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Italian neurologist finds Irish Set Dancing helps Parkinson’s patients

set dancing parkinson

Dr Daniele Volpe set dancing in Feakle, Co Clare

Irish Set Dancing can be more beneficial than standard physiotherapy, particularly in dealing with symptoms such as Freezing Gait, Balance & Motor Disability, according to research by Dr Daniele Volpe, Parkinson’s Rehabilitation Unit ,St. John of God Hospital, Venice.

Italian neurologist Dr Daniele Volpe heads the Parkinson’s Rehabilitation unit at the St. John of God hospital in Venice. He also happens to be a musician who loves Irish traditional music and he visits Ireland frequently to play traditional music.

While on holidays in Feakle, Co Clare Dr Volpe was playing with a traditional band in a local pub when he noticed a man with Parkinson’s enter the pub. Later in the evening, a set dance began and Dr Volpe was amazed to see that not only was one of the set dancers the man with Parkinson’s but that this man, who had earlier walked very unsteadily, needed no assistance to dance.

Not only did he not require assistance, he danced smoothly and effortlessly, showing no trace of his Parkinsons. Dr Volpe was curious and watched the movements. He noticed a particular leg movement and asked his band member what it was. They explained that it was called the “Reel step.”

According to a report on Irish Central:

Dr. Volpe made an important observation. For many with Parkinson’s, posterior-anterior advancement of the lower limb during the swing phase of the gait’s cycle is compromised. Yet, the Reel Step enabled a dancer with Parkinson’s to override the neurological impediments that affect the gait.

As he thought about the Reel Step, he noted that Irish Set Dance is patterned, but steps are not overly repetitious. Execution of the pattern requires the dancer to change direction frequently. Directional change plus the need to maintain reasonably consistent step lengths require the dancer to be in a state of constantly transferring weight from one leg to the other. The overall effect is a remarkable improvement.

But why? The answer may be the music. The strong upbeat rhythmic pattern of an Irish reel or jig may provide the brain with periodic acoustic cues that somehow enable it to by pass transmission dysfunctionalities in the Basal Ganglia (BG) and in the SMA (Supplementary Motor Area) networks.

In 2013 Dr.Volpe hosted a conference on set dancing for Parkinson’s. Please see the video below, which is an October 2014 interview with Dr Volpe.

On his return to Italy, Dr Volpe undertook research which proved the physical benefits.

The Study

Twenty-four people with idiopathic Parkinson’s Disease (PD) referred for movement rehabilitation were randomized to receive standard physiotherapy exercises or Irish set dancing classes once per week plus a weekly home program for 6 months (12 in each group). The feasibility and safety of the proposed RCT protocol was the main focus of this evaluation.

Participants in the Irish set dancing group received a 90 minute set dancing class weekly for six months in a dance studio located in Venice. The dance classes were held by two set dancing teachers of the Blacksheep Irish Set Dancing School in Venice, Italy. People with PD were partnered with members of the Irish set dancing school to ensure their safety. Family members were also invited to assist or partner the people with PD.

The Irish set dancing class included a preliminary warm up consisting of range of movement, balance and postural exercises. The goal of the warm up was to prepare people with PD for the set dancing class focusing on steps, turning, balance and posture. The class used different set dancing steps and in particular reel and polka steps. The teachers taught sets, in group formation, in four pairs of two. They were taught sets from different counties of Ireland and in particular the Corofin plain reel set, the Antrim reel set, the Black Valley Jig square, and the Durrow Threshing polka set. The sets were chosen to improve motor symptoms in Parkinson’s disease such as balance impairment, freezing of gait and hypokinesia using Irish music as a rhythmical cue.

Each class ended with a group dance in a circle and then with relaxation exercises. The protocol incorporated 10 minutes of warm up range of movement, balance and postural exercises, 70 minutes of Irish dance lessons and a 10 minutes cool down. Each person with PD was also given a video with recordings of the steps danced by the teacher. They were requested to watch the video at home once during each week, for a period of 1 hour.

The weekly standard physiotherapy exercise sessions included individual sessions delivered by a physiotherapist or physiotherapy assistant designed to improve muscle strength, mobility, balance, and postural control. The physiotherapy program was in according to the KNGF Guidelines for physical therapy in Parkinson’s disease as described below. For each session each person had warm up range of movement and stretching exercises for 10 minutes followed by 50 minutes of strength training, balance training and postural re- education, then 20 minutes of gait training and a 10 minute cool down.

Each person with PD was given a video with recordings of the physiotherapy exercises. They were requested to watch the video at home once during each week, for a period of 1 hour. Over the six month intervention period, participants had on average 21.08 individual sessions of physiotherapy and 21.83 dance classes.

The primary outcome was motor disability measured by the motor component of the UPDRS, which was assessed prior to and after therapy by trained assessors blinded to group assignment. The Timed Up and Go, the Berg Balance Scale and the modified Freezing of Gait Questionnaire were secondary measures. Quality of life of the people with PD was evaluated using the PDQ-39.

Results:

Both the Irish set dancing and physiotherapy exercise program were shown to be feasible and safe. There were no differences between groups in the rate of adverse events such as falls, serious injuries, death or rates of admission to hospital. The physiotherapists who provided usual care remained blind to group allocation, with no change in their standard clinical practice.

Compliance and adherence to both the exercise and dance programs were very high and attrition rates were low over the 6 months of therapy.

Although improvements were made in both groups, the dance group showed superior results to standard physiotherapy in relation to freezing of gait, balance and motor disability.

Next steps..

The study concludes that Irish set dancing appears to be safe, simple, and enjoyable with the potential to improve mobility, reduce disability and enhance health related quality of life. As a preliminary investigation to provide data to show that a larger trial would be safe and feasible, the study authors  feel that a large trial is now needed to ascertain the effectiveness of Irish set dancing compared with routine physiotherapy exercises over the long term.

Video of Set Dancing in action from the 2014 International Parkinson’s Empowerment Summit 2014 

 

References:

Volpe, D et al (2013) A comparison of Irish set dancing and exercises for people with Parkinson’s disease: a phase II feasibility study. BMC Geriatr. 2013 Jun 4;13:54. doi: 10.1186/1471-2318-13-54. http://www.ncbi.nlm.nih.gov/pubmed/23731986

Irish Central.com Italian doctor finds cure for Parkinson’s Disease in Irish dancing

Move4Parkinsons.com http://www.move4parkinsons.com/our-activities/set-dancing/

 

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