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Janine Clark

CUE Research Proposal

Dance Movement Therapy and its Effects
on Parkinsons and Dementia Patients
Janine Clark
Research Proposal
Dance CUE


As one grows in age, certain diseases or disorders become a concern; such as Dementia

or Parkinsons disorder. Recent studies however have been done to help with the symptoms, such

as Dance Movement Therapy (DMT). Dementia is a general term for memory loss as a person

becomes older, often referred to as senile; this occurs when brain cells are damaged, and can no

longer communicate normally or properly among the brain. The most common type of dementia

is Alzheimers, but there is also multiple more types affecting the geriatric population. The

symptoms are most often memory loss, difficulty communicating, focusing and reasoning. The

next disorder I wish to address and research is Parkinsons Disease (PD). Parkinsons is a

neurodegenerative disorder that causes the release of dopamine- producing neurons to decrease.

There is no exact reason to why this occurs in the brain, but symptoms can develop over years.

This includes small tremors, typically in the hands, muscle rigidity, slowness in movements, gait

and balance problems. And within all these disorders and several others, side effects like

depression, anxiety and frustration can occur, resulting in the patients loss of quality of life.

Since not all patients who have been diagnosed, are comfortable with or cannot afford

taking drugs to reduce the symptoms, an alternative, less expensive holistic approach has been

gaining popularity to those who are interested. Dance Movement Therapy was first created by

Marian Chace in 1966, and continued to be the President of the American Dance Therapy

Association from 1966 to 1968. Her research has evolved since the beginning, and continues to

develop and help patients all over the world. As I continue in research and analyzation I wish to

compare the relationships between this form of therapy and the benefits it has on the geriatric

population. Depending on the severity and length the patient has been diagnosed will be looked

Janine Clark
Research Proposal
Dance CUE

into, as well as the type of movement that will be taught, for example a creative movement class

with more free style creative thinking verse a tango class that is very structured and detailed.

Overall in this study, I will look at the comparative measures that can be taken to use

Dance Movement Therapy as a type of therapy to improve mobility, balance, gait and the overall

quality of life.

Statement of Purpose

The purpose of this study is to see how a non-pharmacological approach like Dance

Movement Therapy can assist the geriatric population with relieving symptoms caused by the

disorders like Parkinsons or Dementia.

Statement of the Problem

The geriatric population that have been diagnosed with Parkinsons or Dementia, suffer

from symptoms such as memory loss, tremors, balance instability, and gait problems. There are

very few case studies done with the geriatric patients, often done in small sample sizes.


Dance Movement Therapy can help reduce symptoms of Parkinsons or Dementia, such

as balance and gait.

An assumption is that the disorders end up affecting the patient's emotions and

personalities, becoming depressed, anxious, and frustrations. Through movement classes,

patients can find joy in moving and the music.

Janine Clark
Research Proposal
Dance CUE

After taking several Dance Movement classes we can assume the overall these patients

quality of life will improve.


The general hypothesis for this study is there is a positive treatment relationship between

Dance Movement Therapy and the geriatric population diagnosed with Parkinsons and

Dementia. In sources I have researched a similar hypothesis and discussion has occurred, stating

there was an improvement in the individuals in the case studies that were tested.


In my study I will only be researching and reviewing cases that worked with geriatric

patients; avoiding Young-Onset Parkinson's patients.

A delimitation will be only the case studies that have been published within the past two

decades, for more recent data.


One limitation is the very few case studies that research how DMT affects those with

Dementia or Parkinsons.

Another limitation is an empirical-bias exists in this research. Which means all research

gathered is through observation in a direct or indirect approach or experience. Empirical research

can also analyzed qualitatively or quantitatively. Previous research on this topic has been for the

most part bias on and indirect approach through observation, and quantitatively analyzed.

Janine Clark
Research Proposal
Dance CUE

This topic becomes personal when my grandparents developed a type of dementia. This is

something I will need to take into consideration to avoid being biased, and taking it too personal

in researching.

Limitations could also be the little time spent on furthering my research within two

semester at Muhlenberg, and the lack of funding to contribute to the study, and access to geriatric


Definitions of Terms

Dance Movement Therapy (DMT): A psychotherapeutic approach to movement to

improve emotional, social, cognitive, and physical abilities of individuals; overall improving the

quality of life.1

Dementia: A general term for a decline in memory ability, can be severe enough to

interfere and disturb daily activities. Most common type of dementia is Alzheimer's, and often

referred to as being senile.2

Parkinsons Disease (PD): A neurodegenerative disorder that interferes with the

dopamine-producing neurons in the brain. Common symptoms slowly generate over a long

period of time are tremors, slowness of movement, limb rigidity, balance and gait problems.3

Geriatric: Population of people typically over the age of 65.

