Improvisational Dance for Parkinson Disease

The long-term goal of this work is to maintain or improve daily function of people with PD by addressing cognition. The overall objective is to discover interventions that aid in cognitive functioning. The central hypothesis is that engagement in an improvisational dance (ID) class will benefit cognition among people with PD. Improvisational dance involves spontaneously generated movement, similar to how one moves in everyday life. The literature shows that ID classes positively impact motor impairments associated with PD, such as balance, gait, and functional mobility. Along with being physically demanding, ID requires the use and coordination of a number of cognitive capacities to properly execute movements. This type of activity challenges, and thus may strengthen, cognitive processes such as motor planning, decision making, flexible thinking, initiation, and execution, which may give people cognitive based strategies to be utilized in various aspects of daily life. By improving motor function and/or cognition, ID may also contribute to improved daily functioning, or the ability to perform and participate in daily activities. Despite these theoretical links, evidence for the effect of ID on cognition and overall daily function is limited. The current project objective is to address this gap and better understand the effects of ID for people with PD. Specifically, it will test the effect of IMPROVment®, a method of ID designed for people with PD, on cognition and daily function.

Participants' cognition will be assessed at baseline (T1) using the NIH Toolbox Cognitive Battery, the Alternate Uses Task, and the Weekly Calendar Planning Activity. Global cognition will be assessed using the Montreal Cognitive Assessment. They then will be randomly assigned to either the immediate intervention (ID) or waitlist-control (WC) group. The ID group will start the 12-week IMPROVment® intervention, which consists of weekly ID classes that progress according to a standardized method while the WC group will receive no intervention and continue with their regular daily routine and activity level. After 12 weeks, both groups will complete cognitive testing again (T2). Cognitive test scores will be compared across time points and between groups using a mixed model repeated measures ANOVA. The investigators hypothesize that IMPROVment® will have positive effects on the cognitive abilities of people with PD. Participants will also complete two questionnaires to assess daily function at T1 and T2: Older Americans Resources and Services Scale- Extended Version and PROMIS Satisfaction with Participation in Discretionary Social Activities. These scores will be compared similar to the above aim. The investigators hypothesize that IMPROVment® will have positive effects on daily function in people with PD.

Participant mood will be assessed in two different ways. The first being to investigate the immediate effect of participating in an IMPROVment® class on mood, fatigue, and anxiety. The investigators hypothesize that mood will positively improve from pre to post of each class. To assess this, participants will respond to a scale assessing mood, specifically sadness, nervousness, energy, and overall well-being before and after each class every week. The second measurement is to investigate the effect of IMPROVment® on anxiety, fatigue, and depression. The investigators hypothesize that IMPROVment® class will decrease feelings of depression for those with PD. All participants will fill out the Parkinson's Anxiety Scale, the Parkinson's Disease Fatigue Scale, and the Geriatric Depression Scale short form before and after participating in the 12-week IMPROVment® program.

Achievement of these aims will provide further support for the IMPROVment® method for people with PD experiencing cognitive deficits. The long-term impact will better cognition and daily functioning in people with PD, and thus enhanced everyday lives.


Eligibility Criteria:
Inclusion Criteria:

* aged 50 years or older
* Parkinson Disease Diagnosis
* Hoehn-Yahr score between 1-3
* independently walk at least 3 meters
* cognitive ability to follow simple commands

Exclusion Criteria:

* Montreal Cognitive Assessment score less than or equal to 22
* diagnosis of other severe comorbidities
* contraindications to physical activity