Abstract
This chapter aims to present important aspects of dance for people with Parkinson's disease and the benefits of dance practice for cognition and quality of life in this population. In the first part, the context of the topic addressed was explained, presenting the main characteristics of the disease and the main contributions of dance for people with Parkinson's disease. The available literature on the impacts of dance on cognition for this population was presented and discussed. After, the findings related to the potential of dance for the population's quality of life are demonstrated and commented on. In the end, the main results found are pointed out. Although some studies did not show significant improvements in these aspects, dance practice seems to be efficient to improve cognition, mainly executive function, and increasing quality of life in people with Parkinson's disease.
TopIntroduction
Parkinson's disease (PD) is a progressive, chronic, neurodegenerative disorder that progressively incapacitates its carriers, with causes still unknown. In the disease, cells of the substantia nigra1 are affected, and there is a reduction in the production of dopaminergic neurons, which are located in the basal nuclei (Elbaz et al., 2016; Berrios, 2016). PD causes various motor and non-motor symptoms, cognitive loss and decreases functional independence, leading to a substantial negative impact on the quality of life (Balestrino and Schapira, 2021; Martinez‐martin, 2017).
Figure 1 shows that the main lost neurons in people with Parkinson (PwP) are located in a region called substantia nigra in the basal nuclei and are responsible for the production and release of dopamine, a neurotransmitter responsible for the communication between brain cells and muscle cells (Balestrino and Schapira, 2021). Due to the decrease in dopamine, the communication between brain cells and muscle cells is delayed, causing the motor signs of the disease.
Figure 1. Substantia Nigra in people with Parkinson's Disease
Bradykinesia, stiffness, rest tremor and postural instability are called cardinal signs of the disease and are the primary motor symptoms through which it is possible to obtain a neurologist diagnosis. Other motor symptoms may also appear along with the disease progression, such as facial expression decrease, speech and swallowing difficulties, changes in the respiratory system, postural and balance deficits, disturbances in gait quality, freezing, and festination (Balestrino and Schapira, 2021; Frazzitta et al., 2013). In addition to these symptoms, there are many silent and subjective signs that affect PwP: autonomic disorders of constipation, postural hypotension, sexual dysfunction, urinary disorders, oily skin, dry eyes and excessive sweating, sleep disorders such as restless legs, nightmares, insomnia, frequent waking and daytime sleepiness, and, neuropsychiatric symptoms with cognitive losses and changes in behaviour and mood (Galhardo et al., 2009; Teive & Hélio, 1998).
Each person with PD has a specific individuality, and it is affected to a greater or lesser extent by some symptoms. For this reason, treatment must be individualised in order to reach a better quality of life. Drug therapy provides a momentary relief and decreases the effects of the disease progression. However, it can induce many side effects, presenting a wide variety of symptoms during the day (Rodríguez-Violante et al., 2018). According to Pfeiffer (2016), PD non-motor symptoms do not respond positively and efficiently to drug treatment, thus requiring the help of other therapeutic practices combined with pharmacological treatment. In addition to medications, other interventions can also alleviate certain damages caused by PD, such as neurosurgical treatment and complementary rehabilitation therapies (Balestrino and Schapira, 2021; Feng et al., 2020).
Key Terms in this Chapter
Cognition: It refers to the sphere of mental functioning, which includes the ability to feel, think, reason, form complex structures of thought, respond to external stimuli, short- and long-term memory, working memory, verbal fluency, among other aspects.
Motor Symptoms: They are more objective and noticeable symptoms of Parkinson's disease. The main motor symptoms are: bradykinesia (slowness of movement), stiffness, rest tremor and postural instability.
Non-Motor Symptoms: They are more subjective and silent symptoms that affect people with Parkinson's Disease. The main non-motor symptoms are: autonomic disorders, sleep disorders and symptoms neuropsychiatric (cognitive losses and changes in behavior and mood).
Quality of Life: It is a broad and subjective theme, it has a multidimensional, dynamic, subjective, and individual concept. The expression refers to a well-being, usually arising from habits and living conditions, even if this changes for each individual.
Parkinson's Disease: It is a chronic, neurodegenerative, and progressive disease, which causes motor and non-motor symptoms to affected patients.
Executive Function: It is a type of cognitive ability that allows to control and regulate tasks of cognitive planning and flexibility, abstract thinking, inhibition of inappropriate actions and initiation of appropriate actions, working memory and attention control.
Dance: It is an artistic expression. Body practice that has an organised set of movements and gestures with rhythm. Usually accompanied by music.