Non-Pharmacologic: A more holistic approach to therapy, where drugs are not used, such

as massage, or physical activity.

Janine Clark
Research Proposal
Dance CUE

Quality of Life: This is a unique definition depending on the individual; something that

gives joy or pleasure to ones own life such as a time gathered with family, enjoying the

outdoors, working on a pleasurable hobby, etc.4

Mode of inquiry, methodology, procedures and explains reasons for these choices

This study will be a compilation of articles and case studies that have been written and

researched within the past few decades. Using these sources I intend to form connections

between Dance Movement Therapy and the progression in the population with Parkinsons and

Dementia. Due to limitations, further research will be difficult to test, however these are the

questions and aspects I wish to attempt to answer:

What type of Dance Movement Therapy are available to geriatric patients?

Does the severity affect the progress of improvements of symptoms?

How often do these patients need to go to classes to have results?

What neurologically in the brain happens when the patients take the class, that reverses

the symptoms?

How does resistance play in? (If the patient is resistant against trying something new like

dance, does DMT not work the same way?)

Does the type of movement class affect the patients progress?

With these questions, I hope to form more connections and answers for the geriatric patients, to

help improve their quality of life. From this point I hope to get incontact with facilities and
Janine Clark
Research Proposal
Dance CUE

programs who offer Dance Movement Therapy to the geriatric population with these disorders,

for example the Mark Morris Nonprofit in the city, or our own faculty member Cori Cowart.

Review of related Literature

Within Rosalind Mandelbaum and Albert C. Los article Examing Dance as an

Intervention in Parkinsons Disease: A Systematic Review, it was brought to my attention his

detail in addressing programs and organizations that work with geriatric patients in Dance

Movement Therapy. They mention the Mark Morris dance group located in Brooklyn, New

York; a non for profit program for patients with Parkinsons Disease. This brought to my interest

of looking up program as well as case studies, for their missions and visions as a Dance

Movement Therapy facilitator.

Madeleine E. Hackney and Gammon M. Earhart, discuss the advantages of a specific

style such as Argentine Tango and how it can impact those with Parkinsons. There article

Recommendations for Implementing Tango Classes for Persons with Parkinson Disease, dives

into how the interpersonal connection while performing a style like tango can be beneficial

psychologically to these patients. They state that the connection to loved ones can provide a daily

break from the stress and frustration that the side effects of the disease has, and house a

communal support between patients. This article has be interested in looking at the comparison

between a structured interpersonal class like Tango and a more creative free flowing, expressive

class like creative movement.

The idea of creative thinking is addressed in Natasha Goldstein-Levitass article

Dance/Movement Therapy and Sensory Stimulation: A Holistic Approach to Dementia Care. The

Janine Clark
Research Proposal
Dance CUE

idea of sensory stimulation is very interesting thing to think of for geriatric patients. I most often

heard of sensory therapy for young children with diagnoses. However, within the classes she

discusses the patients respond well to the sensory aspects and imagery. She mentions how the

class began agitated and withdrawn, however near the end of the class eye contact had appeared,

and smiles were drawn. This article is something I can use to compare and contrast to the

previous article written by Hackney and Earhart, to see how the two styles affect not only the

physical symptoms but cognitive as well.

Annotated Bibliography
1. Manley, Mary-Elizabeth, and Vietta Elin Wilson. Anxiety, Creativity, and Dance
Performance. Dance Research Journal, vol. 12, no. 2, 1980, pp. 1122. JSTOR, JSTOR,
Manleys Article came from the Dance Research Journal, focused on analyzing
the anxiety that comes along with personal experience in dance and the creative
behavior. Along the way several sub questions that were raised; including how
dancers anxiety relate to personal creativity and performance in general. This
research was determined through a study that included university students, both
dancers majors and non dance majors. Within this study the students were split
into two groups. The non dance majors and dance majors both took dance classes
either for their major or as an elective. When the dancers walked into their class
along with a picture they were given a poem and certain amount of time to create
a composition that would be judged. Before each dancer performed they took a
PARQ situational anxiety form, and again right after. From their the researchers
performed t-test to evaluate the data. Researchers found that their was not a
significant difference within anxiety levels between the two groups. Among with
other discoveries that were not directly related to the larger question, once data
was pulled together into two groups; one of non dance majors and dance majors,
the non dance majors did have a slightly higher anxiety level. Several other

