Including Arts Practices in a Policy Framework to Reduce the Burden of Neurodegenerative Disease: dance for people with Parkinson’s

Main Article Content

Sara Houston

Abstract

As cases of Parkinson’s Disease rise in Europe, there is an urgency to reduce its burden on those living with Parkinson’s and on health services. Whilst the search for a cure is on-going, and the use of medication is an on-going experiment for many people, the engagement with non-pharmaceutical interventions is imperative. Under this topic, the 2024 Policy Framework to Reduce the Burden of Neurodegenerative Diseases in Europe and Beyond notes the important role that non-pharmaceutical interventions play. In exploring in detail the contribution of arts practices, in particular dancing, this paper argues that they have a potentially impactful role to play as non-pharmaceutical interventions for people with Parkinson’s.


This discursive article critically engages with current research discussing what factors are important to be considered for the integration of arts practices – in particular dancing - in a successful implementation of a roadmap for better relieving the burden of Parkinson’s. Key points laid out include:


  • It needs to be recognised that arts practices are heterogenous and do not have treatment goals, but do emphasise what the person brings to a process. The lack of standardisation and goals are to be embraced, rather than criticised for being difficult to measure.

  • The evidence around dancing for people with Parkinson’s is not conclusive, yet largely positively framed.

  • To increase understanding of what quality of life and relief of burden feels like to people with Parkinson’s - and so greater success in implementing arts practices as NPIs in a Europe-wide policy - a broader range of studies from different disciplines need to be used in researching or reviewing this area of work; researchers need to actively listen to what matters to people with Parkinson’s and be critically reflective of their own studies consequently.

  • The Action Plan for non-pharmacological interventions in the Policy Framework is welcomed. Policy implementation needs to happen in consultation with dance organisations operating strategically around Europe, with people with Parkinson’s and with those who are underrepresented in Parkinson’s initiatives and dance activity.

Article Details

How to Cite
HOUSTON, Sara. Including Arts Practices in a Policy Framework to Reduce the Burden of Neurodegenerative Disease: dance for people with Parkinson’s. Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5755>. Date accessed: 15 nov. 2024. doi: https://doi.org/10.18103/mra.v12i10.5755.
Section
Research Articles

