Objective: This study determined the efficacy of internally guided (leading) versus externally guided (following) in adapted tango versus a contact-matched control group (wellness education) for improving endurance, visuospatial function, and mental quality of life in individuals with mild-moderate PD.

Background: Individuals with Parkinson’s disease (PD) have trouble internally generating (IG) movement, but this impairment can be aided by external cues (Kadivar et al., 2011). Adapted Tango has benefitted motor and cognitive function in people with PD, but participants danced both roles previously (McKee & Hackney 2013). This study isolated the effects of predominantly IG versus EG training by assigning participants to leading or following exclusively.

Methods: This randomized controlled trial enrolled 83 individuals with PD (age 70 (7) years, time with PD 6.5(5) years, Unified Parkinson Disease Rating Scale-III (UPDRS), 36.0(12)), evaluated while OFF medications. Participants attended 20 sessions of 90-minute tango classes engaging in IG (leaders; n=33), or EG training (followers; n=29 ) or Education (n= 21) within 13 weeks. Motor, cognitive, and psychosocial function were evaluated immediately before and after, and 1 month after the intervention. The primary motor, cognitive and psychosocial endpoints were the 6 minute walk test (6MWT), the Corsi blocks, and the Parkinson disease questionnaire-39. The MDS-UPDRS and the Tower of London were also administered. Repeated-measures analyses of variance (ANOVAs) with post hoc comparisons were used.

Results: 24 leaders, 23 followers, and 18 Education participants completed 20 sessions. Significant group by time interactions revealed an effect on the UPDRS IV, i.e., (OFF Time, p=.035) and the Tower of London (TOL) Time/move (p=.005). Leaders improved on the UPDRS-IV scores at posttest, Followers improved on TOL time/move at 1-month posttest, and Education improved on TOL Time/move at both posttest and 1-month posttest. Planned a priori comparisons revealed that Followers improved at posttest and 1-month posttest on the primary endpoints, 6MWT, Corsi blocks, and the the PDQ-39 Summary index. Leaders and Education improved on the TOL Rule violation at posttest and 1-month posttest.

Conclusions: Expected gains were noted in Education in cognition. Following, which involves EG training, may benefit more aspects of motor, cognitive and psychosocial function than leading in partnered dance for people with mild-moderate PD. However, leading may be associated with greater improvements in PD-related motor fluctuations. Further research is necessary to confirm these findings.

References: Kadivar Z, Corcos DM, Foto J, Hondzinski JM, Effect of step training and rhythmic auditory stimulation on functional performance in Parkinson patients. Neurorehabil Neural Repair. 2011; 25(7):626-35. McKee KE, & Hackney ME. The effects of adapted tango on spatial cognition and disease severity in Parkinson’s disease. Journal of motor behavior, 2013; 45(6): 519-529.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/it-takes-two-to-tango-but-following-may-be-more-beneficial-for-rehabilitating-people-with-mild-moderate-parkinsons/