Aug. 11, 2021 -- When J.M. Tolani was diagnosed with Parkinson’s disease at the age of 49, he was devastated.
“I felt as though I had been hit by a truck. Everything felt like it came to a standstill. My life was altogether changed,” he tells WebMD.
Originally a photojournalist, Tolani was no longer able to travel the world carrying heavy equipment and had to give up the profession he loved, which contributed to his emotional struggle.
Then he discovered dancing, which was recommended by a member of a support group he was attending. He began taking classes with Dance for PD, a specialized dance program for people with Parkinson’s disease, their families, friends, and care partners.
“I found I could move, and the dancing seemed to provide a replacement for the dopamine I lost in the brain. Dancing motivates me and makes me happy, flexible, and mobile,” Tolani says.
The benefits Tolani receives from dancing have been corroborated by a substantial body of scientific research, most recently a study that showed that patients with mild to moderate Parkinson’s slowed the progression of their disease by participating in dance training with music for an hour and a quarter per week.
“The classes were very beneficial for these individuals with PD, and we know that dance activates brain areas, even in people without PD,” senior investigator Joseph DeSouza, PhD, an associate professor in the Department of Psychology at York University in Toronto, tells WebMD.
Less Motor and Non-Motor Impairment
The researchers aimed to determine if the progression could be slowed or halted if people took part in dance classes. So, they followed 11 men and five women, with an average age of 69 years, who had mild to moderate Parkinson’s over a 3-year period. Dance participants were compared to 16 people with Parkinson’s who did not take dance classes. Participants had an average disease duration of about 5½ years -- when people are particularly vulnerable to rapid symptom decline.
“None of the participants had been dancers before, and all were pretty early in their disease,” DeSouza says.
Classes were offered through a program called Dance for Parkinson’s Canada, which is part of Dance for PD, a program based in New York City that offers classes in more than 300 communities and 25 countries around the world through its affiliates.
The classes studied by DeSouza and his colleague Karolina Bearss, a PhD candidate in the Department of Psychology at York University, consisted of live music during a seated warmup, followed by work on the barre and movement across the floor.
In a news release, Bearss described dance as “complex” and a “multisensory environment” that differs from ordinary exercise.
“It incorporates and stimulates your auditory, tactile, visual, and kinesthetic senses and adds an interactive social aspect,” she said.
The researchers recorded videos of the participants. They also used the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) to assess and track participants’ motor and non-motor symptoms of Parkinson’s disease and also the Leisure Time Activity subsection of another rating scale called the Physical Activity Scale for the Elderly (PASE).
The dancers had an overall slower annual rate of change in motor scores. And when measured on a day basis, the dancers had less motor impairment than the non-dancers (average MDS-UPDRS score of 18.75, vs. 24.61, respectively).
Dancers also showed no non-motor impairment across time in aspects of daily living, compared to the non-dancers.
To date, most research investigating progression of Parkinson’s symptoms has looked at the difference between a baseline score and the last score in various measures. This is the first study to follow people with the disease over a 3-year period during weekly dance classes.
DeSouza says this “provides additional information regarding the nature of progression of both motor and non-motor PD symptoms.”
Dance Is a Full-Brain Experience
Founded in 2001, Dance for PD was a joint project of the Mark Morris Dance Group and the Brooklyn Parkinson Group and is now fully run by the Mark Morris Dance Group, says David Leventhal, who is the program director.
Leventhal, who had been a professional dancer with the Mark Morris Dance Group, says he was “interested in the power of dance to inspire and transform the experience of people who had not danced before, which was the vast majority of this particular group.” When he transitioned from performing to full-time teaching, he knew that he “wanted to commit energy and time to working with people with Parkinson’s and sharing what we had learned with teaching artists around the world.”
Leventhal says the principle behind Dance for PD is that professionally trained dancers are actually movement experts, and their knowledge about balance, sequencing, rhythm, and esthetic awareness is useful to people who have Parkinson’s. Classes use movement from a wide variety of dance styles, including modern, ballet, tap, folkloric, social dancing, traditional, and choreographic repertory, which can “engage participants’ minds and bodies and create an enjoyable, social environment for artistic exploration.”
DeSouza, who attends classes with the subjects in his study, says that as a scientist, one has to “watch and observe,” and he began attending classes to “learn and watch them” and now finds them “fun and enjoyable.” When he was on leave from work with his third child, he even brought his new baby to class as well.
