Effect of musical cues on gait in individuals with Parkinson disease with comorbid dementia.

BACKGROUND: Individuals with Parkinson disease and comorbid dementia (PDD) demonstrate gait impairments, but little is known about how these individuals respond to interventions for gait dysfunction. Rhythmic auditory stimulation (RAS), which utilizes music or other auditory cues to alter gait, has been shown to be effective for improving gait in individuals with PD without dementia, but has not been explored in individuals with PDD. RESEARCH QUESTION: Can individuals with PDD modulate their gait in response to music and mental singing cues? METHODS: This single center, cross-sectional, interventional study included 17 individuals with PDD. Participants received Music and Mental singing cues at tempos of 90 %, 100 %, 110 %, and 120 % of their uncued walking cadence. Participants were instructed to walk to the beat of the song. Gait variables were collected using APDM Opal sensors. Data were analyzed using mixed effect models to explore the impact of tempo and cue type (Music vs Mental) on selected gait parameters of velocity, cadence, and stride length. RESULTS: Mixed effects models showed a significant effect of tempo but not for cue type for velocity (F=11.51, p < .001), cadence (F=11.13, p < .001), and stride length (F=5.68, p = .002). When looking at the marginal means, velocity at a cue rate of 90 % was significantly different from 100 %, indicating participants walked slower with a cue rate of 90 %. Participants did not significantly increase their velocity, cadence, or stride length with faster cue rates of 110 % and 120 % SIGNIFICANCE: Individuals with PDD appear to be able to slow their velocity in response to slower cues, but do not appear to be able to increase their velocity, cadence, or stride length in response to faster cue tempos. This is different from what has been reported in individuals with PD without dementia. Further research is necessary to understand the underlying mechanism for these differences.

The effect of auditory cues on gait variability in people with Parkinson's disease and older adults: a systematic review.

Aim: The goal of this study was to analyze the effects of external rhythmic auditory stimulation (RAS) on gait variability in older adults and people with Parkinson's disease (PD). Methods: Academic databases searched included PubMed, Web of Science, PEDro and Cochrane, from inception to September 2021. Eligible articles scored a minimum of 4 on the PEDro scale. Results: Twenty-three papers were included. People with PD show varied responses in gait variability to RAS during cued walking trials. Healthy older adults tended to increase variability during cued trials. Cue rates below preferred walking cadence tend to increase gait variability. Conclusion: Gait variability is closely associated with fall risk and an important consideration in development of gait rehabilitation techniques.

People with Parkinson's disease (PD) tend to walk slower and with higher gait variability. Walking to metronome tones or musical cues are common rehabilitation techniques to improve gait speed and stride length for people with PD. However, recent reports suggest that cues may augment differences between each stride, making walking less even and less rhythmic, in other words, more variable. Gait variability is closely associated with fall risk. In this review, we investigated the effects of external rhythmic auditory cues ­ both metronome and music ­ to see how they affected gait variability for people with PD and older adults. The results of our analysis suggest that cues may increase gait variability for both groups. Several factors that may foster positive responses to cues are considered.

The Effectiveness of Classical Ballet as a Therapeutic Intervention: A Narrative Review.

There has been increasing research on the impact of dance as a therapeutic intervention and alternative exercise for improving physical health and psychosocial outcomes. Prior reviews center on specific populations, such as those living with Parkinson's disease or older adults, but few center on a specific dance style such as classical ballet. This review aims to synthesize the current literature on classical ballet as a therapeutic intervention for novices and analyze its effects on movement outcomes, perceived value, and other health outcomes to inform future research directions. In total, 23 articles were identified using PubMed and Scopus from inception through March 2022; 14 that met the inclusion criteria are discussed in this review. Altogether, the literature is extremely mixed-spanning different populations, intervention protocols, doses, and measurement tools-making comparisons difficult. Overall, classical ballet appears to be a safe and feasible intervention for multiple populations. Engaging in classical ballet may be associated with improvements in balance and postural control and has a high perceived value among participants and instructors, but the evidence is limited and of poor quality. Rigorous research is required to provide stronger, more credible evidence on the potential value of classical ballet as a therapeutic intervention.

Resting-state functional connectivity associated with gait characteristics in people with Parkinson's disease.

