Efficacy of a slow waltz-based program on gait and balance problems in parkinson’s disease.

INTRODUCTION: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor impairments such as tremor, rigidity, bradykinesia and postural instability which significantly impair daily functioning and quality of life1. While pharmacological treatments primarily address motor symptoms, non-pharmacological therapies like exercise have gained recognition for their potential to improve motor function, mobility and mental health2. Among various form of physical activities, studies reported that dance positively influences motor functions in Parkinson’s disease3. The primary aim of this study was to examine whether an adapted waltz-based program could improve gait and balance in patients with PD. METHODS: The project involved 12 subjects (age 72±9 yrs; MMSE score ≥24; H&Y stages 1-4; ability to stand unaided). Participants attended 8 sessions of slow waltz and basic technique exercises at home for 8 weeks. Assessments were conducted at the beginning (T0) and at the end of the program (T1) using Body Sway test, Gait analysis, Stepping in place and Timed Up and Go (TUG) tests. RESULTS: Data are expressed as median and interquartile range (IQR) and compared using Mann-Whitney test in 9 out of 12 participants. Results showed that Mean distance A/P (T0:3,9±5 vs T1:3,4±3,4 mm), Mean distance M/L (T0:1,5±1 vs T1:0,8±0,8 mm) and Area (T0:158,8±349 vs T1:82,7±109,1 mm2) in Body sway test with opened feet improved during the 8 weeks. The same trend was shown with closed feet in Mean distance A/P (T0:5,3±2 vs T1:4,8±2,1 mm), Mean distance M/L (T0:4,8±3 vs T1:2,6±3,8 mm) and Area (T0:755±646 vs T1:271,8±476,1 mm2). Parameters of Gait analysis showed an enhancement in Stride time (T0:1,5±0 vs T1:1±0,2 s), Cadence (T0:0,9±1 vs T1:1±0,1 steps/sec), and Velocity (T0:1±0 vs T1:1,1±0,4 m/s), while Stride length (T0:123,4±31 vs T1:113,8±12,1 cm, p=0,001) decreased. Stepping in place test revealed significant improvements in A/P Displacement (T0:1,5±1 vs T1:0,4±1,5 cm, p=0,0077) as well as improvements in R/L Displacement (T0:-0,2±1 vs T1:0,1±0,5 cm) and Area (T0:10,7±9 vs T1:9±10,2 cm2). Lastly, significant positive shifts in performance were observed in the TUG as indicated by the reduced task completion time (T0:13,4±8 vs T1:8,6±2,1 s, p=0,0051) and the increased score in the assessment of biomechanical strategies tool (T0:43±2 vs T1:44±2 score, p=0,018). CONCLUSION: The data are highly encouraging, indicating that a slow waltz-based program can improve gait and balance in patients with PD. However, a longer experimental period should likely lead to even more marked improvements. References: 1Kalia LV. Lancet. 2015 Aug 29;386(9996):896-912. 2Goodwin VA. Mov Disord. 2008 Apr 15;23(5):631-40. 3Hackney ME. Neurorehabil Neural Repair. 2010 May;24(4):384-92.