TITLE: Effects of Group-Delivered Improvisational Dance on Balance in Adults with Middle Stage Parkinson Disease: A Two-Phase Pilot with fMRI Case Study
AUTHORS:
Glenna Batson,1,2 Christina Soriano,3 Jonathan H. Burdette,4 Sara Migliarese,2 Paul J. Laurienti,4 and Nickolai Hristov5
1Wake Forest University Translational Science Center, Winston-Salem, N.C.
2 Department of Physical Therapy, Winston-Salem State University, Winston-Salem, N.C.,
3 Department of Theatre and Dance, Wake Forest University
4 Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest Baptist Medical Center, Winston-Salem, NC
5 Center for Design Innovation, Winston-Salem, N.C.
ABSTRACT - not for distribution or publication People with Parkinson disease experience motor problems that place them at risk for falls. Research on visually cued rhythmic dance has shown select functional gains in balance. What remains uninvestigated is the effect dance improvisation has on the ability to self-generate strategies needed for complex balance tasks. This two-phase pilot first examined the effects of group-delivered improvisational dance on balance. Subsequently, changes on whole-brain functional network connectivity using functional magnetic resonance imaging (fMRI) were examined in a neuroplasticity case study. In Phase I seven community-dwelling adults (mean age 69) with middle stage Parkinson disease completed a 7-week improvisation series. Group pretest-posttest balance comparisons were significant on the Fullerton Advanced Balance Scale (p=.017) with a total group average increase of five points. In Phase II (3 months later), one participant from the pilot group underwent brain scanning following a 5-day intensive trial of the same dance protocol. Following the intervention week, the posttest fMRI scans exhibited significantly increased network connectivity between the basal ganglia and premotor cortices. For this group, dance improvisation resulted in significant gains in balance. For one participant, positive neuroplastic changes in brain connectivity were recorded in the strength of network connectivity between the basal ganglia and cortical motor centers.
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Key Words: Parkinson’s, dance, balance, fMRI, global efficiency