Jaques-Dalcroze’s music-based rhythmic training affects gait parameters and quality of life in Parkinson’s Disease Promotion de la santé et la prévention face au vieillissement 22. Novembre 2019 Jennifer Masset [email protected]
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Jaques-Dalcroze’s music-based rhythmic training affects gait
parameters and quality of life in Parkinson’s Disease
Promotion de la santé et la prévention face au vieillissement
22. Novembre 2019
Jennifer Masset
Introduction Parkinson‘s Disease (PD)
GaitIncreased risk of falls
• High impact of multi-task performance in everyday life
MotorCognitiveBradykinesia
Tremor at rest
Rigidity
Dopaminergic medication
?
? - Reduced walking speed
- Increased gait variability(Yogev-Seligmann et al. 2008)
Apathy/ Depression
Attentional Deficits
„Loss of automaticity“
Memory
• Falls major cause of mobidity and mortality in PD
(Jankovic, 2008; Bloem et al. 2006)
Introduction
Neurologic Music Therapy (NMT)
Keus, S. (2014). Poster: Physiotherapy for Parkinson’s disease. A joint Europe Guideline.
• Auditory Stimulation Thaut et al. 1996
• Argentinian Tango Review: Lotzke et al. 2015
• Tai Chi Review: Ni et al. 2014
Exercise paradigm: Jaques Dalcroze
- Emile Jaques Dalcroze (1865 – 1950)
- Children‘s and adolescents‘ music education all over the world
- Music movement therapy
Mind
Body
Space
Time
Bachmann ML. Dalcroze today. An Education Through and into Music. New York: Oxford University Press, 1991
Corporal expression in synchrony with external cues
• Motor-cognitive: balance, coordination, attention, memory
• Multisensory: visual, auditory, tactile
• Emotional: social aspect / group belonging
Exercise paradigm: Jaques Dalcroze
Literature
ConclusionLong-term JD exercise intervention can preventage-related gait impairment under a dual-task
Improved gait under dual-task condition, improved balance, reduced rate of falls and risk of falling
Dalcroze and Geriatrics (Jaques Dalcroze long-term intervention)
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
+ temporal processing and internal rhythmic timing
+ gait parameters for single and dual task (motor-cognitive interference)
+ quality of life, course satisfaction
Positive effects after short-term intervention Jaques Dalcroze in Parkinson’s Disease
Dual-Task paradigm:
• Walking while cognitive task:
- Animal naming
Methods
Pilot Study
Participants: n=16
• Parkinson’s Disease: Hoehn &Yahr 2-3
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »
Intervention: 1 monthCourse: 2 x 45min / week
Testing Session Testing Session
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
Mean Age 67 ± 7 yrs
Gender 12 w / 4 m
Diseaseduration
9.5 ± 6.5
LEDD 712 ± 480 mg
H&Y 2.5
Methods
Pilot Study
Participants: n=16
• Parkinson’s Disease: Hoehn &Yahr 2-3
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »
Intervention: 1 monthCourse: 2 x 45min / week
Testing Session Testing Session
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
2) Gait Variability (CV%)1.1) Walking Speed (m/s)
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
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
p = 0.001
pre post pre post
20
16
12
8
20
16
12
8
Walking Speed (sec)
ResultsSingle Task 10 m
1.25
1.0
0.75
0.5
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
p = 0.011
pre post
Walking Speed (m/s)
p = 0.050
pre post
12
8
4
Gait Variability (CV%) – Stride Length
Results
Dual Task
pre post
p = 0.015
1.25
1.0
0.75
0.5
Walking Speed (m/s) Gait Variability (CV%) – Stride Length
pre post
p = 0.008
12
4
16
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
+ significant increase of walking speed for Single-Task, p = 0.01 (gait variability tendency, p = 0.050)
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 Dual-Task, p = 0.015
+ highly significant improvement of gait variability for dual-task, p=0.008
Methods
Pilot Study
Participants: n=16
• Parkinson’s Disease: Hoehn &Yahr 2-3
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »
Intervention: 1 monthCourse: 2 x 45min / week
Testing Session Testing Session
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
Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
p = 0.021
p = 0.013
p = 0.041
p = 0.033
p = 0.053
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 EurythmicsPhoto by Arthur Tanner/Fox Photos/Getty Images
Related Documents
