Dance Down the Cobblestone Road

Dance Down the Cobblestone Road

by Marrina Jacka

Edited by Aston K. McCullough

For five years now, I have been actively volunteering with Stony Brook Hospital, where I assist with the Dance for Parkinson’s Disease (PD) program. The Dance for PD classes utilize structures that often appear in dance classes to help people with PD improve motor function and wellbeing. The classes begin with participants seated in a chair. They move a foot, then a leg, then progress into both feet and legs gesturing to perform ballet actions like tendus and piques. The class participants then advance to standing activities, wherein the goal is to engage them in synchronized actions that utilize dance forms like waltz, ballet, modern, and others that require motor coordination and group interaction.

Throughout my time working in Dance for PD classes, I have remained curious about how long the effects of dance persist after a single exposure and how the brain adapts or finds new pathways thanks to these practices. One experience from the Dance for PD classes that clearly stands out for me was when I worked with Steve (a dance class participant) and his wife, Jill. In the studio, Steve and Jill were always the first to greet me with a smile. In our interactions, I occasionally perceived some skepticism in Steve about how the effects of dance would support his quality of life and motor function. As dancers, we know intimately that consistency and focused, correct practice improves dance performance technique. When I recall my experiences of working with Steve, I distinctly remember him beginning the dance program with little confidence and a lot of trouble maintaining balance while standing. A little less than a year after he began the Dance for PD program, Steve and Jill traveled to Europe for a vacation. When Steve and Jill returned from their trip, they greeted me with the smiles I’d come to know, but this time they both had a fresh glow in their eyes. Steve shared that while traveling with his wife, he was able to walk confidently down cobblestone roads without any help throughout the entire trip. Their gleaming pride was indelible. With Steve, I saw how much consistent participation in the Dance for PD classes played a role in improving motor function and confidence in his own movement. Anecdotally, I was reassured, once again, that dance has the power to help him and others in mediating the sequelae associated with this neurodegenerative disease.

An early 2021 study published in Frontiers in Psychology, “Beauty that Moves: Dance for Parkinson’s Effects on Affect, Self-Efficacy, Gait Symmetry, and Dual Task Performance,” by Dr. Cecilia Fontanesi contributes to the current evidence on the benefits of Dance for PD classes and their impact on health. 

Dr. Fontanesi’s report included 7 people living with PD who were tested before and after both a Dance for PD class and a matched intensity exercise session. In my interview with Dr. Fontanesi, I learned about some of the choices she made while designing her study. From the outset, Dr. Fontanesi was clear to keep the activity intensity the same in the exercise control and the dance conditions. As a result of her prior knowledge of the relationship between aerobic activity and enhanced neuroplasticity as well as the benefits of physical activity and dance for people living with PD, Fontanesi hypothesized that a single exposure to a Dance for PD session, when compared to exercise, would yield significantly different responses in self-efficacy, physiological, motor, and affective outcomes in a cohort of adults with PD. 

Building the exercise control condition required Dr. Fontanesi to create a movement environment that was free of artistic elements such as music, metaphorical language, and a shared reality of partaking in art. She used her expertise as a Laban Movement Analyst to focus solely on the body and space to ensure the exercise control condition was free of any expressive elements. This led Fontanesi to use a metronome during the exercise control condition, instead of music, thus removing any potential emotional stimuli from the environment. Guided opportunities to relate to one’s movement or develop meaning from one’s movement were not included in the exercise condition.

In order to understand responses to a single Dance for PD session, Fontanesi conducted assessments of gait symmetry and dual-task performance. Before both the exercise control and Dance for PD sessions, the 6-minute walk test and a dual-task “Timed Up & Go” test were used to collect data on gait symmetry and dual-task performance by using body-worn sensors that collected triaxial motion data for each person. Participants were given questionnaires before and after the exercise control and Dance for PD sessions to measure positive and negative affect, body self-efficacy, and “beauty.” Wearable devices were used to measure heart rate and electrodermal activity during both the exercise control and Dance for PD sessions.

All these tests helped Fontanesi identify that dance, when compared to an exercise session of the same intensity, may elicit different responses in gait symmetry, feelings of beauty, body self-efficacy, dual-task performance, and electrodermal activity. After the dance session, participants had relatively higher gait symmetry and performed better on a dual-task performance test than after the exercise control session. Participants also reported higher body self-efficacy, higher ratings of their own movement being perceived as beautiful, and that they could move with elegance and grace after dance more than exercise. The researchers also reported that skin conductance levels from electrodermal activity measurements were related to participants’ self-reported general positive affect—as skin conductance levels during a session increased, self-reported general positive affect also increased following that session. Average skin conductance levels were also higher during the dance session than during the exercise session.

Overall, these results intrigued Dr. Fontanesi because they may provide some answers about why people move better after class and why they keep returning to Dance for PD classes for benefits that appear to transfer to everyday life, as reported by Steve and Jill. The practice of dance is not a mandate nor prescription, Fontanesi explains—the results from her study provide clues about why someone might feel different after dance than another activity modality. As Dr. Fontanesi notes, “Dance is integration between emotional, cognitive, and physical levels; we do not exist in compartments.” These data led Fontanesi to, again, return to the importance of artistry within the context of dance and health, and especially within Dance for PD sessions.

In addition to repeating this study with a larger cohort, Dr. Fontanesi intends to continue her investigations by focusing further on mechanisms of action that help to explain the benefits of dance for people living with Parkinson’s Disease. “Dance science is being built now,” Fontanesi emphasizes, so she is motivated to inspire others to grow the field, as well as to continue her own work in this evolving area of research. As for advice to budding dance scientists at the high school level and earlier, Dr. Fontanesi underscored the power of curiosity and asking the right questions in dance science research, and she concluded with a timeless quote from Pina Bausch: “Dance, dance otherwise we are lost.”

Author Bio

Marrina Jacka is a senior at the Ross School in East Hampton New York and she studies dance at Hampton Ballet Theater School. Inspired by Anna Halprin’s dance works, legacy, and text Making Dances that Matter, Ms. Jacka is interested in the effects of dance on cognition and the therapeutic effects of dance, especially among individuals with post-traumatic stress disorder. Ms. Jacka has worked for four years with the Dance for Parkinson’s Disease program at Stony Brook Hospital. Over the past four years, she has also developed a passion for physics. Ms. Jacka was delighted to join LAB:SYNC at UMass Amherst as a 2021 Summer Research Intern, and she is excited to continue studying dance science in the years to come.