INTRODUCTION: Parkinson's disease (PD) is a movement disorder caused by dysfunction in the basal ganglia (BG). Clinically relevant gait deficits, such as decreased velocity and increased variability, may be caused by underlying neural dysfunction. Reductions in resting-state functional connectivity (rs-FC) between networks have been identified in PD compared to controls; however, the association between gait characteristics and rs-FC of brain networks in people with PD has not yet been explored. The present study aimed to investigate these associations. METHODS: Gait characteristics and rs-FC MRI data were collected for participants with PD (N = 50). Brain networks were identified from a set of seeds representing cortical, subcortical, and cerebellar regions. Gait outcomes were correlated with the strength of rs-FC within and between networks of interest. A stepwise regression analysis was also conducted to determine whether the rs-FC strength of brain networks, along with clinical motor scores, were predictive of gait characteristics. RESULTS: Gait velocity was associated with rs-FC within the visual network and between motor and cognitive networks, most notably BG-thalamus internetwork rs-FC. The stepwise regression analysis showed strength of BG-thalamus internetwork rs-FC and clinical motor scores were predictive of gait velocity. CONCLUSION: The results of the present study demonstrate gait characteristics are associated with functional organization of the brain at the network level, providing insight into the neural mechanisms of clinically relevant gait characteristics. This knowledge could be used to optimize the design of gait rehabilitation interventions for people with neurological conditions.

The Role of Mental Imagery in Parkinson's Disease Rehabilitation.

Parkinson's disease (PD) is a disabling neurodegenerative disease whose manifestations span motor, sensorimotor, and sensory domains. While current therapies for PD include pharmacological, invasive, and physical interventions, there is a constant need for developing additional approaches for optimizing rehabilitation gains. Mental imagery is an emerging field in neurorehabilitation and has the potential to serve as an adjunct therapy to enhance patient function. Yet, the literature on this topic is sparse. The current paper reviews the motor, sensorimotor, and sensory domains impacted by PD using gait, balance, and pain as examples, respectively. Then, mental imagery and its potential for PD motor and non-motor rehabilitation is discussed, with an emphasis on its suitability for addressing gait, balance, and pain deficits in people with PD. Lastly, future research directions are suggested.

Finger tapping as a proxy for gait: Similar effects on movement variability during external and self-generated cueing in people with Parkinson's disease and healthy older adults.

BACKGROUND: Rhythmic auditory cueing has been widely studied for gait rehabilitation in Parkinson's disease (PD). Our research group previously showed that externally generated cues (i.e., music) increased gait variability measures from uncued gait, whereas self-generated cues (i.e., mental singing) did not. These different effects may be due to differences in underlying neural mechanisms that could be discerned via neuroimaging; however, movement types that can be studied with neuroimaging are limited. OBJECTIVE: The primary aim of the present study was to investigate the effects of different cue types on gait, finger tapping, and foot tapping, to determine whether tapping can be used as a surrogate for gait in future neuroimaging studies. The secondary aim of this study was to investigate whether rhythm skills or auditory imagery abilities are associated with responses to these different cue types. METHODS: In this cross-sectional study, controls (n=24) and individuals with PD (n=33) performed gait, finger tapping, and foot tapping at their preferred pace (UNCUED) and to externally generated (MUSIC) and self-generated (MENTAL) cues. Spatiotemporal parameters of gait and temporal parameters of finger tapping and foot tapping were collected. The Beat Alignment Task (BAT) and Bucknell Auditory Imagery Scale (BAIS) were also administered. RESULTS: The MUSIC cues elicited higher movement variability than did MENTAL cues across all movements. The MUSIC cues also elicited higher movement variability than the UNCUED condition for gait and finger tapping. CONCLUSIONS: This study shows that different cue types affect gait and finger tapping similarly. Finger tapping may be an adequate proxy for gait in studying the underlying neural mechanisms of these cue types.

A walking dance to improve gait speed for people with Parkinson disease: a pilot study.

