefit from antiparkinsonian medications to participate, and you cannot be taking moderate to high doses of beta-blockers with a resting heart rate below 60 beats/min.

Do I need to stop my current medications for the trial?

The trial protocol does not specify if you need to stop your current medications. However, you must show clear benefits from your current Parkinson's medications to participate.

What data supports the idea that Dance Aerobics for Parkinson's Disease is an effective treatment?

The available research shows that Dance Aerobics for Parkinson's Disease can be an effective treatment. One study found that participating in a 2-year community-based dance class helped improve disease severity and mobility in people with Parkinson's. Another study compared Brazilian dance styles like Samba and Forró to walking and found that dance could be more effective in improving movement and walking patterns. Additionally, a program involving Argentine tango increased activity participation among individuals with Parkinson's. These studies suggest that dance can be a beneficial alternative to other exercises for managing symptoms of Parkinson's Disease. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Partnered Dance Aerobic Exercise for Parkinson's Disease?

Research shows that community-based dance programs, like Argentine tango and Brazilian rhythmic dance, can improve functional mobility and increase activity participation in people with Parkinson's disease. These studies suggest that dance, as a form of aerobic exercise, may help manage symptoms and enhance quality of life for those with Parkinson's. ^{1 2 3 4 5}

What safety data exists for dance aerobics in Parkinson's treatment?

The provided research does not directly address safety data for dance aerobics or related exercise programs in Parkinson's treatment. However, studies like those on Zumba Gold® and Brazilian rhythmic dance suggest that dance-based exercises are being explored for their feasibility and effects on Parkinson's patients, indicating ongoing research into their safety and benefits. ^{1 2 4 6 7}

Is dance aerobics safe for people with Parkinson's disease?

The research does not provide specific safety data for dance aerobics in Parkinson's disease, but it suggests that physical exercise, including dance, is generally beneficial and often recommended for people with Parkinson's disease. ^{1 2 4 6 7}

Is Partnered Dance Aerobic Exercise a promising treatment for Parkinson's Disease?

Yes, Partnered Dance Aerobic Exercise is a promising treatment for Parkinson's Disease. Studies show that dance can improve balance, walking ability, and activity levels in people with Parkinson's. Dance programs, like those inspired by Samba and Forró, have shown positive effects on movement and mobility. Additionally, dance is engaging and can help people stick with their exercise routine, which is important for long-term benefits. ^{1 2 6 8 9}

How is the treatment Partnered Dance Aerobic Exercise (PDAE) unique for Parkinson's disease?

Partnered Dance Aerobic Exercise (PDAE) is unique for Parkinson's disease as it combines physical activity with social interaction, which can improve balance, gait, and activity levels. Unlike traditional exercise, it incorporates music and rhythm, making it more engaging and potentially improving adherence to the exercise routine. ^{1 2 6 8 9}

What is the purpose of this trial?

Parkinson's disease (PD) is a difficult to treat condition that impairs mobility and thinking. It is not fully treated by drugs and surgery. Two priority issues for most people with PD are "OFF-time" and Cognitive impairment. Even under best medical management, 74% of people with PD experience "OFF-time," which is when medications are just not working right. OFF-time severely impacts both quality of life and thinking. Cognitive problems are found even in newly diagnosed people with PD and are very difficult to treat. However, the investigators' research has shown that partnered dance-aerobic exercise (PDAE) reduces OFF-time on the official test for OFF-time of the Movement Disorders Society, the Movement Disorders Society Unified Parkinson Disease Rating Scale-IV, (MDS-UPDRS-IV). PDAE improves other symptoms too. Benefits of the therapy have lasted for at least one-month after PDAE sessions stopped. PDAE provides aerobic exercise during an improvisational, cognitively-engaging physical activity. Cognitive engagement is a critical component of PDAE. Previous research showed PDAE improved spatial cognition, the ability to navigate, to mentally picture shapes and paths in the mind and to know the relationships between objects, people and places. Also, the investigators showed with imaging of the brain using a magnet in a scanner that twice weekly PDAE training increases activity in brain regions used in thinking and decision making. The investigators know that exercise benefits mobility and cognitive problems. The investigators even think exercise might protect brain cells in people with PD. But no one has really been able to show with biomarkers that exercise is protective of brain cells in humans.

