Improvisational Dance for Parkinson Disease
Improvisational Dance for Parkinson Disease
The long-term goal of this work is to maintain or improve daily function of people with PD by
 addressing cognition. The overall objective is to discover interventions that aid in
 cognitive functioning. The central hypothesis is that engagement in an improvisational dance
 (ID) class will benefit cognition among people with PD. Improvisational dance involves
 spontaneously generated movement, similar to how one moves in everyday life. The literature
 shows that ID classes positively impact motor impairments associated with PD, such as
 balance, gait, and functional mobility. Along with being physically demanding, ID requires
 the use and coordination of a number of cognitive capacities to properly execute movements.
 This type of activity challenges, and thus may strengthen, cognitive processes such as motor
 planning, decision making, flexible thinking, initiation, and execution, which may give
 people cognitive based strategies to be utilized in various aspects of daily life. By
 improving motor function and/or cognition, ID may also contribute to improved daily
 functioning, or the ability to perform and participate in daily activities. Despite these
 theoretical links, evidence for the effect of ID on cognition and overall daily function is
 limited. The current project objective is to address this gap and better understand the
 effects of ID for people with PD. Specifically, it will test the effect of IMPROVment®, a
 method of ID designed for people with PD, on cognition and daily function.

 Participants' cognition will be assessed at baseline (T1) using the NIH Toolbox Cognitive
 Battery, the Alternate Uses Task, and the Weekly Calendar Planning Activity. Global cognition
 will be assessed using the Montreal Cognitive Assessment. They then will be randomly assigned
 to either the immediate intervention (ID) or waitlist-control (WC) group. The ID group will
 start the 12-week IMPROVment® intervention, which consists of weekly ID classes that progress
 according to a standardized method while the WC group will receive no intervention and
 continue with their regular daily routine and activity level. After 12 weeks, both groups
 will complete cognitive testing again (T2). Cognitive test scores will be compared across
 time points and between groups using a mixed model repeated measures ANOVA. The investigators
 hypothesize that IMPROVment® will have positive effects on the cognitive abilities of people
 with PD. Participants will also complete two questionnaires to assess daily function at T1
 and T2: Older Americans Resources and Services Scale- Extended Version and PROMIS
 Satisfaction with Participation in Discretionary Social Activities. These scores will be
 compared similar to the above aim. The investigators hypothesize that IMPROVment® will have
 positive effects on daily function in people with PD.

 Participant mood will be assessed in two different ways. The first being to investigate the
 immediate effect of participating in an IMPROVment® class on mood, fatigue, and anxiety. The
 investigators hypothesize that mood will positively improve from pre to post of each class.
 To assess this, participants will respond to a scale assessing mood, specifically sadness,
 nervousness, energy, and overall well-being before and after each class every week. The
 second measurement is to investigate the effect of IMPROVment® on anxiety, fatigue, and
 depression. The investigators hypothesize that IMPROVment® class will decrease feelings of
 depression for those with PD. All participants will fill out the Parkinson's Anxiety Scale,
 the Parkinson's Disease Fatigue Scale, and the Geriatric Depression Scale short form before
 and after participating in the 12-week IMPROVment® program.

 Achievement of these aims will provide further support for the IMPROVment® method for people
 with PD experiencing cognitive deficits. The long-term impact will better cognition and daily
 functioning in people with PD, and thus enhanced everyday lives.
Inclusion Criteria:

 -  aged 50 years or older

 -  Parkinson Disease Diagnosis

 -  Hoehn-Yahr score between 1-3

 -  independently walk at least 3 meters

 -  cognitive ability to follow simple commands

 Exclusion Criteria:

 -  Montreal Cognitive Assessment score less than or equal to 22

 -  diagnosis of other severe comorbidities

 -  contraindications to physical activity