Aim: To determine the effectiveness of a targeted dance intervention to improve walking speed for people with Parkinson disease (PD) by increasing motor motivation. Materials & methods: 11 participants with PD participated in a 6-week pilot study in which they learned a contemporary dance composed of walking steps and designed to mimic everyday walking. 1 h classes occurred twice-weekly. Results: Pre- and post-intervention assessments revealed a significant increase in gait speed (t9 = 3.30; p = 0.009), cadence (t9 = 2.345; p = 0.044), and stride length (t9 = 3.757; p = 0.005), and a significant decrease (improvement) in single support time variability (t9 = -2.744; p = 0.022). There were no significant changes in other measures of gait variability nor in motor symptoms, mood and anxiety, extent of life-space mobility, or quality of life. No adverse events were reported. Conclusion: Joywalk provides preliminary evidence that a targeted physical intervention for people with PD may specifically counter bradykinesia.

Yoga Improves Balance and Low-Back Pain, but Not Anxiety, in People with Parkinson's Disease.

Individuals with Parkinson's disease (PD) experience postural instability, low-back pain (LBP), and anxiety. These symptoms increase the risk of falls and decrease quality of life. Research shows yoga improves balance and decreases LBP and anxiety in healthy adults, but its effects in PD are poorly understood. All participants were part of a larger intervention study. Participants received pretest and posttest evaluations, including the Balance Evaluation Systems Test (BESTest), Beck Anxiety Inventory (BAI), and Revised Oswestry Disability Index (ROSW). Total scores for each measure, as well as individual balance system section scores from the BESTest (biomechanical constraints, stability limits/verticality, transitions/anticipatory, reactive, sensory orientation, and stability in gait) were compared within groups pre- to posttest. Participants in the yoga group (n = 13) completed a twice-weekly 12-week yoga interve n t i o n , whereas controls (n = 13) continued their usual routines for 12 weeks. Both the yoga (Z = -3.20, p = 0.001) and control (Z = -2.10, p = 0.040) groups improved on the BESTest total score. The control group showed no changes in individual balance systems, whereas the yoga group improved in stability limits/verticality (Z = -2.3, p = 0.020), transitions/ anticipatory (Z = -2.50, p = 0.010), reactive (Z = -2.70, p = 0.008), and sensory orientation (Z = -2.30, p = 0.020). ROSW decreased in the yoga group only (Z = -2.10, p = 0.030). BAI did not change in either group. Yoga is a nonpharmacological intervention that can improve balance and LBP in people with PD. This study demonstrated that yoga is feasible for people with PD, and participants reported high levels of enjoyment and intent to practice yoga after the study.

Exercise and Parkinson Disease: Comparing Tango, Treadmill, and Stretching.

BACKGROUND AND PURPOSE: Impaired gait, balance, and motor function are common in Parkinson disease (PD) and may lead to falls and injuries. Different forms of exercise improve motor function in persons with PD, but determining which form of exercise is most effective requires a direct comparison of various approaches. In this prospective, controlled trial, we evaluated the impact of tango, treadmill walking, and stretching on gait, balance, motor function, and quality of life. We hypothesized tango and treadmill would improve forward walking and motor symptom severity, and tango would also improve backward walking, balance, and quality of life. METHODS: Ninety-six participants (age: 67.2 ± 8.9 years, 42% female) with mild to moderate idiopathic PD were serially assigned to tango, treadmill walking, or stretching (active control group) and attended 1-hour classes twice weekly for 12 weeks. Assessments occurred OFF anti-PD medication before and after the intervention and at follow-up 12 weeks after the intervention. RESULTS: Forward velocity and backward velocity improved for the treadmill group from baseline to posttest and improvements persisted at follow-up. Backward velocity and motor functioning improved for the stretching group from baseline to posttest, but results did not persist at follow-up. There were no significant changes in the tango group across time points. DISCUSSION AND CONCLUSIONS: Contrary to our hypotheses, only treadmill improved forward walking, while backward walking improved with treadmill and stretching. Future research should examine combinations of exercises with a focus on optimizing dosing and examining whether specific characteristics of people with PD correlate with different types of exercise.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A237).

Internal cueing improves gait more than external cueing in healthy adults and people with Parkinson disease.

