Comparing Dance and Physical Therapy for Balance in Parkinson's Disease: A Systematic Review

Summary of how dance interventions exceeded traditional PT in some aspects of balance and gait training

Introduction

Parkinson's disease (PD) significantly impacts balance, increasing the risk of falls. While traditional physical therapy is a recognized intervention, researchers are increasingly exploring alternative approaches like dance, which offers a unique blend of physical, cognitive, emotional, and social stimulation. This article summarizes a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of dance interventions compared to physical therapy or other control groups for improving balance control in individuals with PD.

Methodology

This systematic review and meta-analysis followed rigorous standards, including searching multiple databases for RCTs that evaluated dance interventions in adults with PD. The primary outcomes of interest included disease severity, gait, balance, cognition, and quality of life. A meta-analysis was performed to synthesize data, and the certainty of the evidence was assessed using the GRADE approach.

Results

The review included 20 RCTs with 723 participants, examining various dance styles. Compared to control groups (no dancing), dance interventions, particularly those lasting 12 weeks or longer, showed a medium effect size favoring dance for improving balance, as measured by the Berg Balance Scale. When comparing dance to physical therapy, specifically Irish dance was found to be associated with improvements in disease severity (as measured by the MDS-UPDRS-III), balance (Berg Balance Scale), and freezing of gait compared to physiotherapy. However, other studies did not show significant differences in gait or cognitive outcomes between dance and other exercise programs.

Discussion

The findings of this review suggest that dance, especially certain styles like Irish dance, may offer modest improvements in balance and motor function for individuals with PD compared to usual care or physical therapy. Dance incorporates rhythmic auditory stimulation and sensorimotor, cognitive, and emotional elements that may contribute to positive outcomes. The high adherence rates often reported with dance interventions could also contribute to their effectiveness. However, the low certainty of the evidence, due to factors like small sample sizes and potential for bias in the included studies, necessitates cautious interpretation of these results.

Conclusion

Based on the available evidence, dance interventions may offer benefits for improving balance in individuals with Parkinson's disease, particularly when certain dance styles and longer intervention durations are employed. Dance may be a promising complementary approach to traditional physical therapy, potentially offering advantages in terms of adherence and psychosocial benefits. However, further high-quality RCTs are needed to provide more definitive evidence on the optimal dance styles, intervention durations, and specific effects on balance and other outcomes in PD. The evidence should be considered in the context of individual patient preferences and safety when making recommendations for practice.

Reference

Ong, S. R., Lim, N. M., See, W. H. L., Ng, P. S. N. M., Chong, M. S., & Ong, T. (2021). Evidence of disease severity, cognitive and physical outcomes of dance interventions for persons with Parkinson’s Disease: a systematic review and meta-analysis. BMC Geriatrics.