Janine Clark
Research Proposal
Dance CUE

references were mentioned in regards to other determined perspectives or past

research experiences, these were able to support Manleys research. This article is
beneficial to my research because it adds a baseline to the negative ways dance
can affect the self esteem and mental state of dancers, which is the opposite of
what I want to research. However, I can use it to compare to other articles and
figure out ways not to perform as a teacher.
2. Margartiti, Alexa , and Periklis Ktonas. An application of the Primitive Expression form
of dance therapy in a psychiatric population . SciVerse ScienceDirect, 2012, Accessed 18 Sept. 2017.
This article was found in the SciVerse ScienceDirect Database through the
Muhlenberg Trexler Library. Under the section The Arts in Psychotherapy, this
article discusses how the idea of Primitive Expression can help patients with in a
psychiatric setting. Unlike the first article I read, this article discussed how dance
can help with anxiety and mental illness. This study used a quantitative
(experimental) method to work with the patients. Eleven patients in the Athens
Psychiatric Clinic, with ages ranging from 21-64, had 12 sessions of Primitive
Expression therapy. Throughout the sessions the researchers evaluated several
aspects of PE therapy, including force of rhythm, sound of percussion, use of
voice, simplicity of movements, etc. Each of these subjects within the therapy
can be adjusted and affected the patients in different ways. From there they
collected data to compare how the patients were improving if there was any
improvement. Once the study concluded and data was analyzed the researchers
found the there was in fact an increase in happiness level, and positive attitude.
This was a very small study, and they do present the factor that not all patients
have the same disorder or severity. Throughout the article, several references
were brought up to support their original findings and to back up their statistical
evaluations. As well at the end they recognized the Professor who was able to
help this study follow through. This article is a good starting point for my
research and I intend to use some of their references as my own.
3. Panagiotopoulou, Efthimia. Dance Therapy Models: An Anthropological Perspective.
American Dance Therapy Associaition , 4 Oct. 2012,
Janine Clark
Research Proposal
Dance CUE Accessed
18 Sept. 2017.
Panagiotopoulou from the beginning in the abstract states that dance therapy is a
new study and discipline being explored. Which means this is something new she is
researching to tell the public about and inform others; this article was taken from
the American Dance Therapy Association. Panagiotopoulou states in the abstract
very clearly what this article will be talking and analyzing which is the founding
and development of dance therapy as an applied discipline; unlike the other two
articles she is looking at this from anthropological view instead of a quantitative
perspective. Panagiotopoulou looks at two different therapies, Dance/Movement
Therapy and Expression Primitive, each having similar concepts and conclusions. It
is brought up that Dance Therapy is a new study that is still being introduced in
America, unlike the rest of the world that has been using for a while. A large aspect
of this article that Panagiotopoulou wanted to stress is that therapists know their
patients and their cultural identity to make sure that the therapy session is
appropriate for their background and they feel comfortable. Several surveys are
brought up that other researchers did to help prove and support their points. In the
conclusion, she determines the two therapies only have superficial differences but
depending on the patient both work in similar ways. Throughout the entire article
Panagiotopoulou references other researchers and anthropologists to support her
research and conclusions. Lastly Panagiotopoulou talks about her own experience
with these therapies. She was able to put in her own personal reference and make
the article personal to her success in life.
4. Kahlich, Luke. Educating Dance Educators-What Next. University of Illinois Press on
behalf of the Council for Research in Music Education, vol. 117. Jstor, Accessed 18 Sept. 2017.
Kahlich decided to not only discuss dance but the educators behind it. Along with
this idea of incorporating dance into academic schools and especially into
elementary schools. Being a dance education major, I wanted to research this
topic on how dance can be a positive influence in lives. And Kahlich is feeding

