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      Verbal Auditory Cueing of Improvisational Dance: A Proposed Method for Training Agency in Parkinson’s Disease

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          Abstract

          Dance is a non-pharmacological intervention that helps maintain functional independence and quality of life in people with Parkinson’s disease (PPD). Results from controlled studies on group-delivered dance for people with mild-to-moderate stage Parkinson’s have shown statistically and clinically significant improvements in gait, balance, and psychosocial factors. Tested interventions include non-partnered dance forms (ballet and modern dance) and partnered (tango). In all of these dance forms, specific movement patterns initially are learned through repetition and performed in time-to-music. Once the basic steps are mastered, students may be encouraged to improvise on the learned steps as they perform them in rhythm with the music. Here, we summarize a method of teaching improvisational dance that advances previous reported benefits of dance for people with Parkinson’s disease (PD). The method relies primarily on improvisational verbal auditory cueing with less emphasis on directed movement instruction. This method builds on the idea that daily living requires flexible, adaptive responses to real-life challenges. In PD, movement disorders not only limit mobility but also impair spontaneity of thought and action. Dance improvisation demands open and immediate interpretation of verbally delivered movement cues, potentially fostering the formation of spontaneous movement strategies. Here, we present an introduction to a proposed method, detailing its methodological specifics, and pointing to future directions. The viewpoint advances an embodied cognitive approach that has eco-validity in helping PPD meet the changing demands of daily living.

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          Most cited references26

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          Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease.

          Exercise interventions in individuals with Parkinson's disease incorporate goal-based motor skill training to engage cognitive circuitry important in motor learning. With this exercise approach, physical therapy helps with learning through instruction and feedback (reinforcement) and encouragement to perform beyond self-perceived capability. Individuals with Parkinson's disease become more cognitively engaged with the practice and learning of movements and skills that were previously automatic and unconscious. Aerobic exercise, regarded as important for improvement of blood flow and facilitation of neuroplasticity in elderly people, might also have a role in improvement of behavioural function in individuals with Parkinson's disease. Exercises that incorporate goal-based training and aerobic activity have the potential to improve both cognitive and automatic components of motor control in individuals with mild to moderate disease through experience-dependent neuroplasticity. Basic research in animal models of Parkinson's disease is beginning to show exercise-induced neuroplastic effects at the level of synaptic connections and circuits. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis.

            Parkinson's disease (PD) is a neurodegenerative disorder affecting the physical, psychological, social, and functional status of individuals. Exercise programs may be an effective strategy to delay or reverse functional decline for people with PD and a large body of empirical evidence has emerged in recent years. The objective is to systematically review randomized controlled trials (RCTs) reporting on the effectiveness of exercise interventions on outcomes (physical, psychological or social functioning, or quality of life) for people with PD. RCTs meeting the inclusion criteria were identified by systematic searching of electronic databases. Key data were extracted by two independent researchers. A mixed methods approach was undertaken using narrative, vote counting, and random effects meta-analysis methods. Fourteen RCTs were included and the methodological quality of most studies was moderate. Evidence supported exercise as being beneficial with regards to physical functioning, health-related quality of life, strength, balance and gait speed for people with PD. There was insufficient evidence support or refute the value of exercise in reducing falls or depression. This review found evidence of the potential benefits of exercise for people with PD, although further good quality research is needed. Questions remain around the optimal content of exercise interventions (dosing, component exercises) at different stages of the disease. 2008 Movement Disorder Society
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              Temporal structure of motor variability is dynamically regulated and predicts motor learning ability.

              Individual differences in motor learning ability are widely acknowledged, yet little is known about the factors that underlie them. Here we explore whether movement-to-movement variability in motor output, a ubiquitous if often unwanted characteristic of motor performance, predicts motor learning ability. Surprisingly, we found that higher levels of task-relevant motor variability predicted faster learning both across individuals and across tasks in two different paradigms, one relying on reward-based learning to shape specific arm movement trajectories and the other relying on error-based learning to adapt movements in novel physical environments. We proceeded to show that training can reshape the temporal structure of motor variability, aligning it with the trained task to improve learning. These results provide experimental support for the importance of action exploration, a key idea from reinforcement learning theory, showing that motor variability facilitates motor learning in humans and that our nervous systems actively regulate it to improve learning.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/204434
                URI : http://frontiersin.org/people/u/287341
                URI : http://frontiersin.org/people/u/318317
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                17 February 2016
                2016
                : 7
                : 15
                Affiliations
                [1] 1Department of Physical Therapy, Winston-Salem State University , Winston-Salem, NC, USA
                [2] 2Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine , Winston-Salem, NC, USA
                [3] 3Department of Theatre and Dance, Wake Forest University , Winston-Salem, NC, USA
                Author notes

                Edited by: Marta Bieńkiewicz, Aix-Marseille University, France

                Reviewed by: Madeleine Hackney, Atlanta VA and Emory University, USA; Daniele Volpe, Casa di Cura “Villa Margherita”, Italy

                *Correspondence: Glenna Batson, glenna.batson@ 123456gmail.com

                Specialty section: This article was submitted to Movement Disorders, a section of the journal Frontiers in Neurology

                Article
                10.3389/fneur.2016.00015
                4756105
                26925029
                07598fcd-5027-4bfe-8185-dfbf15d6f9b3
                Copyright © 2016 Batson, Hugenschmidt and Soriano.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 September 2015
                : 02 February 2016
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 47, Pages: 10, Words: 8949
                Funding
                Funded by: Wake Forest University 10.13039/100007154
                Funded by: National Parkinson Foundation 10.13039/100001262
                Categories
                Neuroscience
                Methods

                Neurology
                parkinson’s,dance,improvisation,cognition,spontaneity,balance,function,agency
                Neurology
                parkinson’s, dance, improvisation, cognition, spontaneity, balance, function, agency

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