It is “important for the brain to learn something new, especially when you have Parkinson’s, and what I learned from my friends in the class is that they continually pushed themselves to learn new things, both in dance and in general,” DeSouza says.
Leventhal says he’s noticed that those who take his Dance for PD classes “over time become better dancers, have better rhythm, are able to learn material more efficiently, sequence movements more fluidly and with more ease, and, in general, be more confident in their performance of specific motor tasks.”
“What is wonderful about the study is that Dr. DeSouza, as a neuroscientist, is interested not only in motor but also in non-motor aspects of dance, like social interaction, cognitive effects, and social and emotional aspects of the class, because all of those are in the brain as well. Dance is not just a physical experience, but a full-brain experience,” he says.
Taking Dance a Step Further
Pamela Quinn, a professional dancer and Parkinson’s coach, tells WebMD that when she was diagnosed with the disease in her 40s, she thought it was the end of dancing.
“But dance became my savior, not something that needed to be discarded, and the reason is that it’s physical and social and, together with music, has the power to change one’s mood. And this unusual array of elements is particularly suited to help people with Parkinson’s,” she says.
When she was first diagnosed, she wanted to have a second child and was “determined to find non-chemical ways of improving my gait, balance, and postures.” She began to discover “cues, external prompts that facilitate movement, which are naturally embedded in the dance form.”
When the iPod was developed, it allowed Quinn to “take dance experience and integrate it into everyday life.” With that, she was not only dancing in a studio; whenever she was walking and wearing headphones, she was “reinforcing good movement patterns with music.”
Quinn, who today takes medication and continues to dance, says she is an “outlier” in terms of Parkinson’s disease progression.
“I’ve had this disease for over 25 years, and I’m doing fairly well, which I attribute to the dance background and also integrating these techniques into everyday life so it’s not just once a week in a dance class setting,” she says.
Quinn calls her program the PD Movement Lab.
“A lab is a setting where people experiment, and in this lab, I experiment with techniques that help people move. So, it is more of a functional class than a traditional dance class in that it bridges the world between what dance can do in the studio and what it can help people do in everyday life.”
Online Classes Are Safe
Quinn’s classes were originally offered at the Mark Morris Dance Studio in Brooklyn, NY, with the support of Dance for PD as well as the Jewish Community Center in Manhattan. But since the start of the COVID-19 pandemic, classes have been offered virtually. The Dance for PD classes are also offered virtually and can safely be adapted for the home environment.
“In-person classes usually have volunteers as well as the instructor, so that if a participant is known to have balance issues, the volunteer is close behind them and dancing with them. If they lose balance, they can easily be assisted to a chair. So, the caveat is if you are taking classes at home, always remain within your comfort zone and stay seated if you have to,” DeSouza advises.
Quinn says it can be helpful to ask someone else to assist you or, if you feel safe, to hold onto the back of a chair or table, but it’s also OK to be seated. The dance moves “can be adjusted to suit the individual needs of people.”
Leventhal says the Dance for PD online classes have been very helpful, even though they lack certain elements that in-person classes have, particularly the sense of touch and in-person connection. Nevertheless, the online classes incorporate social interaction and breakout rooms, which have increased the sense of socializing within a community. Dance for PD plans to continue with a “hybrid model” of in-person and online classes, because online classes are much more accessible for people with Parkinson’s disease, who often have challenges getting out of the house and accessing transportation.
The social factor is key, Quinn emphasizes.
“It’s not as important if your stride is 2 inches longer or if you can get up out of a chair in one action, but what’s more important is that your life is fulfilled in some meaningful way. That’s why the social aspect is so critical -- because it’s part of the happiness factor.”
“Health is not just the ability to move, but also the ability to think and love and be loved and laugh and have empathy and interact with the world,” Quinn says.
She notes that one of the main non-motor symptoms of Parkinson’s is anxiety, which “keeps people indoors and isolated, and isolation is one of the worst things for anyone. If you don’t feel good about how you look, you don’t want to go outside. You need to have a way to interact with other people and be with others who accept you for who you are -- with all your quirks, tics, curvatures, or whatever else you might have.”
Tolani, who says he continues to do photography, agrees.
“I take three to four classes a week, and they allow me to get out and meet people and interact with them. They put me in a good, positive state of mind,” he says. “I wake up and look forward to enjoying myself, and dancing with others in the Parkinson’s community, where I feel I’m allowed to completely be myself.”