Janine Clark
Research Proposal
Dance CUE

this thought in my mind, he goes in his paper on how to train these future teachers
and implementing certain characteristics. Throughout the article he incorporates
historical data analysis to influence his ideas and research for the future. His
research is interesting in how his conclusion is the largest aspect of his work, and
how he implements what he thinks teachers should and should not do and how
dance show be included in schools. Although he has a lot of resources to backup
his ideas and thoughts he also he's very opinionated in his writing. Which can be
problematic when it comes to using him as a reference in my work. This article
will be used more as starting ground for my ideas and research.
5. Dale, J. Alexander, et al. The Neuroscience of Dance and the Dance of Neuroscience:
Defining a Path of Inquiry. The Journal of Aesthetic Education, vol. 41, 2007, pp. 89110.
Jstor, Accessed 18 Sept. 2017.
This article goes inside a dancers mind and looks at the neuroscience behind it.
This study brings up important and questions I have not thought of yet, which can
spark other questions and research for me to look into. As well they bring up this
idea that dance can be healing to diseases such as Parkinsons which is an idea I
had not looked into exploring. These researchers however, do not leave out the
negative impacts in dance, yet like I will possibly write about and researching
now it is good to explore both the good and evils of anything to know how to
support your research and avoid contracting opinions. Although dance is very
difficult to not only research historically and anthropologically, it is also very
hard to study from a science perspective. Since dance has not always been
recorded in a neural perspective there is not much to work off making it unstable.
This article is can be an asset to my research and can act as counterpoints to the
research I continue doing. This team of researchers have multiple sources and
references to look into and bounce off points to continue the research they started.
For example I am interested in looking into how dance affects diseases like
Parkinsons or Alzheimer's.

Janine Clark
Research Proposal
Dance CUE

6. Lovatt, Peter. Can dance improve your mental health? News Medical LifeSciences, vol.
20, no. 9, 8 Mar. 2017, doi:10.7748/mhp.20.9.7.s6.
This article sparked an interest in research. It started off talking about dance and
parkinsons disease, however switched over to discussing the relationship
between dance and depression and mood. Which is something I was interested in
researching, but was unable to find studies done for it. This article talked about
several studies that have been done in the past and how people react towards
dancing. Professor Lovatt did not go into much detail on every study but
overviews. So, I am interested on reading more of his work and looking at these
studies. Throughout the article he addresses several questions and asks many
questions I did not think about yet, which is beneficial in finding a question I wish
to address and study. So far all my articles have influenced me in different ways
and allowed more jumping off points to more problem questions I wish to address
or look into.
7. Edwards, Scott. Dancing and the Brain. Dancing and the Brain | Department of
s/dancing-and-brain. Accessed 1 Oct. 2017.
This article written on The Harvard Medical School page discusses the possibility
of dance positively influencing and helping those who were diagnosed with
Parkinsons disease. Although this is a short article written about dance and
movement corresponding with the development and progress of Parkinsons it
helped advance my research and ideas of what I am intending on researching.
Unfortunately it does not reference many other researchers or cite many sources,
but I can use this as a jumping point in how to phrase my research and questions I
will be further asking.
Janine Clark
Research Proposal
Dance CUE

12. Mandelbaum, Rosalind, and Albert C. Lo. 2014. "Examining dance as an intervention
in Parkinsons disease: A systematic review." American Journal Of Dance Therapy 36, no.
2: 160-175. PsycINFO, EBSCOhost (accessed September 28, 2016).
13. Hackney, Madeleine E., and Gammon M. Earhart. 2010. "Recommendations for
Implementing Tango Classes for Persons with Parkinson Disease." American Journal Of
Dance Therapy 32, no. 1: 41-52. International Bibliography of Theatre & Dance with Full
Text, EBSCOhost (accessed September 28, 2016).
14. Coaten, Richard, and Donna Newman-Bluestein. "Embodiment and dementiaDance
Movement psychotherapists respond."Dementia: The International Journal Of Social
Research And Practice 12, no. 6 (November 2013): 677-681. PsycINFO, EBSCOhost
(accessed October 1, 2016).
15. Goldstein-Levitas, Natasha. 2016. "Dance/movement therapy and sensory stimula
tion: A holistic approach to dementia care."American Journal Of Dance TherapyPsycINFO,
EBSCOhost (accessed October 1, 2016).
16.Duncan, Ryan P., and Gammon M. Earhart. 2014. "Are the effects of community-based
dance on Parkinson disease severity, balance, and functional mobility reduced with time?
A 2-year prospective pilot study." The Journal Of Alternative And Complementary Medicine
20, no. 10: 757-763. PsycINFO, EBSCOhost (accessed October 1, 2016).