Title: Dancing with Parkinson's disease (PD): feasibility randomised controlled trial (RC)
Funder: Department of Health (England)

Abstract: Background People with PD (PwPD) frequently experience deterioration of spinal posture, mobility and stability, leading to dependency and falls. Preventing the cycle of inactivity and secondary complications is a priority. There is growing evidence of the benefits of exercise for PwPD but research into the benefits of long-term exercises through leisure pursuits such as dance and self-help activities is very limited. People with PD are interested in dance but research has been restricted to small studies predominantly in the USA. Early findings suggest a positive effect on balance and gait. Components of dance reflect aspects of physiotherapy for PwPD e.g. rotational movements of the head and trunk, lower limb movements and stepping to rhythmical external cues i.e. music. Aims Our aim is to determine the methodological feasibility of evaluating the benefits of dance as a precursor to a future phase III trial. We have built on the proof of principle studies from the USA and address gaps in knowledge impacting on spinal posture, long-term follow up, economic evaluation and user views. We will test the feasibility of our primary comparison, balance control and spinal posture at 3 and 6 months post randomisation, and justify a future sample size. Our secondary outcomes include self-reported measures of PD-specific health status, balance confidence and measures of turning and walking. The study will provide a novel insight into user involvement in dance through a qualitative component and the development of procedures for economic evaluation in a future trial. Plan of Investigation Fifty PwPD (mild to moderate) will be randomised to the control group (usual care) or dance plus usual care. Dance will be taught by professional teachers in a local Dance Centre. Each participant will have a dance partner. A blinded assessor will complete clinical measures of physical function mid-medication cycle and self-reported ability at baseline, 3 and 6 months post randomisation. Balance and spinal posture are primary comparisons. A qualitative component will focus on personal experiences and insights of a sub-group of participants and partners. The researcher will explore views about appropriateness and acceptability of the interventions, physical outcome and trial procedures. Procedures for an economic evaluation of dance for health care will be developed for a phase III trial. Potential Impact PD is a common, progressive neurological condition estimated to affect 100-180 per 100,000 of the population and characterised by deteriorating movement disorders and postural responses over time. Long-term physical interventions are not widely available on the NHS due to limited resources, in particular access to physiotherapy. Self-help and physical leisure activities become increasingly important in the maintenance of safe functional mobility. The evidence base on dance in PD is small; initial proof of principle studies from the USA have demonstrated the beneficial effects on balance control, gait and activity levels but there has been no research into the long-term effects, cost effectiveness, the influence on spinal posture, turning or the personal insights of participants.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;6.7 PHYSICAL
Health categories: NEUROLOGICAL