Research Team

Madeleine E. Hackney, PhD

Principal Investigator

Atlanta VA Medical and Rehab Center, Decatur, GA

Eligibility Criteria

This trial is for people over 40 with Parkinson's Disease who can walk at least 10 feet, have mild cognitive impairment or better, and experience 'OFF-time' when their medication isn't effective. They must see benefits from Parkinson's medications and speak English well. Excluded are those with major depression, brain injuries, severe hearing loss, past PDAE/WAE class attendance, alcohol abuse, plans to move away soon, MRI contraindications like claustrophobia or metal implants.

Inclusion Criteria

I am fluent in English and can understand and participate fully.

I can walk at least 10 feet, with or without help like a cane.

I am over 40 years old.

Exclusion Criteria

You have previously taken part in PDAE or WAE classes.

Lives outside of the study site or is planning to move out of the area in next year or leave the area for >1 month during the next year

Any contraindications to MRI (e.g. claustrophobia, etc)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in either Partnered Dance Aerobic Exercise (PDAE) or Walking Aerobic Exercise (WAE) for 16 months. The first 3 months involve twice-weekly sessions, followed by once-weekly sessions for the remaining 13 months.

16 months

Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of OFF-time, cognitive tests, and brain imaging.

4 weeks

2 visits (in-person)

Treatment Details

Interventions

• Partnered Dance Aerobic Exercise
• WAE

Trial Overview The study tests whether Partnered Dance Aerobic Exercise (PDAE) can protect the brain and improve movement and thinking in Parkinson’s patients compared to Walking Aerobic Exercise (WAE). It looks at how these exercises affect 'OFF-time', cognition by using a special brain scan called an MRI to measure changes in brain activity related to exercise.

Participant Groups

Group I: Partnered Dance Aerobic Exercise Experimental Treatment 1 Intervention

Partnered Dance-Aerobic Exercise (PDAE) is an adapted form of Argentine tango, aka Adapted tango. Participants with PD will dance the follower role only and will dance with new partners (individuals without PD) every 15-20 minutes, a widely practiced method considered by the dance teaching community to enhance learning. Participants will engage in partnering exercises on how to interpret motor goals through touch, exercises to develop understanding of temporal relationship of movement to music, novel step introduction, connecting previously learned and novel step elements. Frequent repetition and musical stereotypes may foster implicit learning or muscle memory (i.e., motor learning, or procedural memory that involves consolidating a specific motor task into memory through repetition). Participants will not be required to memorize specific step patterns but will learn new steps in each class

Group II: Walking Aerobic Exercise Active Control 1 Intervention

Walking Aerobic Exercise (WAE) Participants in WAE will receive equivalent dose, volume, frequency, intensity and duration of exercise to the PDAE group. The investigators will receive equal contact and monitoring from study staff. WAE participants will report to the same facility and interact with the same interventionist and assistants. The investigators will participate in sessions focused on at least 60 minutes of walking with breaks ad libitum, and 1/2 hour balance and stretching. The investigators have a designated, safe and non-cluttered area for walking. WAE will also take place in groups, with research volunteers and assistants to ensure that PDAE and WAE participants both receive a socially engaging intervention.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A 12-week Brazilian dance program significantly improved functional mobility in patients with Parkinson's disease, showing similar benefits to a walking program, as measured by the timed-up-and-go test.

The dance group specifically increased their stride frequency during self-selected walking speed, indicating that dance may enhance certain gait parameters in addition to overall mobility improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can Samba and Forró Brazilian rhythmic dance be more effective than walking in improving functional mobility and spatiotemporal gait parameters in patients with Parkinson's disease? Dos Santos Delabary, M., Monteiro, EP., Donida, RG., et al.[2020]

Zumba Gold(®) is a safe and enjoyable exercise option for individuals with mild-to-moderate Parkinson's Disease (PD), with a high retention rate of 73% and compliance rate of 81% among the 11 participants aged 64 on average.

Participants showed improvements in activity levels over the six sessions, and 38% continued attending Zumba Gold(®) classes in the community afterward, indicating its potential as a sustainable physical activity for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The potential benefits of Zumba Gold(®) in people with mild-to-moderate Parkinson's: Feasibility and effects of dance styles and number of sessions. Delextrat, A., Bateman, J., Esser, P., et al.[2017]

A 2-year community-based Argentine tango dance class significantly improved motor and nonmotor symptoms in individuals with Parkinson disease, as evidenced by lower scores on the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) compared to a control group.

