It takes two: the influence of dance partners on the perceived enjoyment and benefits during participation in partnered ballroom dance classes for people with Parkinson's.

PURPOSE: To explore the views of people with Parkinson's and their dance partners on the influence and issues surrounding dancing with an able-bodied dance partner during partnered ball room dance classes. METHODS: In depth, semi-structured interviews explored purposively selected participants' experiences and views about dance classes. Fourteen people with Parkinson's and their dance partners (six spouses, two friends/relatives, five volunteers) were interviewed within a month of completing the 10-week dance class program. Data were analyzed thematically. RESULTS: Generally, those partnered with a spouse or an experienced dancer, or when dance couples were able to develop good rapport, gained greater enjoyment and sense of achievement from dance classes in comparison to couples who did not enjoy dancing together or had clashing approaches to dance. Managing and negotiating who would "lead" in a dance was challenging for dance couples particularly among male people with Parkinson's. CONCLUSIONS: People with Parkinson's experience of the dance classes were influenced by the relationship and compatibility with their dance partner. Dance partnerships may impact on recruitment, enjoyment, outcome and continued participation in dance classes. Potential effects of partnerships should be analyzed and reported in studies evaluating the outcomes of dance classes. Implications for rehabilitation We recommend that health professionals consider involving spouses in Parkinson's dance classes as this may improve recruitment, adherence, enjoyment and overall outcome of the dance classes. If volunteers are needed, aim to recruit those who already have good dancing ability, convey a love of dancing and have the sensitivity and social skills to interact positively with the person with Parkinson's. Consider dance partnership issues when advertising and promoting dance classes. Address partnership issues through open communication and by changing partners if the dance partnership is not working well.

Dance for Parkinson's-The effects on whole body co-ordination during turning around.

OBJECTIVE: To investigate the effects of ballroom and Latin American dancing classes on turning in people with Parkinson's. DESIGN: This study employed a randomised, controlled, experimental design. SETTING: Dance classes were performed in a community dance centre in Southern England and all assessments took place a gait laboratory. PARTICIPANTS: Twenty-seven people with mild-moderate Parkinson's participated. INTERVENTION: Participants were randomly allocated to receive either 20, 1-h dancing classes over 10 weeks (n=15), or a 'usual care' control group (n=12). MAIN OUTCOME MEASURE: Twelve, 180° on-the-spot turns to the predicted/un-predicted and preferred/un-preferred direction were analysed for each participant, using 3-dimensional motion analysis before and after the intervention period, alongside clinical measures. RESULTS: Movement of the head, pelvis, and feet during turning in people with Parkinson's are affected by dancing with tighter coupling of body segments. Significant 4-way interactions between the groups, over time and turn style, with longer latency of the head (p=0.008) and greater rotation in the pelvis (p=0.036), alongside a trend of slower movement of the first (p=0.063) and second (p=0.081) foot in controls were shown, with minimal change in dancers. All interactions were affected by the type of turn. No significant differences were found in the centre of mass displacement, turn time or clinical measures. CONCLUSION: Those who danced were better able to coordinate their axial and perpendicular segments and surprisingly became more 'en bloc' in their turning behaviour, suggesting this may be a beneficial adaptation, rather than a maladaptive result of Parkinson's, as previously suggested.

Functional electrical stimulation with exercises for standing balance and weight transfer in acute stroke patients: a feasibility randomized controlled trial.

OBJECTIVES: To test parameters needed for the design of a larger trial including the following: 1) identifying eligible participants, recruitment, and retention rates; 2) the feasibility and acceptability of delivering functional electrical stimulation (FES) to the gluteus maximus and quadriceps femoris for acute stroke patients in a hospital rehabilitation setting; 3) the outcome measures; 4) obtaining initial estimates of effect size; and 5) clarifying the relevant control group. MATERIALS AND METHODS: Twenty-one people with acute stroke-mean age = 68 (min to max: 33-87) years; weeks postonset = 4.6 (min to max: 1-14)-were randomized to three groups to receive two weeks of balance training with FES, balance training alone, or usual care. Symmetry in normal standing, weight transfer onto the affected limb, balance, mobility, and speed of walking were assessed before, shortly after the end of training, and two weeks later by a blinded assessor. RESULTS: 1) FES was successfully delivered but not with the planned eight sessions; 2) no trends in favor of FES were found; and 3) 4% of those screened took part but approaching 20% might be recruited in the future, no single outcome measure was suitable for all participants, and more routine physiotherapy was delivered to the control group. CONCLUSIONS: FES is feasible in this patient group but further feasibility and definitive trials are required.

Effect of a yoga programme on an individual with Parkinson's disease: a single-subject design.

PURPOSE: To investigate the effect of eight weekly yoga sessions on balance, mobility and reported quality of life of an individual with Parkinson's disease (PD). Furthermore, to test the methodology in order to inform future research. METHOD: A 69-year-old female with an 8-year history of PD (Hoehn and Yahr rating two) was selected for the study, which had a single subject ABA design. A 1-week baseline was followed by an 8-week period of weekly 60 min yoga classes and a further 5 weeks of treatment withdrawal. Main outcome measures used were Berg Balance Scale (BBS), Timed Up and Go (TUG) and the Parkinson's Disease Questionnaire-39 (PDQ-39); collected at baseline, before, during and after the intervention and at follow-up. RESULTS: An improvement was noted in the BBS and TUG during the intervention phase; although these changes did not appear to be clinically significant. No change in quality of life as measured by the PDQ-39 was noted. CONCLUSIONS: The objective improvements in functional activities during the intervention period were not clinically significant. Subjectively, the participant gained much enjoyment and relaxation from the yoga classes. This study justifies the need for further studies using a larger sample size. Additionally, it will inform the methodological design.

Gait outcome following outpatient physiotherapy based on the Bobath concept in people post stroke.

PURPOSE: The purpose of this study was to characterize the gait cycle of patients with hemiplegia before and after a period of outpatient physiotherapy based on the Bobath concept. METHODS: Nine patients, at least 6 weeks post stroke and recently discharged from a stroke unit, were measured before and after a period of outpatient physiotherapy (mean duration = 17.4 weeks). Therapy was documented using a treatment checklist for each patient. The primary outcome measures were a number of gait variables related to the therapists' treatment hypothesis, recorded during the gait cycle using the CODA motion analysis system. Other secondary outcome measures were the Motor Assessment Scale, Modified Ashworth Scale, subtests of the Sodring Motor Evaluation Scale, the Step test, a 10-m walk test, the Barthel Index and the London Handicap Score. RESULTS: Recovery of more normal gait patterns in the gait cycle (using motion analysis) did not occur. Significant changes in temporal parameters (loading response, single support time) for both legs, in one kinematic (dorsiflexion during stance) and one kinetic variable on the unaffected side (hip flexor moment), and most of the clinical measures of impairment, activity and participation (with the exception of the Modified Ashworth Scale and the 10-m walk) were noted. CONCLUSIONS: Study findings did not support the hypothesis that the Bobath approach restored more normal movement patterns to the gait cycle. Further research is required to investigate the treatment techniques that are effective at improving walking ability in people after stroke.