References

1. European Society of Medicine. Policy Framework: Reducing the Burden of Neurodegenerative Disease in Europe and Beyond. European Society of Medicine; 2024.
2. Dorsey ER, Elibaz A, et al. Global, regional, and national burden of Parkinson’s disease, 1990–2016: A systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2018;17:939–953. http://dx.doi.org/10.1016/ S1474-4422(18)30295-3
3. Aguiar LPC, da Rocha PA, Morris M. Therapeutic dancing for Parkinson's disease. Int J Gerontol. 2016;10(2):64-70. https://doi.org/10.1016/j.ijge.2016.02.002
4. Berganzo K, Tijero B, González-Eizaguirre A, Somme J, Lezcano E, Gabilondo I, Fernandez M, Zarranz JJ, Gómez-Esteban JC. Síntomas no motores y motores en la enfermedad de Parkinson y su relación con la calidad de vida y los distintos subgrupos clínicos. [Motor and non-motor symptoms of Parkinson’s disease and their impact on quality of life and on different clinical subgroups]. Neurología. 2016;31(9):585-591. https://doi.org/10.1016/j.nrl.2014.10.010
5. Bock MA, Brown EG, Zhang L, Tanner C. Association of motor and nonmotor symptoms with health-related quality of life in a large online cohort of people with Parkinson disease. Neurology. 2022;May 31:e2194 – e2203. doi:10.1212/WNL.0000000000200113
6. Dorsey ER, De Miranda BR, Horsager J, Borghammer P. The body, the brain, the environment, and Parkinson’s disease. J Parkinsons Dis. 2024;14(3):363–381. 10.3233/JPD-240019
7. Oonk NGM, Movig KLL, Munster EM, Koehorst-Ter Huurne K, van der Palen J, Dorresteijn LDA. The effect of a structured medication review on quality of life in Parkinson's disease: The study protocol. Contemp Clin Trials Commun. 2019;13. https://doi.org/10.1016/j.conctc.2018.100308
8. Houston S. Dancing with Parkinson’s. Intellect Books; 2019.
9. Houston S. Embodied agency through soft skills development in dance. Front. Cognit. 2024;3. https://doi.org/10.3389/fcogn.2024.1396904
10. Thompson J. Performance Affects: Applied Theatre and the End of Affect. Palgrave Macmillan; 2009.
11. Barnstaple RE, Laurita-Spanglet J, Fanning J, Soriano C, Hugenschmidt C E. This time with feeling: recommendations for full-bodied reporting of research on dance. Front. Cognit. 2024;3. https://doi.org/10.3389/fcogn.2024.1385087
12. Yoeli H, MacNaughton J, McLusky S, Robson M. Arts as treatment? innovation and resistance within an emerging movement. Nordic Journal of Arts, Culture and Health. 2020;2(2):91–106. https://doi.org/10.18261/issn.2535-7913-2020-02-02
13. Fancourt D, Finn S. What is the Evidence of the Role of Arts in Improving Health and Wellbeing? Health Evidence Network Synthesis Report 67, World Health Organisation; 2019.
14. All Party Parliamentary Group on Arts, Health and Wellbeing. Creative Health: The Arts for Health and Wellbeing. All Party Parliamentary Group on Arts, Health and Wellbeing Inquiry; 2017.
15. All Party Parliamentary Group on Arts, Health & Wellbeing & National Centre for Creative Health. Creative Health Review: How Policy Can Embrace Creative Health. National Centre for Creative Health; 2023.
16. Zbranca R, Dâmaso M, Blaga O, Kiss K, Dascl MD, Yakobson D, Pop O. CultureForHealth Report. Culture’s Contribution to Health and Well-being: A Report on Evidence and Policy Recommendations for Europe. CultureForHealth and Culture Action Europe; 2022.
17. Clift S, Phillips K, Pritchard S. The need for robust critique of research on social and health impacts of the arts. Cultural Trends. 2021;30(5):442–459. https://doi.org/10.1080/09548963.2021.1910492
18. Phillips K. A constructive-critical response to Creative Health: The Arts for Health and Wellbeing (July 2017) by the All–Party Parliamentary Group on Arts, Health and Wellbeing. International Journal of Art Therapy. 2018;24(1):21–29. https://doi.org/10.1080/17454832.2018.1491612
19. Daykin N. Social movements and boundary work in arts, health and wellbeing: A research agenda. Nordic Journal of Arts, Culture and Health. 2019;1(1):9–20. https://doi.org/10.18261/issn.2535-7913-2019-01-02
20. Houston S, McGill A. A mixed-methods study into ballet for people living with Parkinson’s. Arts & Health: An international journal for research, policy and practice. 2013;5(2):103–119. 10.1080/17533015.2012.745580
21. Sridharan S, Nakaima A. Valuing and embracing complexity: How an understanding of complex interventions needs to shape our evaluation capacities building initiatives. Evaluation and Program Planning. 2020;80. https://doi.org/10.1016/j.evalprogplan.2017.05.001
