Regular physical exercise has been shown to improve quality of life for patients with Parkinson’s disease (PD), a degenerative disorder of the central nervous system that causes tremors and difficulty with movement and coordination. To encourage PD patients to incorporate physical activity into their weekly routines, the Arts in Medicine Programs at the University of Florida in 2009 partnered with the University of Florida Center for Movement Disorders and Neurorestoration to launch the Dance for Life program, which offers supervised dance classes for patients three times per week.
In 2008, Jill Sonke, assistant director of Shands Arts in Medicine and director of the UF Center for Arts in Medicine, saw a YouTube video featuring a dance program for Parkinson’s patients in Arizona. Sonke forwarded the video to colleagues in the UF Department of Neurology, and they decided the same day to institute the program for UF’s PD patients. Each of the partners was equally compelled, not only by the promising early research that was being conducted on dance and PD, but also by the joyfulness of the experience of dancing for people with PD.
For two afternoons, Sonke, neurology department clinicians, dance faculty and senior dance students collaborated in the dance studio to develop the program – the dancers taught the clinicians about dance, and the clinicians taught the dancers about Parkinson’s disease. Together, they created a format that would be the most useful and safe for the patients. The class structure includes exercises that address key goals for people with PD, including enhancing balance, grace, range of motion and strength. The class also includes hydration breaks, appropriate props such as chairs and ballet barres, and partner dancing to enhance social interaction.
Shands now holds three 75-minute dance classes per week, where patients – supervised by two instructors and dance majors from the university – do a seated warm-up in chairs before “barre work.” During the remainder of the class, patients learn a social dance, like the polka, American folk dance, a Latin dance or ballroom dance. “It’s a really serious dance class. We don’t dumb it down. We don’t make it simple,” Sonke says.
Overall, the program strives to:
- help PD patients achieve improvements in balance, mobility and coordination, posture, quickness and kinetic awareness;
- reduce depression, anxiety, isolation, fatigue, pain and constipation;
- enhance quality of life by providing regular social interaction with friends and family;
- increase motivation and self-confidence through goal-setting and periodic “performance;” and
- encourage engagement in dance as a lifestyle change by including significant others in weekly classes.
For patients, the positive effects often are visible. Sonke describes one patient who had pain and rigidity prior to starting the class, and couldn’t raise his arms above his shoulders. Within months, he had regained full range of motion in his arms.
The physical exercise isn’t the only element of the class that has benefited patients. “Social interaction is a big, big piece. They love the peer interaction and the relationships they develop with students,” Sonke says. “With Parkinson’s, so many people feel isolated. They stop participating in things because it takes so much effort to get out and move. [With the class], not only do they get so many benefits psychosocially, but they and their significant others have reported that since starting the class their engagement in other activities has increased as well.”
Because “the neurologists were adamant that [the class] be goal-oriented” to establish a consistent routine for patients, the class also includes a performance component. Typically, the class holds three performances per year, one of which usually is a social event (a barn dance, for example). All events are free and open to the public.
Program serves as foundation for research
In 2012, the Parkinson Research Foundation awarded the UF Center for the Arts in Medicine a grant to study the effect of dance on PD patients. UF staff conducted a qualitative pilot study with dance class participants in 2009 to better understand how the disease was affecting various areas of their lives. Participants then described the physical, cognitive, social and emotional impacts of joining the dance class.
The pilot study helped the Center develop its research agenda and garner a grant from the Parkinson Research Foundation to support a major study now being conducted in partnership with the University of Florida Center for Movement Disorders and Neurorestoration. The study’s general hypothesis is that dance, like aerobic activity, potentiates neuroplasticity, particularly in the frontal lobes and, thus, enhances behavioral measures of walking ability, balance, cognition and language production in people who participate in the Dance for Life program.
The University of Florida Center for Movement Disorders and Neurorestoration has a grant from the National Institutes on Aging to assess aerobic exercise and targeted balance exercise under this same hypothesis, and the grant funds have allowed the Center for Arts in Medicine to add a grant group to the larger study. According to Sonke, the study will be broader in scale than any other research currently available on how dance impacts Parkinson’s disease.
For more information on Shands HealthCare’s Dance for Life program, please contact:
Assistant Director, Shands Arts in Medicine
Director, Center for Arts in Medicine
University of Florida