Walking can be challenging for aging individuals and people with neurological disorders such as Parkinson disease (PD). Gait impairment characterized by reduced speed and higher variability destabilizes gait and increases the risk of falls. External auditory cueing provides an effective strategy to improve gait, as matching footfalls to rhythms typically increases gait speed and elicits larger steps, but the need to synchronize to an outside source often has a detrimental effect on gait variability. Internal cueing in the form of singing may provide an alternative to conventional gait therapy. In the present study, we compare the effects of internal and external cueing techniques on forward and backward walking for both people with PD and healthy controls. Results indicate that internal cueing was associated with improvements in gait velocity, cadence, and stride length in the backward direction, and reduced variability in both forward and backward walking. In comparison, external cueing was associated with minimal improvement in gait characteristics and a decline in gait stability. People with gait impairment due to aging or neurological decline may benefit more from internal cueing techniques such as singing as compared to external cueing techniques.

The feasibility of singing to improve gait in Parkinson disease.

Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.

Feasibility and preliminary efficacy of a telerehabilitation approach to group adapted tango instruction for people with Parkinson disease.

People with Parkinson disease (PD) demonstrate improvements in motor function following group tango classes, but report long commutes as a barrier to participation. To increase access, we investigated a telerehabilitation approach to group tango instruction. Twenty-six people with mild-to-moderate PD were assigned based on commute distance to either the telerehabilitation group (Telerehab) or an in-person instruction group (In-person). Both groups followed the same twice-weekly, 12-week curriculum with the same instructor. Feasibility metrics were participant retention, attendance and adverse events. Outcomes assessed were balance, PD motor sign severity and gait. Participant retention was 85% in both groups. Attendance was 87% in the Telerehab group and 84% in the In-person group. No adverse events occurred. Balance and motor sign severity improved significantly over time ( p < 0.001) in both groups, with no significant group × time effects. Gait did not significantly change. Since a priori feasibility criteria were met or exceeded, and there were no notable outcome differences between the two instruction approaches, this pilot study suggests a telerehabilitation approach to group tango class for people with PD is feasible and may have similar outcomes to in-person instruction.

Are the effects of community-based dance on Parkinson disease severity, balance, and functional mobility reduced with time? A 2-year prospective pilot study.

OBJECTIVE: To determine the effects of participation in a 2-year community-based dance class on disease severity and functional mobility in people with Parkinson disease (PD). DESIGN: Randomized controlled trial. SETTINGS/LOCATION: Dance classes took place in a community-based location. Outcome measures were collected in a university laboratory. PATIENTS: Ten individuals with PD were randomly assigned to the Argentine tango (AT) group (n=5 [4 men]; mean age±standard deviation, 69.6±6.6 years) or the control group (n=5 [4 men]; mean age±standard deviation, 66±11.0 years). INTERVENTIONS: The AT group participated in a community-based AT class for 1 hour twice weekly for 2 years. Control group participants were given no prescribed exercise. Blinded assessments occurred at baseline and 12 and 24 months. OUTCOME MEASURES: Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) III, Mini-Balance Evaluation Systems Test (Mini-BESTest), gait velocity (forward and backward), Timed Up and Go and dual-task Timed Up and Go, Six-Minute Walk Test (6MWT), MDS-UPDRS II, MDS-UPDRS I, and Freezing of Gait Questionnaire. RESULTS: There were no differences between groups at baseline. A significant group-by-time interaction (F [2,8]=17.59; p<0.0001) was noted for the MDS-UPDRS III, with the AT group having lower scores at 12 and 24 months than the controls. Significant interactions were also noted for the Mini-BESTest, MDS-UPDRS II and I, and 6MWT. CONCLUSION: This is believed to be one of the longest-duration studies to examine the effects of exercise on PD. Participation in community-based dance classes over 2 years was associated with improvements in motor and nonmotor symptom severity, performance on activities of daily living, and balance in a small group of people with PD. This is noteworthy given the progressive nature of PD and the fact that the control group declined on some outcome measures over 2 years.

Randomized controlled trial of community-based dancing to modify disease progression in Parkinson disease.