22. Chappell K, Redding E, Crickmay U, Stancliffe R, Jobbins V, Smith S. The aesthetic, artistic and creative contributions of dance for health and wellbeing across the lifecourse: A systematic review. International Journal of Qualitative Studies on Health and Well-Being. 2021;16(1). https://doi.org/10.1080/17482631.2021.1950891
23. Petts L, McGill A. Disrupting the obligation of objective knowledge in dance science research. J Dance Med Sci. 2024;0(0). https://doi.org/10.1177/1089313X241245493
24. Senter M, Clifford AM, Bhriain ON. Using theory knitting to conceptualize social phenomena in the design and evaluation of dance programs for people living with Parkinson’s disease. Evaluation and Program Planning. 2024;104. https://doi.org/10.1016/j.evalprogplan.2024.102430
25. Westheimer O. Why dance for Parkinson’s disease?. Top Geriatr Rehabil. 2008;24:127–140. 10.1097/01.TGR.0000318900.95313.af
26. Goldsmith S, Kokolakakis T. A cost-effectiveness evaluation of Dance to Health: A dance-based falls prevention exercise programme in England. Public Health. 2021;198:17-21. 10.1016/j.puhe.2021.06.020
27. Mandelbaum R, Triche EW, Fasoli SE, Lo AC. A pilot study: Examining the effects and tolerability of structured dance intervention for individuals with Multiple Sclerosis. Disability and Rehabilitation. 2015;38(3):218–222. https://doi.org/10.3109/09638288.2015.1035457
28. Salgues J, Chéhère P. Huntington and dance. J Neurol, Neurosurg Psychiatry. 2016;87:A104-A105. https://doi.org/10.1136/jnnp-2016-314597.295
29. Klimova B, Valis M, Kuca K. Dancing as an intervention tool for people with dementia: A mini-review dancing and dementia. Curr Alzheimer Res. 2017;14(12):1264-1269. doi:10.2174/1567205014666170713161422
30. Patterson KK, Wong JS, Prout EC, Brooks D. Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review. Heliyon. 2018;4(3). 10.1016/j.heliyon.2018.e00584
31. Scheidler AM, Kinnett-Hopkins D, Learmonth YC, Motl R, López-Ortiz C. Targeted ballet program mitigates ataxia and improves balance in females with mild-to-moderate Multiple Sclerosis. PloS one. 2018;13(10). 10.1371/journal.pone.0205382
32. Trinkler I, Chéhère P, Salgues J, Monin ML, Tezenas du Montcel S, Khani S, Gargiulo M, Durr A. Contemporary dance practice improves motor function and body representation in Huntington's disease: A pilot study. J Huntingtons Dis. 2019;8(1): 97–110. 10.3233/JHD-180315
33. Sonke J, Langley J, Whiteside B, Gyang T, Borgert B, Mason K, Sollero C. Movement for Multiple Sclerosis: A multi-site partnership for practice and research. Arts & Health. 2020;13(2):204–212. https://doi.org/10.1080/17533015.2020.1852435
34. Sharp K, Hewitt J. Dance as an intervention for people with Parkinson's disease: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2014;47:445-456. https://doi.org/10.1016/j.neubiorev.2014.09.009
35. Delabary MDS, Komeroski IG, Monteiro EP, Costa RR, Haas AN. Effects of dance practice on functional mobility, motor symptoms and quality of life in people with Parkinson’s disease: A systematic review with meta-analysis. Aging Clin Exp Re. 2018;30:727–735. https://doi.org/10.1007/s40520-017-0836-2
36. Carapellotti AM, Stevenson R, Doumas M. The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis. PLoS ONE. 2020;15(8). https://doi.org/10.1371/journal.pone.0236820
37. Hasan SM, Alshafie S, Hasabo EA, Saleh M, Elnaiem W, Oasem A, Alzu’bi YO, Khaled A, Zaazouee MS, Ragab KM, Nourelden AZ, Doheim MF. Efficacy of dance for Parkinson’s disease: A pooled analysis of 372 patients. J Neurol. 2022;269:1195–1208. https://doi.org/10.1007/s00415-021-10589-4
38. Emmanouilidis S, Hackney ME, Slade SC, Heng H, Jazayeri D, Morris ME. Dance is an accessible physical activity for people with Parkinson’s disease. Parkinson’s Disease. 2021;2021. https://doi.org/10.1155/2021/7516504
39. Ismail SR, Lee SWH, Merom D, Kamaruddin PSNM, Chong MS, Ong T, Lai NM. Evidence of disease severity, cognitive and physical outcomes of dance interventions for persons with Parkinson’s Disease: A systematic review and meta-analysis. BMC Geriatr. 2021;21. https://doi.org/10.1186/s12877-021-02446-w
40. Zhang Q, Hu J, Wei L, Jia Y, Jin Y. Effects of dance therapy on cognitive and mood symptoms in people with Parkinson's disease: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2019;36:12-17. https://doi.org/10.1016/j.ctcp.2019.04.005
41. Wang Ll, Sun Cj, Wang Y, Zhan Tt, Yuan J, Yang J, Huang S, Cheng L. Effects of dance therapy on non-motor symptoms in patients with Parkinson’s disease: A systematic review and meta-analysis. Aging Clin Exp Res. 2022;34:1201–1208. https://doi.org/10.1007/s40520-021-02030-7
