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Effectiveness of a dance-physiotherapy combined intervention in Parkinson’s disease: a randomized controlled pilot trial

Neurological Sciences volume 42, pages 5045–5053 (2021)Cite this article

Abstract

Background

Physical therapies have been recommended as crucial components in Parkinson’s disease (PD) rehabilitation.

Objective

The study aims to examine the effectiveness of a new dance-physiotherapy combined intervention, called DArT method, in mild PD patients.

Methods

A prospective, randomized, single-blind, controlled pilot trial was conducted on 38 mild PD patients under dopaminergic therapy. The intervention consisted in an add-on protocol: the control group received 1 h of conventional physiotherapy followed by 1 h of conventional physiotherapy each day, 3 times a week, for 5 weeks. The experimental group received 1 h of conventional physiotherapy followed by 1 h of dance class each day, 3 times a week, for 5 weeks. The week before and after the training period, patients were assessed for motor, cognitive, emotional, and sensory components of PD, with MDS-UPDRS-III as primary outcome measure.

Results

DArT method was associated with a 2.72-point reduction in the post-treatment MDS-UPDRS-III total score compared to control group (95% CI − 5.28, − 0.16, p = 0.038, d = 0.71), and with a 2.16-point reduction in the post-treatment MDS-UPDRS-III upper body subscore (95% CI − 3.56, − 0.76, p = 0.003, d = 1.02). Conversely, conventional physiotherapy program was associated with a 2.95-point reduction in the post-treatment trait anxiety compared to the experimental group (95% CI 0.19, 5.71, p = 0.037, d = 0.70). Withdrawal and fall rates were equal to 0% in both groups.

Conclusion

DArT method showed to be safe, well accepted, and more effective than an intensive program of conventional physiotherapy in improving motor impairment in mild PD.

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Fig. 1

Data Availability

The data that support the findings of this study are available on request from the corresponding author (Frisaldi Elisa).

Code availability (software application or custom code)

Not applicable.

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Acknowledgements

We would like to acknowledge the Direction, health workers, and staff of the San Camillo Hospital (Turin, Italy) for the expertise, administrative and technical supports, gyms, and equipment made available for the whole study period; all patients for their time, enthusiasm, and commitment to this research; Jan Vollert, from the Imperial College of London, for his assistance in statistical analysis; and Vanessa Maher, Honorary Professor in Cultural Anthropology at the University of Verona and native-English speaker, for valuable editing the description of DArT method.

Funding

This study was supported by grants from Innovative Clinical Trainings, Trials & Healthcare Worldwide Initiative (Italy/Switzerland, grant number KCL-001) to Fabrizio Benedetti; the Ministry of Education, University and Research (MIUR) under the program “Dipartimenti di Eccellenza ex L. 232/2016” to the Department of Surgical Sciences of the University of Turin; and the Opera San Camillo Foundation, Milan, Italy.

Author information

Authors and Affiliations

  1. Rita Levi-Montalcini Department of Neuroscience, University of Turin Medical School, corso Raffaello 30, 10125, Turin, Italy

    Elisa Frisaldi, Diletta Barbiani & Fabrizio Benedetti

  2. Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Turin, Italy

    Piero Bottino, Marco Trucco, Alessandra De Ceglia, Nadia Esposito, Cristina Destefanis & Edoardo Milano

  3. Rita Levi-Montalcini Department of Neuroscience and Regional Reference Center of Movement Disorders, University of Turin Medical School, Turin, Italy

    Margherita Fabbri, Maurizio Zibetti & Leonardo Lopiano

  4. Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park/FCRIN Network and Neuro Toul COEN Centre; Toulouse University Hospital; INSERM; University of Toulouse 3, Toulouse, France

    Margherita Fabbri

  5. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy

    Eleonora Maria Camerone

  6. Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy

    Federico Costa & Giuseppe Massazza

  7. Medicine and Physiology of Hypoxia, Plateau Rosà, Switzerland

    Fabrizio Benedetti

Authors
  1. Elisa Frisaldi
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  2. Piero Bottino
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  3. Margherita Fabbri
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  4. Marco Trucco
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  5. Alessandra De Ceglia
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  6. Nadia Esposito
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  7. Diletta Barbiani
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  8. Eleonora Maria Camerone
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  9. Federico Costa
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  10. Cristina Destefanis
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  11. Edoardo Milano
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  12. Giuseppe Massazza
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  13. Maurizio Zibetti
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  14. Leonardo Lopiano
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  15. Fabrizio Benedetti
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Contributions

Design: Benedetti, Frisaldi, Lopiano, Zibetti, Massazza, Milano, Bottino, Trucco. Execution and data collection: Frisaldi (dance classes), Bottino (recruitments, reading and signing of the informed consent, reference doctor for the enrolled patients), De Ceglia (second hours of physiotherapy classes), Esposito (first hours of physiotherapy classes), Fabbri (recruitment and first assessor), Zibetti (recruitment and second assessor), Barbiani (first assessor), Camerone (first assessor), Costa (first assessor), Destefanis (recruitment). Statistical analysis: Frisaldi. Manuscript: Frisaldi (first draft); Frisaldi, Trucco, De Ceglia (supplementary material); all co-authors (review and critique).

Corresponding author

Correspondence to Elisa Frisaldi.

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Ethics approval

The study was approved by the local Ethics Committee (CS2/472) and conducted in agreement with the Declaration of Helsinki Ethical Principles.

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All subjects provided written informed consent.

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The authors declare that they have no conflict of interest.

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Frisaldi, E., Bottino, P., Fabbri, M. et al. Effectiveness of a dance-physiotherapy combined intervention in Parkinson’s disease: a randomized controlled pilot trial. Neurol Sci 42, 5045–5053 (2021). https://doi.org/10.1007/s10072-021-05171-9

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  • DOI: https://doi.org/10.1007/s10072-021-05171-9

Keywords

  • Parkinson’s disease
  • Rehabilitation
  • Physiotherapy
  • Dance
  • Motor impairment
  • Mind-body