An investigation of the acute effects of dance on heart rate variability in patients with Parkinson’s disease

Parkinson’s is a neurodegenerative movement disorder that has no cure. The most common motor symptoms observed are postural instability, rigidity, and bradykinesia. The role of therapies is well documented, however, there is now substantial evidence to support the use of alternative therapies to alter the progression of Parkinson’s. Dance has shown improvements in mobility and balance. There is limited research currently available that investigates cardiovascular autonomic dysfunction in people with Parkinson’s (PwP), especially in a dance community setting. Therefore, HRV could be used as a non-invasive marker during dance to detect autonomic dysfunction in PwP in its early stages and assess any autonomic benefits of dance. The main aim of this study was to investigate the effects of dance on heart rate variability in patients with Parkinson’s.

Ten PwP were recruited from a Parkinson’s dance class, situated at Pavilion Dance Southwest, Bournemouth with written informed consent. The study was approved by the Faculty of Health Research Ethics and Integrity Committee and procedures were in accordance with the Declaration of Helsinki. Inclusion criteria was mild-moderate Parkinson’s diagnosis for more than 6 months. Exclusion criteria was previous surgeries that could alter their physiological response to dance. The classes took place once weekly for 90 minutes and consisted of the following sections in chronological order: rest 1, teach 1, dance 1, teach 2, dance 2 and rest 2. The first half was danced sitting while the latter half was standing. Wireless physiological monitoring measurements including breathing rate (BR), skin temperature and heart rate variability (HRV) were taken before, during and after the dance classes using LabChart software. HRV was assessed using time domain (heart rate – HR, standard deviation of the RR interval – SDRR, SD1 and SD2) and frequency domain (low and high frequency – LF and HF). Data was also normalised by considering the heart rate [1], prefixed by n. The results were statistically analysed in SPSS by repeated measures ANOVA. p < 0.05 was considered as significant.

Analysing all six sections together showed skin temperature (p=0.00001), HR (p=0.029), SD1 (p=0.025), nSDRR (p=0.028), and BR (p=0.001) were significantly different across all sections. LH and HF showed no significant difference.

The main finding of our study was that significant changes in HR, SD1, nSDRR, BR and skin temperature of PwP occurred during all six sections. Furthermore, it was noted that HR and HRV frequency domain variables altered, albeit non-significantly, for both the sitting and standing sections, with similar patterns, demonstrating internal consistency throughout dance classes. Our data showed dance improved autonomic function. However further work examining the long-term effects of HRV in a community setting with diverse groups is needed to fully understand the potential benefits of Parkinson’s dance.