42. Senter M, Clifford AM, O’Callaghan M, McCormack M, Bhriain, ON. Experiences of people living with Parkinson’s disease and key stakeholders in dance-based programs: A systematic review and meta-ethnography. Disability and Rehabilitation. 2024:1–14. https://doi.org/10.1080/09638288.2024.2327499
43. Cheng Wh, Quan Y, Thompson WF. The effect of dance on mental health and quality of life of people with Parkinson's disease: A systematic review and three-level meta-analysis. Arch Gerontol Geriatr. 2024;120. https://doi.org/10.1016/j.archger.2024.105326
44. Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P. (2012) WHO European review of social determinants of health and the health divide. The Lancet. 2012;380:1011-1029. https://doi.org/10.1016/S0140-6736(12)61228-8
45. Nakaima A, Sridharan S, Gibson R. Towards an evolutionary approach to learning from assumptions: Lessons from the evaluation of Dancing with Parkinson’s. Evaluation and Program Planning. 2023;97. https://doi.org/10.1016/j.evalprogplan.2023.102259
46. Houston S. The methodological challenges of researching dance for people living with Parkinson’s. Dance Research. 2011;29(2):329–351. https://doi.org/10.3366/drs.2011.0023
47. McGill A, Houston S, Lee RY. Dance for Parkinson’s: a new framework for research on its physical, mental, emotional, and social benefits. Complementary Therapies in Medicine. 2014;22:426-432. https://doi.org/10.1016/j.ctim.2014.03.005
48. Rocha PA, Slade SC, McClelland J, Morris ME. Dance is more than therapy: Qualitative analysis on therapeutic dancing classes for Parkinson’s. Complementary Therapies in Medicine. 2017;34:1-9. https://doi.org/10.1016/j.ctim.2017.07.006
49. Houston S, McGill A. Understanding quality of life through the experiences of dancers with Parkinson’s. In Bond K, ed. Dance and The Quality of Life. Social Indicators Research Series 73. Springer Nature; 2019:281-291.
50. Belfiore E. The social impacts of the arts: myth or reality?. In Murza M, ed. Culture Vultures: Is UK Arts Policy Damaging the Arts? Policy Exchange; 2006:20–37.
51. Westheimer O, McRae C, Henchcliffe C, Fsharaki A, Glazman S, Ene H, Bodis-Wollner I. Dance for PD: A preliminary investigation of effects on motor function and quality of life among persons with Parkinson’s disease (PD). J Neural Transm. 2015;122(9):1263–1270. 10.1007/s00702-015-1380-x
52. Houston S. Feeling lovely: An examination of the value of beauty for people dancing with Parkinson’s. Dance Research Journal. 2015;47(1):26–43. doi:10.1017/S0149767715000042
53. Fontanesi C, DeSouza JXF (2021) Beauty that moves: Dance for Parkinson’s effects on affect, self-efficacy, gait symmetry, and dual task performance. Front. Psychol. 2021;11. doi:10.3389/fpsyg.2020.600440
54. Frazzitta G, Maestri R, Bertotti G, Riboldazzi G, Boveri N, Perini M, Uccellini D, Turla M, Comi C, Pezzoli G, Ghilardi MF. Intensive rehabilitation treatment in early Parkinson's disease: a randomized pilot study with a 2-year follow-up. Neurorehabil Neural Repair. 2015;29(2):123–131. 10.1177/1545968314542981
55. Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, Josbeno DA, Christiansen CL, Berman BD, Kluger BM, Melanson EL, Jain S, Robichaud JA, Poon C, Corcos DM. Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: A phase 2 randomized clinical trial. JAMA Neurol. 2018;75(2):219–226. 10.1001/jamaneurol.2017.3517
56. Bearss KA, DeSouza JFX. Parkinson's disease motor symptom progression slowed with multisensory dance learning over 3-years: A preliminary longitudinal investigation. Brain Sciences. 2021;11(7):895. https://doi.org/10.3390/brainsci11070895
57. Hulbert S, Fullam J, Hunt C, Goodwin VA. ‘Digital dancing’ – “Can you see, what I feel” – An exploration of the physical ‘experience’ of dance for Parkinson’s through 3-dimensional motion analysis. Complementary Therapies in Medicine. 2020; 20. https://doi.org/10.1016/j.ctim.2020.102508
58. Carmody T, Park R, Bennett E, Kuret E, Klein B, Costa À, Messner S, Hursey A. An ethnographic study of patient life experience in early stage Parkinson’s disease in the United States and Germany. Neurol Ther. 2024;13:1219–1235. https://doi.org/10.1007/s40120-024-00632-7
59. Batson G, Hugenschmidt CE, Soriano CT. Verbal auditory cueing of improvisational dance: a proposed method for training agency in Parkinson’s disease. Front. Neurol. 2016;7(15). https://doi.org/10.3389/fneur.2016.00015
60. Goldman D. I want to Be Ready: Improvised Dance as a Practice of Freedom. University of Michigan Press; 2010.
61. Geertz C. Thick description: Towards an interpretive theory of culture. In Delanty, G, Strydom P, eds. Philosophies of Social Science: The Classic and Contemporary Readings. Open University; 2003:310 – 323.
