The Exercise Files: Why Tango May Benefit Balance In Those With PD

Beginning physical activity, even late in life, can improve balance and mobility difficulties in older people and those suffering from age-related diseases. Dance uplifts mood and requires the ability to adapt to changing demands on balance; therefore, it may be particularly appropriate for older and physically challenged individuals. Recently the physical and emotional benefits of Argentine tango dance for individuals for Parkinson disease (PD) have been demonstrated. This article outlines some reasons why Tango may have been so effective.

Tango features

Argentine tango has steps, patterns, music and partnering that may benefit specific impairments associated with PD, such as balance problems, stride-length and walking speed regulation, slowness of moving, freezing of gait (an utter stopping of gait, as though feet were glued to the floor), and multi-tasking.

Balance: Tango places demands on attention to posture and balance that may increase general awareness of personal mobility and paths in space. While partners coordinate their movement timing to music and to each other, they must continually maintain their core over their own axis to anticipate postural perturbation from their partner, and to smoothly shift their weight from step to step.

Moving Slowly: Individuals with PD tend to move slowly. Tango’s wide range of speeds and the coordination of movement and time with another human encourage dancers to push the boundaries of speed limitation.

Increasing stride length: Dancing tango is ideal for practicing adjustments of stride length. To increase stride length, dancers are taught to maintain their weight over their supporting leg until they have stretched their reaching foot far enough for the succeeding step. Dancers generally take longer backward steps while dancing than they would otherwise, and if proceeding forward dancers should maintain a comfortable stride or lengthen their stride, to match the strides and timing of the partner.

Turning: When attempting to turn, individuals with PD use more steps to turn, show less axial rotation during turns, and many individuals with PD may also experience freezing of gait. Tango dancers turn in spatiotemporal coordination with the assistance, guidance and body-cueing of each other, implementing a pivoting strategy over a single foot to varying degrees of rotation or using several steps. Practice of turning in the context of tango, with a) external cueing aid of the partner and music, and b) the mechanistic breakdown of turning patterns and footwork by the instructor may prove beneficial.

Multi-tasking: While most of us don’t feel we can walk and chew gum at the same time, the ability to effectively multi-task is impaired with aging and further impaired in PD; however, practice in situations that require divided attention can improve dual task ability. Tango is an excellent example of multi-tasking. One dances tango in close proximity to a partner while among other couples on the dance floor. Navigation through couples occurs both while traveling around the dance floor and performing intricate steps in place. Dancers must attend to posture, balance, foot placement, and the upcoming move: planning the next move (for leaders), as well as reception/enactment based on the leader’s cues (for followers). Dancers must be aware of and make appropriate adjustments to: a) the amount of body weight directed towards the partner through the tactile connection of the frame, b) other couples within the space, and the paths followed while couples move as units, and c) the music, through listening, interpreting, and responding to musical rhythms and phrasing, all the while considering aesthetics: body postures, lines and shapes of movement.

Freezing of Gait: Walking in small and narrow spaces can trigger freezing in people with PD. Using visual cues, such as a foot to step over, can help relieve freezing of gait in some individuals with Parkinson disease.  Some tango steps include stepping over a partner’s foot, tapping a partner’s foot, or crossing one foot over another. Conventional rehabilitation uses similar types of visual cues to address freezing. Moreover, many tango steps involve a rhythmic rocking of body weight, similar to strategies commonly taught to people with freezing of gait by physical therapists. For patients with freezing of gait, skilled partners with experience moving with another person in spatiotemporal coordination can be especially helpful when trying to help the person with PD develop their movement abilities.

Movement Initiation: Using external cues for gait initiation can improve the ‘start-up’ of walking, which can be tough for some people with PD; therefore, to facilitate movement dancers with PD may use cues like a) the choreography itself, b) the partner’s weight shifting which indicates the direction of movement and/or c) musical beats.

In short, there are multiple reasons that Tango may help people with PD enhance their movement capabilities, just as it can for older individuals, and those with sensory and motor impairments.

[Editor's Notes: (1) Dr. Hackney is currently recruiting for a research study on the effects of Tango and Health Education in people with PD on cognition, mobility and balance. (2) This post first appeared in Alfredo Melendez's Dance Blog on July 19, 2010.]

Dr. Madeleine E. Hackney, Ph.D, is a Research Health Scientist at the Atlanta VA Center for Visual and Neurocognitive Rehabilitation and an Assistant professor of Medicine in the division of General Medicine and Geriatrics at the Emory School of Medicine. She holds a Ph.D. in Movement Science from Washington University and a BFA in Dance from NYU, Tisch School of the Arts and has also been an American Council on Exercise certified personal trainer since 2000. Dr. Hackney’s extensive research interests include inquiry into challenging exercise programs--traditional exercise, Tai Chi and partnered dance & tango classes--designed to improve physical function and quality of life in people with PD, older adults and those with serious mental illness. In 2014, she co-founded MDT Education Solutions, which has trained almost 60 fitness and allied health professionals how to develop and lead safe, evidence-based exercise programs for people with PD at all stages of the disease, including almost all instructors in the PD Gladiators Metro Atlanta Fitness Network (including the YMCA of Metro Atlanta).

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