Argentine Tango Puts Parkinson’s Patients a Step Ahead

Flatley

Image by Margaret Flatley

A forthcoming study hopes to shed new light on how tango impacts the progression of Parkinson’s disease. Dr. Gammon Earhart, PT, PhD, at the Washington University School of Medicine, leads this effort, combining traditional Argentine tango with the latest fMRI procedures to uncover how dance can rewire the brain to improve locomotor function.

Earhart said an abstract presented at a Society for Neuroscience meeting prompted her realization that tango dancing could improve motor ability.

Dr. Gammon Earhart

Dr. Gammon Earhart, PT, PhD, Washington University School of Medicine

“A group from McGill University did a pilot study on older people that were at risk for falling but did not have Parkinson’s, and they had compared walking for exercise to learning to dance the tango,” Earhart said. “Their results suggested that the people who had learned to dance tango showed bigger improvements in their walking performance and cognitive performance than people who had done walking for exercise. So I came back from the meeting and talked with Madeleine Hackney, who was a PhD student at the lab at the time and had just joined the lab a few months earlier after a career as a professional dancer.”

This serendipitous series of events motivated Earhart’s own pilot study into how people with Parkinson’s disease would respond to tango.

“So many aspects of the dance intuitively make sense that they would be potentially beneficial to people with Parkinson’s,” said Earhart. “For tango in particular, the basic step is walking. If you are the follower, you are walking backwards, and people with Parkinson’s have trouble walking backwards, so here is a way to practice a task that’s difficult again and again in the context of the dance so it doesn’t seem like forced practice.”

Other factors of tango include the music, which serves as an external cue for people with Parkinson’s to take quicker and larger steps, and floorcraft, which may improve multitasking ability as participants must maintain their own gait while attending to the music, to their partner, and to other couples on the dance floor.

In the case of this and subsequent studies, the theory has held strong: participants have consistently reported benefits of improved motor function in their daily lives.

While the results of the current study are forthcoming, previous studies by Earhart have found improved motor function in participants in as early as two weeks of tango lessons with classes meeting five times per week, though the benefits were greater in studies where participants went to two classes per week for three months. The longest study, which was conducted over the course of an entire year, found improved motor function in the first six months, followed by a steady maintenance of the benefits for the latter six months.

These results suggest that participating in an exercise group may modify the trajectory of the disease. Earhart noted that after the classes, participants with Parkinson’s disease adopted a faster prefered walking speed. In addition, participants demonstrated improvement in dual task performance, which involves performing a cognitive task while maintaining a steady gait.

Anecdotally, the benefits of tango are encouraging.

“One participant had gone to New York for an interview, and she was talking about how she was in the metro. It shook all of a sudden, and she stepped backwards,” said Robin Girard, who, along with Maya Matheis, has acted as an instructor for the tango classes for the past three years. “That was a reflex she had developed from walking backwards constantly, and she felt really comfortable in a situation where she would not have been able to react as well had she not had that training.”

Perhaps it is the distinctive focus that tango places on comfort that facilitates these improvements.

“Tango puts a stronger emphasis on moments that feel good, not an emphasis on performance in front of other people,” Matheis said. “We tell participants not to do anything that feels uncomfortable or unsafe, and that’s not just for this class, that’s true for all of Argentine tango.”

As for the study, in healthy young control subjects, fMRI scans have shown shifts in brain activation related to a more conscious, focused attention towards walking after learning to dance tango. Earhart is interested not only in how physical performance of the participants change, but also how the brain itself changes with exercise. Imaging results before and after exercise will attempt to determine how various exercise interventions change the wiring between different regions of the brain responsible for locomotion.


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