BACKGROUND: Tango dancing has been effective in improving measures of physical function in people with Parkinson disease (PD). However, all previous studies were institution-based, tested participants on medication, and employed short-term interventions. OBJECTIVE: To determine the effects of a 12-month community-based tango program for individuals with PD on disease severity and physical function. METHODS: Sixty-two participants were randomly assigned to a twice weekly, community-based Argentine Tango program or a Control group (no intervention). Participants were assessed off anti-Parkinson medication at baseline, 3, 6, and 12 months. The primary outcome measure was the Movement Disorders Society-Unified Parkinson Disease Rating Scale 3 (MDS-UPDRS-3). Secondary outcome measures were the MDS-UPDRS-1, MDS-UPDRS-2, MiniBESTest balance test; Freezing of Gait Questionnaire (FOG_Q); 6-Minute Walk Test (6MWT); gait velocity for comfortable forward, fast as possible forward, dual task, and backward walking; and Nine-Hole Peg Test (9HPT). RESULTS: Groups were not different at baseline. Overall, the Tango group improved whereas the Control group showed little change on most measures. For the MDS-UPDRS-3, there was no significant change in the Control group from baseline to 12 months, whereas the Tango group had a reduction of 28.7% (12.8 points). There were significant group by time interactions for MDS-UPDRS-3, MiniBESTest, FOG_Q, 6MWT, forward and dual task walking velocities, and 9HPT in favor of the dance group. CONCLUSIONS: Improvements in the Tango group were apparent off medication, suggesting that long-term participation in tango may modify progression of disability in PD.

The impact of attentional, auditory, and combined cues on walking during single and cognitive dual tasks in Parkinson disease.

Auditory and attentional cues improve gait in Parkinson disease (PD), but it is unclear if combining the two cueing strategies offers additional benefit. Further, the effect of a secondary cognitive task on cue efficacy is unknown. Therefore, this study aimed to assess the effects of cue type and task complexity on gait in PD. 11 participants with PD, 11 age-matched controls, and 11 young controls performed 3 walking trials on a GAITRite walkway under the following cueing conditions: no cue (baseline), rhythmic auditory cue at 10% below (AUD-10) and 10% above (AUD+10) self selected cadence, attentional cue (ATT; "take long strides"), and a combination of AUD and ATT (COM-10, COM+10). Each condition was also performed concurrently with a secondary word generation task (dual task, DT). Baseline gait velocity and stride length were less for those with PD and age-matched controls compared to young controls, and the ability of those with PD to use cues differed from the other groups. Gait velocity and stride length increased in PD with ATT, but not with auditory cues. Similar increases in gait velocity and stride length were observed with the combined cues, but additional benefit beyond ATT alone was not observed. Cues did not improve gait velocity during dual task walking, although stride length did increase with COMB+10. It appears persons with PD are able to benefit from attentional cueing and can combine attentional and auditory cues, but do not gain additional benefit from such a combination. During walking while performing a secondary cognitive task, attentional cues may help to facilitate a longer stride length.

Effects of a short duration, high dose contact improvisation dance workshop on Parkinson disease: a pilot study.

OBJECTIVES: This study explored the feasibility and possible benefits of contact improvisation (CI) as an exercise intervention for individuals with PD. DESIGN: This was an uncontrolled pilot study. INTERVENTION: Eleven people with PD (H&Y=2.4 ± 0.4) participated in a workshop of 10 1.5-h CI classes over 2 weeks, dancing with previously trained student CI dancers. MAIN OUTCOME MEASURES: Measures of disease severity, balance, functional mobility, and gait were compared 1 week before and after the workshop. RESULTS: Participants demonstrated improvements on the Unified Parkinson Disease Rating Scale-Motor Subsection and Berg balance scores, along with increased swing and decreased stance percentages during walking. Backward step length also increased. Participants expressed a high level of enjoyment and interest in taking future CI classes. CONCLUSIONS: This pilot study supports the feasibility of CI as an intervention to address mobility limitations associated with PD.

Effects of dance on balance and gait in severe Parkinson disease: a case study.

