Digital Dance for People With Parkinson's Disease During the COVID-19 Pandemic

Dance as a treatment to support physical, cognitive and emotional functioning, has gained increased acceptance as a healthcare intervention for people with Parkinson's Disease (PD). The impact of the COVID-19 pandemic has been far reaching with devastating effects for at-risk populations. To find alternative and safe treatment delivery options during the pandemic has been of outmost importance. This mixed-methods, feasibility study on digital for people with Parkinson's Disease aimed to investigate: (1) the feasibility and safety of a digital home-based dance intervention for people with PD; (2) change in self-reported quality of life, cognitive complaints, psychological health and fatigue; and (3) the experience of digital dance for people with PD. Twenty-three participants partook in 10 weekly digital dance classes at home via zoom. Feasibility outcomes measures were administered at post-test. Pre-post changes in self-reported quality of life, cognitive complaints, psychological health and fatigue were measured, as well as the experience of digital dance via focus groups.

The digital dance class was held via Zoom. The class was scheduled once a week for 60 min and consisted of 10 sessions. A professional, certified Dance for PD and experienced dance instructor was teaching the dance class. The dance classes followed the Dance for PD protocol yet was adjusted to fit the digital zoom format.

The following feasibility outcome measures were assessed: (a) Technical and safety issues, (b) Compliance and motivation, (c) Self-assessed improvement in physical function, wellbeing and cognitive function and (d) The importance of dance as an artistic and creative activity. Each feasibility outcome measure was assessed via a 5-point Likert scale ranging from (1=very unsatisfactory, 5=very satisfactory), (1=not motivated, 5=very motivated), (1=noticeable worsening, 5=noticeable improvement) or (1=not meaningful, 5=very meaningful). Furthermore, each feasibility outcome measure had an open-ended question connected to it in order to capture any details related that feasibility domain. Two open-ended questions regarding positive and negative aspects of digital dancing were also included. For each feasibility outcome measure, a criterion of success was developed in order to judge the the success rate of these feasibility outcome measures.

Severity of depression and anxiety symptoms measured by Hospital Anxiety Depression scale Anxiety score: 0-21 higher score indicate more anxiety Depression score: 0-21 higher score indicate more depression

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39), Summary index: 0-100 higher scores indicate more problems. Furthermore, scores on the following subscales were assessed: Mobility score: 0-100 higher scores indicate more problems Activity of Daily Living score: 0-100 higher scores indicate more problems Emotional well being score: 0-100 higher scores indicate more problems Stigma score: 0-100 higher scores indicate more problems Social support score: 0-100 higher scores indicate more problems Cognition score: 0-100 higher scores indicate more problems Communication score: 0-100 higher scores indicate more problems Bodily discomfort score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Bodily discomfort score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Communication score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale:Cognition score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Social support score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Stigma score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Emotional well being score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale: Activity of Daily Living score: 0-100 higher scores indicate more problems

Quality of life measured by Parkinson's Disease Questionnaire-39 (PDQ39). Subscale Mobility score: 0-100 higher scores indicate more problems

Improvement on subjective memory complaints measured by Prospective Retrospective Memory Questionnaire (PRMQ). Total score: 16-80 higher scores indicate more cognitive complaints prospective score: 0-100 higher scores indicate more cognitive complaints retrospective score: 0-100 higher scores indicate more cognitive complaints short term score: 0-100 higher scores indicate more cognitive complaints long term score: 0-100 higher scores indicate more cognitive complaints self cued score: 0-100 higher scores indicate more cognitive complaints environmentally cued: 0-100 higher scores indicate more cognitive complaints

Two questions from the Mental Fatigue Scale were used to measure mental fatigue (item 3) and recovery (item 4). Answers were given on a 7-point Likert scale.

Two focus group interviews were conducted to examine the broader experience of digital dance for people with PD.

Inclusion Criteria: Self-reported diagnosis of Parkinson's Disease Participant in Dance for PD at Balettakademien, Stockholm, Sweden Exclusion Criteria: None

Walton L, Domellof ME, Astrom AN, Elowson A, Neely AS. Digital Dance for People With Parkinson's Disease During the COVID-19 Pandemic: A Feasibility Study. Front Neurol. 2022 Feb 3;12:743432. doi: 10.3389/fneur.2021.743432. eCollection 2021.