Jaques-Dalcroze’s music-based rhythmic training affects gait
parameters and quality of life in Parkinson’s Disease
Jennifer Masset
Promotion de la santé et la prévention face au vieillissement
22. Novembre 2019
[email protected]
Introduction Parkinson‘s Disease (PD)
Attentional Deficits Dopaminergic medication
Bradykinesia
? „Loss of automaticity“
Memory
Cognitive Motor
Tremor at rest
Apathy/ Depression Rigidity
Increased
Gaitrisk of falls
? - Reduced walking speed
- Increased gait variability
(Yogev-Seligmann et al. 2008)
• High impact of multi-task performance in everyday life
• Falls major cause of mobidity and mortality in PD
(Jankovic, 2008; Bloem et al. 2006)
Introduction
Neurologic Music Therapy (NMT)
• Auditory Stimulation Thaut et al. 1996
• Argentinian Tango Review: Lotzke et al. 2015
• Tai Chi Review: Ni et al. 2014
Keus, S. (2014). Poster: Physiotherapy for Parkinson’s disease. A joint Europe Guideline.
Exercise paradigm: Jaques Dalcroze Mind
Body
- Emile Jaques Dalcroze (1865 – 1950) Space
- Children‘s and adolescents‘ music education all over the world
Time
- Music movement therapy
Corporal expression in synchrony with external cues
• Motor-cognitive: balance, coordination, attention, memory
• Multisensory: visual, auditory, tactile
• Emotional: social aspect / group belonging
Bachmann ML. Dalcroze today. An Education Through and into Music. New York: Oxford University Press, 1991
Exercise paradigm: Jaques Dalcroze
Literature
Dalcroze and Geriatrics (Jaques Dalcroze long-term intervention)
Long-term JD exercise intervention can prevent
Improved gait under dual-task condition, improved balance, reduced
Conclusion age-related gait impairment under a dual-task
rate of falls and risk of falling
Trombetti A et al. Effect of music-based multitask training on gait, balace and fall risk in elderly people: a randomized controlled trial. Arch Intern Med. 2010 Nov 22.
Kressig RW et al. Long-term practice of Jaques-Dalcroze Eurhythmics prevents age-related increase of gait variability under dual-task. J Am Geriatr Soc 2005;53:728-9.
Hypotheses
Positive effects after short-term intervention Jaques Dalcroze in Parkinson’s Disease
+ temporal processing and internal rhythmic timing
+ gait parameters for single and dual task (motor-cognitive interference)
+ quality of life, course satisfaction
Dual-Task paradigm:
• Walking while cognitive task:
- Animal naming
Participants: n=16 Mean Age 67 ± 7 yrs
Methods Gender 12 w / 4 m
• Parkinson’s Disease: Hoehn &Yahr 2-3 Disease 9.5 ± 6.5
Pilot Study duration
• No regular physical activity / No experience NMT
LEDD 712 ± 480 mg
• Stable medication, Testing « Med On »
H&Y 2.5
Testing Session Intervention: 1 month Testing Session
Course: 2 x 45min / week
Gait:
- 2 X 10m self-selected speed
- 1 X 10m dual- task (animals)
- 1 X 10m dual-task (counting)
- TUG
Questionnaires:
- Quality of Life (PDQ modified)
- Satisfaction
Participants: n=16
Methods
• Parkinson’s Disease: Hoehn &Yahr 2-3
Pilot Study
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »
Testing Session Intervention: 1 month Testing Session
Course: 2 x 45min / week
Gait:
- 2 X 10m self-selected speed
- 1 X 10m dual- task (animals)
- 1 X 10m dual-task (counting)
- TUG
Questionnaires:
- Quality of Life (PDQ modified)
- Satisfaction
Methods
Parameters
1.1) Walking Speed (m/s) 2) Gait Variability (CV%)
1.2) Scores cognitives
Stride Stride
Yogev-Seligmann et al. „The role of executive function and attention in gait. Movement Disorder 2008 Feb 15;23(3):329-42.
Results
Timed Up and Go
Walking Speed (sec)
20 20
16 16
12 12
8 8
pre post
pre post
p = 0.001
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
Results
Single Task 10 m
Walking Speed (m/s) Gait Variability (CV%) – Stride Length
1.25 12
1.0
8
0.75
4
0.5
pre post pre post
p = 0.011 p = 0.050
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
Results
Dual Task
Walking Speed (m/s) Gait Variability (CV%) – Stride Length
16
1.25
12
1.0
0.75
0.5 4
pre post pre post
p = 0.015 p = 0.008
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
No change for cognitive scores, for p<0.05
Conclusion
Gait parameters
After short-term intervention Jaques Dalcroze in Parkinson’s Disease…
+ highly significant increase in functional capacities (TUG) , p = 0.001
+ significant increase of walking speed for Single-Task, p = 0.01 (gait variability tendency, p = 0.050)
+ significant increase of walking speed for Dual-Task, p = 0.015
+ highly significant improvement of gait variability for dual-task, p=0.008
Participants: n=16
Methods
• Parkinson’s Disease: Hoehn &Yahr 2-3
Pilot Study
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »
Testing Session Intervention: 1 month Testing Session
Course: 2 x 45min / week
Gait:
- 2 X 10m self-selected speed
- 1 X 10m dual- task (animals)
- 1 X 10m dual-task (counting)
- TUG
Questionnaires:
- Quality of Life (PDQ modified)
- Satisfaction
Quality of life / PDQ
p = 0.021 p = 0.041
p = 0.033
p = 0.013
p = 0.053
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
Feedback Participants
Conclusion
- Mobility: Improved gait parameters (walking speed, gait variability)
- Quality of Life: Improved PDQ in domains: mobility, emotional well-being, stigma, cognition)
- Satisfaction: Extremely high global satisfaction (0 drop-out rate)
Perspectives
- JD rhythmic courses as potential complementary therapy
- RCT
- Contact
Thank you for your attention
Dance Class23rd November 1934: Students at the London School of Dalcroze Eurythmics
Photo by Arthur Tanner/Fox Photos/Getty Images
