Abstract

Dance therapy can improve motor skills, balance, posture, and gait in people diagnosed with Parkinson’s disease (PD) and healthy older adults (OA). It is not clear how specific movement patterns during dance promote these benefits. The purpose of this cohort study was to identify differences and complexity in dance movement patterns among different dance styles for PD and OA participants in community dance programs using approximate entropy (ApEn) analysis. The hypothesis was that PD participants will show greater ApEn during dance than OA participants and that the unique dance style of tango with more pronounced foot technique and sharp direction changes will show greater ApEn than smoother dance types such as foxtrot and waltz characterized by gradual changes in direction and gliding movement with rise and fall. Individuals participated in one-hour community dance classes. Movement data were captured using porTable 3D motion capture sensors attached to the arms, torso and legs. Classes were also video recorded to assist in analyzing the dance steps. Movement patterns were captured and ApEn was calculated to quantify the complexity of movements. Participants with PD had greater ApEn in right knee flexion during dance movements than left knee flexion (p = 0.02), greater ApEn of right than left hip flexion (p = 0.05), and greater left hip rotation than right (p = 0.03). There was no significant difference in ApEn of body movements (p > 0.4) or mean body movements (p > 0.3) at any body-segment in OA. ApEn analysis is valuable for quantifying the degree of control and predictability of dance movements and could be used as another tool to assess the movement control of dancers and aid in the development of dance therapies.

Highlights

  • Introduction published maps and institutional affilParkinson’s disease (PD) is a chronic condition marked by the degeneration of dopaminergic motor neurons in the substantia nigra pars compacta of the midbrain [1,2]

  • The goal of this study was to demonstrate a protocol for studying differences in biomechanical movements of PD and older adults (OA) that may provide a basis for the design of dance programs targeted at improving the motor skills of participants with PD and healthy older adults

  • Institutional approvals, preparation and equipment calibration; Solicitation of PD and OA dance volunteers at the dance site; Acquisition of dynamic data during dance; Data validation and time-based correlation with video captured during class; Extraction of statistically relevant movement features for PD and OA participants; Identification of significant movement features related to motor skill performance; Establishment of a framework to define future movement patterns that will improve critical movement features to optimize motor skill performance

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Summary

Introduction

Parkinson’s disease (PD) is a chronic condition marked by the degeneration of dopaminergic motor neurons in the substantia nigra pars compacta of the midbrain [1,2]. The resulting dopamine deficiency leads to the identifiable motor symptoms of PD including slow movement (bradykinesia), tremors at rest, and rigidity of the upper and lower limbs [2]. Over two thirds of individuals with PD see loss of some autonomic nervous system control [5]. By the time motor symptoms are identifiable, up to 70% of dopaminergic neurons in the substantia nigra have degenerated [6]. There were approximately 680,000 individuals aged 45+ in the US afflicted with PD in 2010 and this is projected to rise to 1,238,000 by 2030 [7]

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