PURPOSE: Dance may improve functional mobility in individuals with mild-to-moderate Parkinson disease (PD), yet dance effects in severe PD remain unexamined. This study's purpose was to evaluate the feasibility and effects of partnered tango classes on balance, endurance and quality of life in an individual with severe PD. DESIGN: Over 10 weeks, the participant attended 20, 1-h tango classes for individuals with PD. Balance, walking, and quality of life were evaluated before and after the intervention and at a 1-month follow-up in this single case design. Caregiver burden was also assessed at all time points. RESULTS: The participant improved on the Berg Balance Scale, 6-min walk test, and functional reach. He reported increased balance confidence and improved quality of life as measured by the Parkinson Disease Questionnaire-39 summary index. Gains were maintained at the 1-month follow-up. Caregiver burden increased from baseline immediately post-intervention and at follow-up. CONCLUSION: Twenty partnered tango lessons improved balance, endurance, balance confidence, and quality of life in a participant with severe PD. This is the first report of the use of dance as rehabilitation for an individual with advanced disease who primarily used a wheelchair for transportation.

Social partnered dance for people with serious and persistent mental illness: a pilot study.

Individuals with serious mental illness (SMI) often experience isolation and poor health, but normalized social opportunities aid recovery. This study aimed to determine social dance's feasibility and effects on mood, functional mobility, and balance confidence in 12 people with SMI. Participants danced once per week in 1-hour lessons for 10 weeks. Before and after lessons, participants were evaluated for gait velocity and with one-leg stance, Timed Up and Go, and 6-minute walk tests. Participants self-completed Beck Depression II and Beck Anxiety Inventories and the Activities-specific Balance Confidence Scale. Posttesting included an exit questionnaire assessing participant experiences. Participants significantly improved on the Timed Up and Go, (p = 0.012, effect size = 0.68), and demonstrated nonsignificant improvements in anxiety, depression, and balance confidence (effect sizes of 0.41, 0.54, and 0.64, respectively). Participants reported enjoying classes, and interest to continue. Social dance is feasible and may benefit mobility for those with SMI.

Effects of dance on gait and balance in Parkinson's disease: a comparison of partnered and nonpartnered dance movement.

Partnered tango dance can improve balance and gait in individuals with Parkinson's disease (PD). Partnered dance may allow these individuals to challenge balance more than nonpartnered dance. Alternatively, partnered practice could reduce balance gains because the participant may rely on the partner as a balance aid when challenged. The authors compared the effects of partnered and nonpartnered dance on balance and mobility in 39 people (11 women) with mild-moderate PD (Hoehn and Yahr stages I-III). Participants were randomly assigned to partnered or nonpartnered tango and attended 1-hour classes twice per week, completing 20 lessons within 10 weeks. Balance and gait were evaluated in the weeks immediately before, immediately after, and 1 month after the intervention. Both groups significantly improved on the Berg Balance Scale, comfortable and fast-as-possible walking velocity, and cadence. Improvements were maintained at the 1-month follow-up. The nonpartnered class improved as much as the partnered class; however, partnered participants expressed more enjoyment and interest in continuing.

Short duration, intensive tango dancing for Parkinson disease: an uncontrolled pilot study.

OBJECTIVE: The goal of this pilot study was to determine the effects of short duration, intensive tango lessons on functional mobility in people with Parkinson disease. DESIGN: This study employed a within-subject, prospective, repeated measures design. SUBJECTS/PATIENTS: Fourteen people with idiopathic Parkinson disease participated. SETTING: All balance and gait assessments were performed in a laboratory, but dance classes took place in a large, open classroom. INTERVENTIONS: Participants completed ten 1.5-h long Argentine tango dance lessons within 2 weeks. Their balance, gait and mobility were assessed before and after the training sessions. MAIN OUTCOME MEASURES: Measures included the Berg Balance Scale, the Unified Parkinson Disease Rating Scale, gait velocity, functional ambulation profile, step length, stance and single support percent of gait, Timed Up and Go, and the 6 min walk. RESULTS: Participants significantly improved on the Berg Balance Scale (effect size (ES)=0.83, p=0.021), Unified Parkinson Disease Rating Scale Motor Subscale III (ES=-0.64, p=0.029), and percent of time spent in stance during forward walking (ES=0.97, p=0.015). Non-significant improvements were noted on the Timed Up and Go (ES=-0.38, p=0.220) and 6 min walk (ES=0.35, p=0.170). CONCLUSIONS: Frequent social dance lessons completed within a short time period appear to be appropriate and effective for these individuals with mild-moderately severe Parkinson disease.