Parkinson's Disease Motor Symptom Progression Slowed with Multisensory Dance Learning over 3-Years: A Preliminary Longitudinal Investigation

Abstract

Parkinson's disease (PD) is a neurodegenerative disease that has a fast progression of motor dysfunction within the first 5 years of diagnosis, showing an annual motor rate of decline of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) between 5.2 and 8.9 points. We aimed to determine both motor and non-motor PD symptom progression while participating in dance classes once per week over a period of three years. Longitudinal data was assessed for a total of 32 people with PD using MDS-UPDRS scores. Daily motor rate of decline was zero (slope = 0.000146) in PD-Dancers, indicating no motor impairment, whereas the PD-Reference group showed the expected motor decline across three years (p < 0.01). Similarly, non-motor aspects of daily living, motor experiences of daily living, and motor complications showed no significant decline. A significant group (PD-Dancers and PD-Reference) by days interaction showed that PD who train once per week have less motor impairment (M = 18.75) than PD-References who do not train (M = 24.61) over time (p < 0.05). Training is effective at slowing both motor and non-motor PD symptoms over three years as shown in decreased scores of the MDS-UPDRS.

Keywords: Parkinson’s disease; longitudinal; motor symptoms; multisensory therapy; neurorehabilitation.

Figure 1

Flow chart of enrolment.

Figure 2

Progression of Parkinson’s disease: PD-Dancer average slopes are indicated by blue color lines and all PD-Reference slopes are represented by black lines. (A) PD-Dancer (n = 16) scores for UPDRS part III (motor examination) across 3 years. Squares (circles) represent scores for males (females); dashed lines indicate participants ≤ 57 years of age at diagnosis, and solid lines indicate age of diagnosis at >57 years of age. Error bars represent the standard error across each experimenter (7–8) scoring for an individual testing session. Solid black line indicates average slope of 0.000146% rate of decline. (B) Matched PD-Reference (n = 16) scores for UPDRS part III (motor examination). Solid black line indicates average slope of 0.008% annual motor rate of decline. Same conventions as Figure 2A, except there are no error bars from UPDRS III data since it was rated by one Movement Disorder Society (MDS) experimenter. Only 3 years of data is displayed. (C) Baselined individual slopes for all 16 PD-Dancers and 16 PD-References sorted from largest to smallest slopes. ★ p < 0.05. (D) Summary of all UPDRS I–IV scores. Grey line indicates Jankovic and Kapadia (2001) [28] UPDRS III annual rate of decline.

Figure 3

Total annual rate of motor score (UPDRS III) progression across all groups and studies discussed in the text. Based on reported values with Jankovic and Kapadia (2001) [28] the annual rate of progression during the ON-state is quoted. Motor scores after (A) 1 year are plotted based on available data and (B) 5 years are projected for each group based on current slope measurements.