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AAN: Tango Dancing for Parkinson's Classy, Fun, and Effective

Patients with Parkinson's Disease enrolled in a Tango dance program improved mobility and balance scores.

By John Gever, MedPage Today

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WEDNESDAY, March 20, 2013 (MedPage Today) —Learning to dance the tango helped patients with Parkinson's disease regain mobility and spatial cognition in a controlled trial — and they liked it, a researcher said here.

Significant improvements were seen in Unified Parkinson's Disease Rating Scale (UPDRS) motor symptom scores and performance in several tests of balance and spatial cognition after 30 hours of tango lessons, compared with a control group participating in an education program of similar duration, said Kathleen E. McKee, a fourth-year medical student at Emory University in Atlanta.

The benefits were still evident months after the training ended, and none of the 24 patients assigned to the trial's tango arm dropped out, McKee said during her presentation at the American Academy of Neurology meeting.

Numerous exercise programs have been devised for Parkinson's disease patients, whose progressive motor and cognition deficits hinder their mobility and increase their risk of falling. However, accessibility and patient acceptance have often been less than ideal.

McKee said that tango dancing was chosen because it involves rhythms that are relatively easy to learn and requires moderate athleticism that would be feasible for a relatively high-functioning Parkinson's disease population.

The trial assigned 24 patients to 20 tango lessons adapted for moderately mobility-impaired individuals. Lessons were 90 minutes long and given over 12 weeks. Patients were evaluated with eight standard instruments for assessing motor skills, balance, and cognition, as well as fall incidence, satisfaction, and overall health and quality of life.

Nine patients were assigned to a patient-centered education program on Parkinson's disease management. McKee said participants worked in pairs during these sessions — because "it takes two to tango," the investigators believed it was important to mirror the partner aspect in the control intervention.

Patients in both groups were evaluated at baseline, after the last training session, and 10 to 12 weeks later.

All but one of the control group were men, whereas the tango group was evenly divided between men and women. Mean age was 74 in the control group and 68 in the tango group. Disease duration was 7 years in both arms.

Mean UPDRS motor scores were 27 and 28 in the control and tango groups, respectively. One-third of both groups showed freezing of gait and just over half had fallen at least once in the previous year.

In the tango group, UPDRS motor scores fell significantly between baseline and the end of training, whereas scores rose significantly in the control group, such that nearly five points separated the groups, McKee reported. The difference was maintained during the post-training follow-up period.

Scores on the Fullerton Advanced Balance Scale increased in both groups, but significantly only in the tango group. These improvements faded somewhat in both groups by the final follow-up, although slightly more so in the control group.

And spatial cognition as evaluated with the Brooks Spatial Task improved significantly in the tango group whereas there was no change in the control group with training. During the follow-up period, performance worsened in the control group but was maintained in the tango group.

Scores on other measures either did not differ significantly between the treatment groups or showed changes that were of marginal clinical relevance.

McKee noted that falls during the tango training were rare, with two participants falling without injury during a total of 48 classes.

And a questionnaire at follow-up that asked participants about their attitudes toward the interventions were overwhelmingly positive about tango versus largely neutral toward the education program.

Nearly all patients in the tango group gave high ratings on "enjoyment" and most indicated that they perceived improvement in balance, walking ability, coordination, endurance, mood, and other outcomes. A large majority indicated they would continue with the dancing if given the opportunity.

In the control group, most also said they enjoyed it and would continue it, but did not report improvements in physical abilities or mood. However, most did indicate that their mental abilities were better than before.






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AAN: Tango Dancing for Parkinsons Classy, Fun, and Effective
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