Tango for treatment of motor and non-motor manifestations in Parkinson's disease: A randomized control study

摘要

Objective: To determine effects of Argentine tango on motor and non-motor manifestations of Parkinson's disease. Design: Randomized control trial. Participants: Forty patients with idiopathic Parkinson's disease. Setting: Movement disorder clinic and dance studio. Intervention: Two randomized groups: group (N= 18) with 24 partnered tango classes, and control self-directed exercise group (N= 15). Main outcomes measures: The primary outcome was overall motor severity. Secondary outcomes included other motor measures, balance, cognition, fatigue, apathy, depression and quality of life. Results: On the primary intention-to-treat analysis there was no difference in motor severity between groups MDS-UPDRS-3 (1.6 vs.1.2-point reduction, p= 0.85). Patient-rated clinical global impression of change did not differ (p= 0.33), however examiner rating improved in favor of tango (p= 0.02). Mini-BESTest improved in the tango group compared to controls (0.7 ?2.2 vs. -2.7 ?5.9, p= 0.032). Among individual items, tango improved in both simple TUG time (-1.3 ?1.6. s vs. 0.1 ?2.3, p= 0.042) and TUG Dual Task score (0.4 ?0.9 vs. -0.2 ?0.4, p= 0.012), with borderline improvement in walk with pivot turns (0.2 ?0.5 vs. -0.1 ?0.5, p= 0.066). MoCa (0.4 ?1.6 vs. -0.6 ?1.5, p= 0.080) and FSS (-3.6 ?10.5 vs. 2.5 ?6.2, p= 0.057) showed a non-significant trend toward improvement in the tango group. Tango participants found the activity more enjoyable (p<. 0.001) and felt more "overall" treatment satisfaction (p< 0.001). We found no significant differences in other outcomes or adverse events. Conclusion: Argentine tango can improve balance, and functional mobility, and may have modest benefits upon cognition and fatigue in Parkinson's disease. These findings must be confirmed in longer-term trials explicitly powered for cognition and fatigue.