Jaques-Dalcroze’s music-based rhythmic training affects gait

parameters and quality of life in Parkinson’s Disease

Jennifer Masset
Promotion de la santé et la prévention face au vieillissement
22. Novembre 2019

Jennifer.masset@hesav.ch
Introduction Parkinson‘s Disease (PD)

Attentional Deficits Dopaminergic medication

Bradykinesia
? „Loss of automaticity“
Memory
Cognitive Motor
Tremor at rest

Apathy/ Depression Rigidity

Increased
Gaitrisk of falls

? - Reduced walking speed

- Increased gait variability
(Yogev-Seligmann et al. 2008)

• High impact of multi-task performance in everyday life

• Falls major cause of mobidity and mortality in PD
(Jankovic, 2008; Bloem et al. 2006)
Introduction
Neurologic Music Therapy (NMT)

• Auditory Stimulation Thaut et al. 1996

• Argentinian Tango Review: Lotzke et al. 2015

• Tai Chi Review: Ni et al. 2014

Keus, S. (2014). Poster: Physiotherapy for Parkinson’s disease. A joint Europe Guideline.
Exercise paradigm: Jaques Dalcroze Mind
Body
- Emile Jaques Dalcroze (1865 – 1950) Space
- Children‘s and adolescents‘ music education all over the world
Time
- Music movement therapy

Corporal expression in synchrony with external cues

• Motor-cognitive: balance, coordination, attention, memory
• Multisensory: visual, auditory, tactile
• Emotional: social aspect / group belonging

Bachmann ML. Dalcroze today. An Education Through and into Music. New York: Oxford University Press, 1991
Exercise paradigm: Jaques Dalcroze
Literature
Dalcroze and Geriatrics (Jaques Dalcroze long-term intervention)

Long-term JD exercise intervention can prevent

Improved gait under dual-task condition, improved balance, reduced
Conclusion age-related gait impairment under a dual-task
rate of falls and risk of falling

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
Positive effects after short-term intervention Jaques Dalcroze in Parkinson’s Disease

+ temporal processing and internal rhythmic timing

+ gait parameters for single and dual task (motor-cognitive interference)
+ quality of life, course satisfaction

Dual-Task paradigm:
• Walking while cognitive task:
- Animal naming
 Participants: n=16 Mean Age 67 ± 7 yrs
Methods Gender 12 w / 4 m
• Parkinson’s Disease: Hoehn &Yahr 2-3 Disease 9.5 ± 6.5
Pilot Study duration
• No regular physical activity / No experience NMT
LEDD 712 ± 480 mg
• Stable medication, Testing « Med On »
H&Y 2.5

Testing Session Intervention: 1 month Testing Session

Course: 2 x 45min / week

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
 Participants: n=16
Methods
• Parkinson’s Disease: Hoehn &Yahr 2-3
Pilot Study
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »

Testing Session Intervention: 1 month Testing Session

Course: 2 x 45min / week

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

1.1) Walking Speed (m/s) 2) Gait Variability (CV%)

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

Walking Speed (sec)

20 20

16 16

12 12

8 8
pre post
pre post

p = 0.001

Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
Results
Single Task 10 m

Walking Speed (m/s) Gait Variability (CV%) – Stride Length

1.25 12

1.0
8

0.75
4

0.5

pre post pre post

p = 0.011 p = 0.050

Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
Results
Dual Task
Walking Speed (m/s) Gait Variability (CV%) – Stride Length
16
1.25

12
1.0

0.75

0.5 4

pre post pre post

p = 0.015 p = 0.008

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

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 Single-Task, p = 0.01 (gait variability tendency, p = 0.050)

+ significant increase of walking speed for Dual-Task, p = 0.015

+ highly significant improvement of gait variability for dual-task, p=0.008
 Participants: n=16
Methods
• Parkinson’s Disease: Hoehn &Yahr 2-3
Pilot Study
• No regular physical activity / No experience NMT
• Stable medication, Testing « Med On »

Testing Session Intervention: 1 month Testing Session

Course: 2 x 45min / week

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

p = 0.021 p = 0.041

p = 0.033

p = 0.013
p = 0.053

Wilcoxon rank-sum test; sum of each domain, pre vs. post intervention for p<0.05
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 Eurythmics
Photo by Arthur Tanner/Fox Photos/Getty Images