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An Investigation Into the Feasibility and Benefit of Irish Set Dancing for People with Parkinson’S Disease

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An Investigation Into the Feasibility and Benefit of Irish Set Dancing for People with Parkinson’S Disease An Investigation into the Feasibility and Benefit of Irish Set Dancing for People with Parkinson’s Disease Joanne Shanahan BSc. MISCP A thesis submitted to the University of Limerick in fulfilment of the requirements for the award Doctor of Philosophy in Clinical Therapies University of Limerick Supervised by: Dr. Amanda M. Clifford Dr. Orfhlaith Ni Bhriain, Prof. Meg E. Morris Submitted to the University of Limerick, November 2016 i i Abstract Title: An investigation into the feasibility and benefit of Irish set dancing for people with Parkinson’s disease Author: Joanne Shanahan Irish set dancing may be beneficial for people with Parkinson’s disease and encourage habitual exercise participation through the integration of dynamic balance activities, socialisation and musical enrichment. Currently, only one published study, which was carried out in a sample of Venetians with Parkinson’s disease, has investigated the feasibility of set dancing. Set dancing has a rich cultural heritage in Ireland and is a popular social and cultural activity in Ireland. Thus, research exploring the role of set dancing as an exercise activity in an Irish population is warranted. The aim of the project presented in this thesis was to investigate the feasibility and benefit of Irish set dancing for people with Parkinson’s disease in Ireland. The findings of a systematic review and single-group feasibility study informed the methods of a multi-centered pilot randomised controlled trial (RCT). Ninety participants were randomised (n=45 per group) into a set dancing group and usual care control group. No adverse effects were reported. Attrition during the study was >40% in both groups and adherence to the intervention was 93.5%. Post- intervention, the dance group demonstrated greater improvements in quality of life compared to the control group. Motor function deteriorated in the control group. An exit questionnaire showed participants enjoyed the classes and would like to continue participation. An educational resource to inform set dancing teachers about Parkinson’s disease was developed using information gathered from the research studies described in this thesis and the broader literature. The results of this project provide new insights into the feasibility, safety and potential benefits of set dancing for those with Parkinson’s disease. These findings i along with the educational resource may guide future research, encourage collaborations between health and dance disciplines and facilitate successful implementation of community set dancing programmes for this population. ii Declaration I, the undersigned declare that this thesis is my own work and that the data presented is accurate. I declare that this thesis has not been submitted for any other award or degree at this or any other University. Joanne Shanahan _________________________ Date: / / iii Acknowledgments I would like to extend my gratitude to my supervisors, Dr. Amanda Clifford, Dr. Orfhlaith Ni Bhriain and Prof. Meg Morris. You provided continued support throughout my PhD. Through good and bad, you offered motivation and an experienced shoulder. Your guidance was instrumental in the development of my knowledge and skills and will never be forgotten. I am sincerely grateful. I would like to acknowledge Dr. Volpe, Margaret Richardson and Jean Saunders. Your advice was of unquestionable benefit to me during my research. To all collaborators including Elaine Harrington, Emer Fallon and Prof. Tim Lynch; your support was paramount to the completion of this research project. I would also like to thank set dancing teachers, assessors, physiotherapists and participants in the research. Without you this project would have not been a success. To my fellow classmates, we travelled this road together and advised each other. Thanks for the motivation. Last but by no means least; I would like to thank my family for supporting me during last four years. Your advice was invaluable and maybe now I might have more free time! iv Table of Contents ABSTRACT .................................................................................................................. I DECLARATION .......................................................................................................... III ACKNOWLEDGMENTS .............................................................................................. IV TABLE OF CONTENTS .................................................................................................V LIST OF TABLES ....................................................................................................... XI LIST OF FIGURES ..................................................................................................... XII LIST OF ABBREVIATIONS ....................................................................................... XIII GLOSSARY OF TERMS ............................................................................................ XIV LIST OF PUBLICATIONS ........................................................................................... XV CHAPTER 1 ............................................................................................................... 1 INTRODUCTION TO RESEARCH PROJECT .................................................... 1 1.0 PROLOGUE ........................................................................................................... 2 1.1 EPIDEMIOLOGY OF PARKINSON’S DISEASE .......................................................... 2 1.2 PATHOPHYSIOLOGY ............................................................................................. 3 1.3 CLINICAL FEATURES ............................................................................................ 5 1.4 MANAGEMENT ..................................................................................................... 6 1.5 DANCE ................................................................................................................. 8 1.6 IRISH SET DANCING ............................................................................................. 9 CHAPTER 2 ............................................................................................................. 15 CREATIVITY IN ARTS AND HEALTH: EMERGENCE OF IRISH SET DANCING FOR PEOPLE WITH PARKINSON’S DISEASE ........................... 15 2.0 PROLOGUE ......................................................................................................... 16 2.1 INTRODUCTION .................................................................................................. 16 2.2 HISTORICAL ELEMENTS OF SET DANCE AND THEIR LINK TO HEALTH ............... 18 2.3 STRUCTURAL, MOVEMENT AND THERAPEUTIC CHARACTERISTICS OF SET DANCING ................................................................................................................. 20 2.3.1 Structure of Set Dancing ........................................................................ 20 2.3.2 Set Dancing Movements and their Therapeutic Potential ...................... 24 2.3.3 The Benefits of Set Dancing Steps ........................................................ 25 2.3.4 Therapeutic Set Dancing: Additional Health Implications .................... 26 2.3.5 Potential Neural Effects of Set Dancing ................................................ 27 v 2.4 CONCLUSION ..................................................................................................... 28 2.5 EPILOGUE .......................................................................................................... 29 CHAPTER 3 ............................................................................................................. 31 DANCE FOR PEOPLE WITH PARKINSON’S DISEASE: WHAT IS THE EVIDENCE TELLING US? ................................................................................... 31 3.0 PROLOGUE ......................................................................................................... 32 3.1 INTRODUCTION .................................................................................................. 32 3.2 METHODS .......................................................................................................... 34 3.2.1 Inclusion criteria..................................................................................... 34 3.2.2 Literature search ..................................................................................... 34 3.2.3 Data extraction ....................................................................................... 36 3.2.4 Outcomes of interest .............................................................................. 36 3.2.5 Quality assessment ................................................................................. 37 3.2.6 Data analysis .......................................................................................... 37 3.3 RESULTS ............................................................................................................ 38 3.3.1 Participants ............................................................................................. 38 3.3.2 Frequency ............................................................................................... 39 3.3.3 Intensity .................................................................................................. 39 3.3.4 Duration ................................................................................................. 39 3.3.5 Type ......................................................................................................
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