The effect of thai dance exercise program on functional performance and quality of life in the patients with parkinson\'s disease

The objectives of this study were to explore the feasibility and acceptability of Thai dance exercise program as well as its impact on the Parkinson’s disease patients (study 1) and to assess the impact of Thai dance exercise program and its retention between on time and off time in the Parkinson’s disease (PD) patients (study 2). A series of 36 Thai dance sessions, each lasting 60 minutes, was designed for the study. Basic movements (mae tha) of Thai classical dance were specifically selected to meet the therapeutic needs of people with Parkinson’s disease whose movements were impaired by the disease. Functional mobility and quality of life were assessed by administering the Unified Parkinson’s disease Rating Scale (UPDRS) subscales II and III, Timed Up and Go Test (TUG), Berg Balance Score (BBS), 360 turning and the 8-item Parkinson’s disease questionnaire (PDQ8). Gait parameters (step length, stride length, velocity and cadence) were assessed by walking along the carpet and computerized GAITRite walkway. In study 1, all parameters were assessed (on time) before and after the 12-week program while in study 2, all parameters were assessed (on and off time) before and after 12-week program and also at 2 months followed-up. Patients receiving care at the Center of Excellence for Parkinson’s Disease and Related Disorders, Chulalongkorn Hospital were recruited for the study. They were divided into Thai dance group (TG) and control group (CG) by voluntary enrollment. The patients in TG attended the Thai dance exercise program 3 times a week for 12 weeks whereas the CG did not attend the Thai dance exercise program. The results of study 1 (only 20 completed patients, TG=10 and CG=10) indicated that, there were significant improvements in all of the functional mobility and quality of life parameters in TG as calculated by the paired t-test. Moreover, there were significant differences between TG and CG in all of the parameters as calculated by the analysis of covariance (ANCOVA). The results in study 2 (only 20 completed patients, TG=11 and CG=9), There were significant improvements in all parameters of the Thai dance group (on time) after participating in specifically designed Thai dance exercise program and there were also significant differences in UPDRS subscale III, TUG, BBS, PDQ8, stride length (Lt.) and gait velocity at 2 months follow-up while step length (Rt.) was decreased significantly from post-test value. In Thai dance group (off time) was found that there was only significant difference among baseline, post-test and 2-month follow-up in UPDRS III. No significant differences were found in the other parameters. The overall results in Control group (on and off time) indicated that there were no significant differences in any parameters. When practiced regularly, Thai dance could lead to improvements in motor functions and quality of life of the participants. Furthermore, dance-based exercise is reported to be enjoyable and may be performed alone or in a group without any special equipment.本研究的研究目标分为两部分：其一，探究泰国舞蹈锻炼项目应用于帕金森病（Parkinson’s Disease, PD）患者的可行性与接受度，及其对患者的干预效果（研究1）；其二，评估泰国舞蹈锻炼项目对帕金森病患者的干预效果，以及该项目在患者开期（on time）与关期（off time）状态下的效果留存情况（研究2）。本研究设计了共计36节、每节时长60分钟的泰国舞蹈课程。研究专门选取泰国古典舞蹈的基础动作（mae tha），以适配因帕金森病导致运动功能受损的患者的康复治疗需求。采用统一帕金森病评定量表（Unified Parkinson’s Disease Rating Scale, UPDRS）第二、第三分量表、计时起身行走测试（Timed Up and Go Test, TUG）、伯格平衡量表（Berg Balance Score, BBS）、360°转身测试以及8项帕金森病问卷（PDQ8），对患者的功能活动能力与生活质量进行评估；通过在地毯上行走并借助计算机化GAITRite步态步道系统，采集患者的步态参数（步长、步幅、步态速度与步频）。本研究招募了在朱拉隆功医院帕金森病及相关疾病卓越中心接受诊疗的患者，通过自愿报名的方式将其分为泰国舞蹈组（Thai Dance Group, TG）与对照组（Control Group, CG）。泰国舞蹈组患者每周参与3次泰国舞蹈锻炼课程，持续12周；对照组患者则不参与该舞蹈锻炼项目。在研究1中，所有评估参数均在12周干预项目开展前后（开期状态下）完成测评。研究1共有20名患者完成全部研究流程（泰国舞蹈组10名，对照组10名），配对t检验结果显示，泰国舞蹈组患者的所有功能活动能力与生活质量参数均得到显著改善；协方差分析（ANCOVA）结果表明，泰国舞蹈组与对照组在所有参数上均存在显著差异。在研究2中，所有参数分别在12周干预项目开展前后，以及随访2个月时，于开期与关期状态下完成测评。研究2共有20名患者完成全部研究流程（泰国舞蹈组11名，对照组9名）。泰国舞蹈组在开期状态下的所有参数，在接受定制化泰国舞蹈锻炼项目后均得到显著改善；在2个月随访时，该组在UPDRS第三分量表、TUG、BBS、PDQ8、左侧步幅以及步态速度上仍存在显著差异，而右侧步长较干预后测评值出现显著下降。对于泰国舞蹈组在关期状态下的测评结果，仅在UPDRS第三分量表的基线、干预后与2个月随访结果间存在显著差异，其余参数均无明显变化。对照组无论处于开期还是关期，其所有参数均未出现显著差异。规律练习泰国舞蹈可显著改善参与者的运动功能与生活质量。此外，现有研究表明，基于舞蹈的锻炼项目趣味性强，可单独或团体开展，且无需任何特殊设备。