Trinkler Iris, Chéhère Philippe, Salgues Julie, Monin Marie-Lorraine, Tezenas du Montcel Sophie, Khani Sonia, Gargiulo Marcela, Durr Alexandra
Brain and Spine Institute (ICM), Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France.
Current affiliation: Department of Sport Sciences, Adapted Physical Activity and Health Unit, University of Strasbourg, 14 Rue René Descartes, 67084 Strasbourg Cedex, France.
J Huntingtons Dis. 2019;8(1):97-110. doi: 10.3233/JHD-180315.
Physical exercise improves neurological conditions, but adherence is hard to establish. Dance might be a promising alternative; however, since patients with Huntington's disease (HD) suffer from rhythmic movement execution deficits, any metric dance practice must be avoided.
Here we asked, if contemporary dance, a lyrical dance form, practiced for two hours per week over five months, might improve motor function, neuropsychiatric variables, cognition and brain volume of HD patients.
Nineteen patients aged between 43 and 78 years with mild to moderate HD (TFC range 7-13, UHDRS motor score range 3-58) participated in this randomized, controlled pilot study (NCT 01842919). The primary outcome measure was total motor score. Secondary outcome measures were differences in brain structure, cognitive function, neuropsychiatric variables, apathy and quality of life. A semi-structured interview assessed participants' experiences.
Adherence to dance classes was very good. All participants completed 5 months of dance practice. Motor impairment (median [IQR] decreased from 28[6-51] to 27[7-33] for the dance group compared to an increase of 19[13-35] - 25[14-42] for usual care, Z = -2.44, p = 0.015). No other behavioral measures showed any changes.Brain volume increased in the medial superior parietal and paracentral lobule, in line with compensatory structural brain changes in areas supporting spatial and somatosensory processing. These changes were also reflected in patients' reports that contemporary dance altered the way they "felt and lived in their bodies".
Contemporary dance practice, through work on spatial and bodily representations, helps improve motor function in HD patients.
体育锻炼可改善神经状况,但难以确立依从性。舞蹈可能是一种有前景的替代方式;然而,由于亨廷顿舞蹈症(HD)患者存在节律性运动执行缺陷,必须避免任何标准的舞蹈练习。
在此我们探究,每周练习两小时、持续五个月的当代舞(一种抒情舞蹈形式)是否可改善HD患者的运动功能、神经精神变量、认知及脑容量。
19名年龄在43至78岁之间、患有轻度至中度HD(总功能能力范围为7 - 13,统一亨廷顿舞蹈病评定量表运动评分范围为3 - 58)的患者参与了这项随机对照试验性研究(NCT 01842919)。主要结局指标为总运动评分。次要结局指标为脑结构、认知功能、神经精神变量、冷漠及生活质量的差异。通过半结构化访谈评估参与者的体验。
舞蹈课程的依从性非常好。所有参与者都完成了5个月的舞蹈练习。与常规护理组运动障碍评分从19[13 - 35]增加到25[14 - 42]相比,舞蹈组的运动障碍(中位数[四分位间距])从28[6 - 51]降至27[7 - 33],Z = -2.44,p = 0.015)。其他行为指标均未显示出任何变化。内侧顶上叶和中央旁小叶的脑容量增加,这与支持空间和躯体感觉处理区域的代偿性脑结构变化一致。这些变化也反映在患者的报告中,即当代舞改变了他们“感受身体及在身体中生活”的方式。
通过对空间和身体表征的训练,当代舞练习有助于改善HD患者的运动功能。