Dancing with Parkinson's disease: a qualitative exploration of the views and experience of participants in a feasibility study

Abstract

Background: There is growing evidence of the benefits of balance training exercise for people with Parkinson's [PwP] but outcomes of long-term exercise through self-help and leisure activities such as dance are less well-researched. Purpose: This qualitative exploration is one component of a study to determine the feasibility of conducting a phase III trial to evaluate the benefits of dance among PwP. Its inclusion has permitted novel examination of participants’ views about the appropriateness of dance as an intervention for PwP. Methods: The two-arm feasibility randomised controlled trial comprised 35 PwP who participated in one-hour dance classes, twice a week for 10 weeks, and 15 PwP who did not undertake the classes. Fourteen of the 35 participants in the dance group were interviewed within a month of completing the dance programme, in which 3 ballroom and 3 Latin American dances were taught by professional teachers in a dance centre. Their dance partners: spouse, friend or a volunteer, were also interviewed. PwP were selected purposively to attain maximum variation in relation to factors that might impact on their experience: age, gender and relationship with dance partner. The sample thus selected comprised 7 men [age range 65–79] and 7 women [age range 49–81]. Six danced with their spouse; 2 with a friend or relative and 6 with one or more volunteer partners not previously known to them. In-depth, semi-structured interviews explored participants’ experiences and views about the venue and access issues; instructors’ teaching styles; challenges encountered; perceived impact on mobility and other outcomes; interest in continuing with dance; and acceptability of trial procedures. Interviews were recorded with consent and fully transcribed. Data were managed and analysed thematically. Results: Participants liked the dance studio and appreciated support with travel arrangements through reserved parking or pre-arranged taxis. The instructors’ technical and interpersonal skills were widely regarded as enabling motivation, encouragement and learning. Challenges encountered whilst dancing related to turning, coordination and keeping up with the music. Learning and remembering the steps was difficult for some PwP and their partners. Participants reported experiencing a multi- faceted feeling of enjoyment incorporating a sense of achievement, pleasure in dancing and a rewarding social interaction. PwP who identified a clear outcome in terms of balance or mobility were a minority; their partners sometimes seemed more confident that they saw positive change. The experience of taking part in the dance programme was heavily influenced by their partner; participant? perceived advantages and the potential for tension arising from dancing with both close relatives and volunteers. All expressed an interest in continuing to dance; potential obstacles identified were lack of knowledge about local options, lack of a partner, cost and indecision about preference for a Parkinson's only or a general class. Trial procedures and assessments were typically perceived as acceptable and not onerous. Conclusion(s): The broad-ranging insights of participants suggest that dance is appropriate and acceptable to PwP and inform plans for running the dance programme on a larger scale and for evaluating the outcomes in a Phase III trial. Implications: Findings will inform clinical trial design.