Dance is more than therapy: Qualitative analysis on therapeutic dancing classes for Parkinson's.

OBJECTIVES: To understand the benefits and limitations of therapeutic dancing classes for people with Parkinson's disease (PD) and how best to design and implement classes. DESIGN: A stakeholder forum explored the opinions of 18 allied health clinicians, dance instructors, people with PD and caregivers. Data were thematically analysed and interpreted within a grounded theory framework. RESULTS: Four main themes were identified: (1) the need to consider the stage of disease progression when designing classes; (2) recognition that dance is more than just therapy; (3) the benefits of carefully selecting music to move by; (4) ways to design classes that are both feasible and engaging. These themes give rise to the theory that dancing classes can provide more than just therapeutic benefits. Dance affords creative expression and enables people to immerse themselves in the art-form, rather than focussing on the disease. The results highlight the benefits of enabling individuals with PD to be able to express themselves in a supportive environment that does not see them solely through the lens of Parkinson's. The feasibility of dance programs can be increased by educating dancing teachers about PD and the unique needs of people living with this condition. CONCLUSION: Well-structured dance classes can promote social-connectedness and joy, in addition to facilitating movement to music and physical activity. Consumers advised that careful planning of the classes and tailoring them to participant needs optimizes outcomes.

Effects of external cues on gait parameters of Parkinson's disease patients: a systematic review.

OBJECTIVES: A systematic review to evaluate the benefits of external cues on the gait of PD patients and their impact on the quality of life, freezing and psychomotor performance was performed. The types of cues that could lead to more significant gains were analyzed. METHODS: We searched for randomized clinical trials (RCTs) and quasi-randomized clinical trial (QRCTs) that assessed the influence of different external cues on gait, freezing, quality of life and psychomotor performance. RESULTS: Of 259 articles collected, seven (six RCTs and one QRCT) were included in the methodological quality criteria (two consider visual cues, two consider auditory cues, one considers verbal instructions, one considers combined cues and one considers sensory cues). All of the data regarding the methodology, interventions, population and bias were described. Cues generally led to a statistically significant improvement in the step and stride length, speed of gait, cadence and UPDRS. None of these studies assessed the quality of life, and one study analyzed freezing. CONCLUSION: Our review could show that external cues are effective for improving the gait parameters and psychomotor performance of PD patients. We need more studies to verify if the impact of this type of treatment could improve the quality of life of patients with PD.

Neural mobilization reverses behavioral and cellular changes that characterize neuropathic pain in rats.

BACKGROUND: The neural mobilization technique is a noninvasive method that has proved clinically effective in reducing pain sensitivity and consequently in improving quality of life after neuropathic pain. The present study examined the effects of neural mobilization (NM) on pain sensitivity induced by chronic constriction injury (CCI) in rats. The CCI was performed on adult male rats, submitted thereafter to 10 sessions of NM, each other day, starting 14 days after the CCI injury. Over the treatment period, animals were evaluated for nociception using behavioral tests, such as tests for allodynia and thermal and mechanical hyperalgesia. At the end of the sessions, the dorsal root ganglion (DRG) and spinal cord were analyzed using immunohistochemistry and Western blot assays for neural growth factor (NGF) and glial fibrillary acidic protein (GFAP). RESULTS: The NM treatment induced an early reduction (from the second session) of the hyperalgesia and allodynia in CCI-injured rats, which persisted until the end of the treatment. On the other hand, only after the 4th session we observed a blockade of thermal sensitivity. Regarding cellular changes, we observed a decrease of GFAP and NGF expression after NM in the ipsilateral DRG (68% and 111%, respectively) and the decrease of only GFAP expression after NM in the lumbar spinal cord (L3-L6) (108%). CONCLUSIONS: These data provide evidence that NM treatment reverses pain symptoms in CCI-injured rats and suggest the involvement of glial cells and NGF in such an effect.