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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how partnered dance aerobic exercise (PDAE), inspired by Argentine tango, can benefit people with Parkinson's disease (PD) by reducing "OFF-time" (periods when medications aren't effective) and enhancing cognitive abilities. Researchers compare PDAE to regular walking aerobic exercise (WAE) to determine which is more effective. The goal is to discover if these physical activities can protect brain cells and improve mobility and cognitive function in people with PD. Individuals who have PD, experience OFF-time, and find symptom relief from medication might be suitable for this trial. Participants should feel comfortable with exercise and be willing to be randomly assigned to either the dance or walking group. As an unphased trial, this study provides a unique opportunity to explore innovative exercise methods that could enhance the quality of life for those with PD.

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 prior data suggests that this partnered dance aerobic exercise is safe for people with Parkinson's disease?

Research shows that partnered dance aerobic exercise (PDAE) is generally well-tolerated by people with Parkinson's disease. Studies have found that PDAE can reduce "OFF-time," when medications are less effective, and improve movement and cognitive skills, such as spatial awareness.

Walking aerobic exercise (WAE), used for comparison, provides a similar amount of exercise and interaction. Both exercises occur in a safe and socially engaging environment, ensuring participant safety.

Overall, aerobic exercises like PDAE and WAE are considered safe and beneficial for people with Parkinson's, with no major negative effects reported in existing studies. This suggests they are viable options for managing Parkinson's symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores partnered dance aerobics as a novel way to help people with Parkinson's disease. Unlike standard treatments that often focus on medication or physical therapy, this method uses adapted Argentine tango to improve motor skills through dance. Participants learn to interpret motor goals through touch and music, which could enhance muscle memory and movement coordination. This socially engaging and interactive approach is expected to offer not just physical benefits but also boost mood and cognitive function, making it a distinctive alternative to typical exercise routines.

What evidence suggests that this trial's treatments could be effective for Parkinson's disease?

Research has shown that Partnered Dance Aerobic Exercise (PDAE), a treatment in this trial, can help people with Parkinson's disease by reducing OFF-time, when medications aren't effective. One study found that PDAE decreases OFF-time, as measured by a special scale used by movement disorder experts. This exercise improves balance, mobility, and cognitive skills. Studies have demonstrated that PDAE increases activity in brain areas involved in decision-making and thought processes. People with Parkinson's disease have experienced better spatial cognition, meaning they can better understand and remember their surroundings. This suggests PDAE might also help protect brain cells, although this has not been confirmed yet. ^{2 3 5 6 7}

Who Is on the Research Team?

Madeleine E. Hackney, PhD

Principal Investigator

Atlanta VA Medical and Rehab Center, Decatur, GA

Are You a Good Fit for This Trial?

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 for a Trial Participant

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)

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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]

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]

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 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 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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2900796/

Effects of Dance on Gait and Balance in Parkinson Disease Partnered tango dance can improve balance and gait in individuals with Parkinson disease (PD). Partnered dance may allow individuals with PD to challenge ...

2. medrxiv.org medrxiv.org/content/10.1101/2025.07.17.25331727.full.pdf

Three Months of Partnered Dance Aerobic Exercise ... An adapted form of the Argentine tango (adapted tango) has also proven to be beneficial for adults with PD, improving mobility and decreasing ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7581698/

Rationale and Design of the PAIRED Trial: Partnered Dance ... Our data suggest that partnered dance aerobic exercise (PDAE) reduces OFF-time on the Movement Disorders Society Unified Parkinson Disease Rating Scale-IV (MDS- ...

4. nature.com nature.com/articles/s41598-024-62786-6

Tango and physiotherapy interventions in Parkinson's ... We found a general stabilization of motor and cognitive abilities, with significant improvements in several motor skills, mainly pertaining to static and ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0965229908001441

Short duration, intensive tango dancing for Parkinson ... The goal of this pilot study was to determine the effects of short duration, intensive tango lessons on functional mobility in people with Parkinson disease ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT04122690

NCT04122690 | Partnered Dance Aerobic Exercise as a ... 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 ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3864026/

The Effects of Adapted Tango on Spatial Cognition and ... This study determined effects of community-based adapted tango upon spatial cognition and disease severity in Parkinson's disease (PD)