62. Bognar S, DeFaria AM, O’Dwyer C, Pankiw E, Bogler JS, Teixeira S, Evans C. More than just dancing: experiences of people with Parkinson’s disease in a therapeutic dance program. Disability and Rehabilitation. 2016;39(11):1073–1078. https://doi.org/10.1080/09638288.2016.1175037
63. Gyrling T, Ljunggren M, Karlsson S. The impact of dance activities on the health of persons with Parkinson’s disease in Sweden. Int J Qual Stud Health Well-Being. 2021;16(1). https://doi.org/10.1080/17482631.2021.1992842
64. Norton E, Hemingway A, Ellis Hill C. The meaning and impact on well-being of bespoke dancing sessions for those living with Parkinson’s. Int J Qual Stud Health Well-Being. 2023;18(1). https://doi.org/10.1080/17482631.2023.2245593
65. Heiberger L, Maurer C, Amtage F, Mendez-Balbuena I, Schulte-Mönting J, Hepp Reymond M, Rumyana K. Impact of a weekly dance class on the functional mobility and on the quality of life of individuals with Parkinson's disease. Front. Aging Neurosci. 2011;3(14):1-15. 10.3389/fnagi.2011.00014
66. Cohen GD, Perlstein S, Chapline, J, Kelly J, Firth KM, Simmens S. The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults. Gerontologist. 2006;46(6):726-734. doi:10.1093/geront/46.6.726
67. Cummings JL. Depression and Parkinson's disease: a review.Am J Psychiatry. 1992;149(4):443-454. doi:10.1176/ajp.149.4.443
68. Williams A, Bowler K, Wright B. Adventures with Parkinson’s: Empowering Parkinson’s patients to become active partners in research and treatment. Regenerative Medicine. 2017;12(7):737–742. https://doi.org/10.2217/rme-2017-0030
69. Iverson D. Capturing Grace. Kikim Media LLC; 2014.
70. Christensen-Strynø MB, Phillips L, Frølunde L. Revitalising sensualities of ageing with Parkinson's through dance. J Aging Stud. 2021;59. https://doi.org/10.1016/j.jaging.2021.100978
71. Pohjola H, Sivak E, Åström ÅN. Performing with Parkinson’s: Leaving traces. Nordic Journal of Dance. 2023;14(1):100–115. https://doi.org/10.2478/njd-2023-0011
72. Whiteside B. Dance for Parkinson's Scotland (DfPS) Programme: An Evaluation. Royal Conservatoire of Scotland; 2017.
73. Bek J, Groves M, Leventhal D, Poliakoff E. Dance at home for people with Parkinson’s during COVID-19 and beyond: Participation, perceptions, and prospects. Front. Neurol. 2021;12. https://doi.org/10.3389/fneur.2021.678124
74. Delabary MDS, Sbeghen IL, Wolffenbuttel M, Pereira DR, Haas AN. Online dance classes during the Covid-19 pandemic: new challenges and teaching strategies for the ‘Dance & Parkinson’s at home’ project. Research in Dance Education. 2022;25(2):118–136. https://doi.org/10.1080/14647893.2022.2083595
75. Delabary MDS, Sbeghen IL, da Silva ECT, Guzzo Jr CCE, Haas AN. Brazilian dance self-perceived impacts on quality of life of people with Parkinson’s. Front. Psychol. 2024;15. https://doi.org/10.3389/fpsyg.2024.1356553
76. Lau YH, Podlewska A, Ocloo J, Gupta A, Gonde C, Bloem BR, Chaudhuri KR. Does ethnicity influence recruitment into clinical trials of Parkinson's disease?. J Parkinsons Dis. 2022;12(3):975–981. https://doi.org/10.3233/JPD-213113
77. Harris S, Narayanan NS, Tranel D. Does black vs. white race affect practitioners’ appraisal of Parkinson’s disease?. NPJ Parkinsons Dis. 2023;9. https://doi.org/10.1038/s41531-023-00549-2
78. McAndrew S, O’Brien D, Taylor M, Wang R. U.K. Arts, Culture and Heritage Audiences and Workforce. Creative Industries Policy and Evidence Centre; 2024.
79. Mak HW, Coulter R, Fancourt D. Associations between neighbourhood deprivation and engagement in arts, culture and heritage: evidence from two nationally-representative samples. BMC Public Health 2021;21. https://doi.org/10.1186/s12889-021-11740-6
80. Cohen E. Black People with Parkinson’s are Underdiagnosed, Miss Treatment. NBC News. Published 4th August, 2024. Accessed 7th August, 2024. https://www.nbcnews.com/health/health-news/black-people-parkinsons-are-underdiagnosed-miss-treatment-rcna164386
81. Cambridge University Hospitals NHS Trust. Dance for Health: Conversations. Published 28th July, 2020. Accessed 10th August, 2024. https://youtu.be/TnjTkMuAAC8?si=2kREa1HyAEWxPfeG
82. Dowler, L. Improvising on the ward: Exploring somatic dance and potential in paediatric health care. Journal of Applied Arts & Health. 2013;4(2):163-178. https://doi.org/10.1386/jaah.4.2.163_1
83. Bungay H, Clift S. Arts on Prescription: A review of practice in the UK. Perspectives in Public Health. 2010;130(6):277 - 281. https://doi.org/10.1177/1757913910384050