The study highlights the potential of dance as a therapeutic intervention for enhancing functional mobility and balance in Parkinson disease patients, especially since the control group showed a decline in some measures over the same period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Are the effects of community-based dance on Parkinson disease severity, balance, and functional mobility reduced with time? A 2-year prospective pilot study. Duncan, RP., Earhart, GM.[2022]

A survey of 64 Parkinson's Disease patients revealed that 67% exercised at least twice a week, with walking being the most common form of exercise, and 97% reported improvements in their symptoms due to exercise.

Patients who exercised in groups experienced greater symptomatic improvements compared to those who exercised alone, highlighting the potential added benefits of social interaction and cognitive engagement in group activities like dance therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-Reported Exercise Trends in Parkinson's Disease Patients. Raje, P., Ning, S., Branson, C., et al.[2019]

A 12-month community-based tango dance program significantly increased activity participation among individuals with Parkinson's disease, with participants showing higher engagement in activities at 3, 6, and 12 months compared to their baseline levels.

Participants in the tango group not only retained more activities lost since the onset of Parkinson's disease (increasing from 77% to 90%), but also gained new social activities, suggesting that dance can enhance both participation and quality of life for those with PD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson's disease. Foster, ER., Golden, L., Duncan, RP., et al.[2022]

Individuals with Parkinson disease (PD) who take at least 4200 steps daily are significantly more likely to meet physical activity guidelines, being 23 times more likely than those who take fewer steps.

High-intensity treadmill exercise effectively increases daily steps and moderate-to-vigorous physical activity in less active individuals with PD, but these increases do not correlate with improvements in fitness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity. Handlery, R., Stewart, JC., Pellegrini, C., et al.[2021]

A review of seven studies indicates that physical exercise significantly improves physical performance and activities of daily living in patients with Parkinson's disease, including enhancements in strength, balance, and mobility.

The findings suggest a need for standardized exercise programs tailored to Parkinson's disease and longer-term studies to evaluate the sustainability of these improvements beyond the intervention period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is physical exercise beneficial for persons with Parkinson's disease? Crizzle, AM., Newhouse, IJ.[2006]

A dance exercise program using the video game 'Dance Dance Revolution' (DDR) was found to be enjoyable and easy to use for 16 participants with mild to moderate Parkinson's disease, potentially improving their adherence to physical activity.

Participants reported benefits such as improved balance and coordination, indicating that DDR could effectively incorporate key physical therapy recommendations for Parkinson's disease, warranting further research in a larger study.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of a Videogame-Based Dance Exercise Program Among Individuals with Parkinson's Disease. Natbony, LR., Zimmer, A., Ivanco, LS., et al.[2021]

This study aims to assess the feasibility of a larger trial evaluating the benefits of dance for people with Parkinson's disease, involving 50 participants who will be randomized to either a dance intervention or usual care.

The research will explore not only the physical benefits, such as balance and spinal posture, but also the personal experiences of participants, which could provide valuable insights for future dance programs tailored for individuals with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A design to investigate the feasibility and effects of partnered ballroom dancing on people with Parkinson disease: randomized controlled trial protocol. Ashburn, A., Roberts, L., Pickering, R., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Can Samba and Forró Brazilian rhythmic dance be more effective than walking in improving functional mobility and spatiotemporal gait parameters in patients with Parkinson's disease? [2020]

2. Scotland pubmed.ncbi.nlm.nih.gov

The potential benefits of Zumba Gold(®) in people with mild-to-moderate Parkinson's: Feasibility and effects of dance styles and number of sessions. [2017]

3. United States pubmed.ncbi.nlm.nih.gov

Are the effects of community-based dance on Parkinson disease severity, balance, and functional mobility reduced with time? A 2-year prospective pilot study. [2022]

4. Scotland pubmed.ncbi.nlm.nih.gov

Self-Reported Exercise Trends in Parkinson's Disease Patients. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson's disease. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Is physical exercise beneficial for persons with Parkinson's disease? [2006]

8. United States pubmed.ncbi.nlm.nih.gov

Perceptions of a Videogame-Based Dance Exercise Program Among Individuals with Parkinson's Disease. [2021]

9. Canada pubmed.ncbi.nlm.nih.gov

A design to investigate the feasibility and effects of partnered ballroom dancing on people with Parkinson disease: randomized controlled trial protocol. [2022]