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Balance, Body Motion, and Muscle Activity After High-Volume Short-Term Dance-Based Rehabilitation in Persons With Parkinson Disease: A Pilot Study

McKay, J. Lucas PhD, MSCR; Ting, Lena H. PhD; Hackney, Madeleine E. PhD

Journal of Neurologic Physical Therapy: October 2016 - Volume 40 - Issue 4 - p 257–268
doi: 10.1097/NPT.0000000000000150
Research Articles
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Background and Purpose: The objectives of this pilot study were to (1) evaluate the feasibility and investigate the efficacy of a 3-week, high-volume (450 minutes per week) Adapted Tango intervention for community-dwelling individuals with mild-moderate Parkinson disease (PD) and (2) investigate the potential efficacy of Adapted Tango in modifying electromyographic (EMG) activity and center of body mass (CoM) displacement during automatic postural responses to support surface perturbations.

Methods: Individuals with PD (n = 26) were recruited for high-volume Adapted Tango (15 lessons, 1.5 hour each over 3 weeks). Twenty participants were assessed with clinical balance and gait measures before and after the intervention. Nine participants were also assessed with support-surface translation perturbations.

Results: Overall adherence to the intervention was 77%. At posttest, peak forward CoM displacement was reduced (4.0 ± 0.9 cm, pretest, vs 3.7 ± 1.1 cm, posttest; P = 0.03; Cohen's d = 0.30) and correlated to improvements on Berg Balance Scale (ρ = −0.68; P = 0.04) and Dynamic Gait Index (ρ = −0.75; P = 0.03). Overall antagonist onset time was delayed (27 ms; P = 0.02; d = 0.90) and duration was reduced (56 ms, ≈39%, P = 0.02; d = 0.45). Reductions in EMG magnitude were also observed (P < 0.05).

Discussion and Conclusions: Following participation in Adapted Tango, changes in kinematic and some EMG measures of perturbation responses were observed in addition to improvements in clinical measures. We conclude that 3-week, high-volume Adapted Tango is feasible and represents a viable alternative to longer duration adapted dance programs.

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The Wallace H. Coulter Department of Biomedical Engineering, Emory University, and the Georgia Institute of Technology (J.L.M., L.H.T.), Atlanta VA Center of Excellence for Visual & Neurocognitive Rehabilitation (M.E.H.), and Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine (M.E.H.), Atlanta, GA.

Correspondence: J. Lucas McKay, PhD, MSCR, Emory Rehabilitation Hospital, Room R154, 1441 Clifton Rd, Atlanta, GA 30322 (

None of the authors have potential conflicts of interest to be disclosed.

This work has been previously published in an abstract form at the International Society for Posture and Gait Research.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

© 2016 Academy of Neurologic Physical Therapy, APTA