Gabrielle Beauchamp, Ian

BALLET AND MOVEMENT-BASED Heinkele, Emily Hoogstra,

& Mackenzie Schumacher
INTERVENTIONS FOR PARKINSON’S
DISEASE
THANK YOU COMMITTEE
MEMBERS!
•Chair member: Cynthia Grapczynski;
Department of Occupational Therapy, Grand
Valley State University

•Chair member: Cathy Harro;

Department of Physical Therapy, Grand Valley
State University

•GR Ballet representative: Atilla

Mosolygo, Parkinson’s Ballet Class Instructor
•Research mentor: Jeanine Beasley;
Department of Occupational Therapy, Grand
Valley State University
OBJECTIVES
•Understand the purpose of the study, problem
statement, and research question.
•Summary of the literature review.
•Discuss methodology used for this study.
•Provide a summary of the results of this study.
•Discuss interpretation of data analysis,
limitations, and implications for future
research.
 OVERVIEW OF PARKINSON’S
DISEASE

Motor Psychologic
Cognitive
symptoms al
symptoms
symptoms
PURPOSE OF THE STUDY
•The purpose of the current study was to address the
gaps within the literature by gaining an understanding
of the perceived effects of Ballet dance classes on
individuals with Parkinson’s Disease.

PROBLEM STATEMENT
•Lack of research that focuses on the personal experience of
individuals participating in a Ballet dance class (McGill, Houston, & Lee, 2014).
RESEARCH
QUESTION
What are the
perceived effects
of Ballet and
movement-based
interventions for
individuals with
PD?
SIGNIFICANCE
•Movement and exercise is a
beneficial form of intervention for
individuals with PD (Earhart, 2009; Farley &
Koshland, 2005; Hashimoto et al., 2015; Hong & ; O’Brien et al.,
2008; Sumec et al., 2015).

•Improving areas of decline in

patients with PD may increase their
function in other areas of their life
that are important to them (Houston &
McGill, 2013).
THEORY
•PEO-interaction between
the person, environment,
and occupation which
results in varying levels of
occupational performance
•Ballet classes for
individuals with PD  are
designed to consider the
impaired body and mind,
as well as environmental,
personal, and contextual
factors
 LITERATURE
REVIEW
•Dance incorporates dynamic balance
practice, which is an effective way to
remediate motor impairments (Hackney &
Earhart, 2008, 2009a, 2009b; Hackney, Kantorovich, Levin, &
Earhart, 2007; Hirsch, Toole, Maitland, & Rider, 2003).

•Drastically increased adherence rate to

dance interventions when compared to
exercise programming (Earhart, 2009; Foster et al.,
2013; Shanahan, et al., 2015)
LITERATURE REVIEW
•Several studies have demonstrated the physical
and cognitive benefits of dance interventions,
including increased gains in:
• Balance (Foster et al., 2013; Shanahan, et al., 2015; Sharp & Hewitt,
2014)

• Functional mobility (Shanahan, et al., 2015)

• Movement (Westbrook and McKibben, 1989)
• Quality of life (Shanahan, et al., 2015; Sharp and Hewitt, 2014)
• Cognitive performance (Earhart, 2009)
• As well as improved fluency in movements,
reduced rigidity in stance, and an increase in
body awareness which directly affected their
performance in dressing activities (Houston & McGill,
2013)
 LITERATURE REVIEW
•Psychological benefits of dance include:
• Improvements in how participants’ bodies felt,
their state of mind, quality of life, and mobility
(Heiberger, L., Maurer, C., Amtage, F., Mendez-Balbuena, I., Schulte-Mönting, J., Hepp-
Reymond, M. C., & Kristeva, R., 2011; Westheimer, 2008).  
• Improvements in the Frontal Assessment
Battery and the Mental Rotation Task, both of
which assess cognition, as well as the Apathy
Scale and Self-rating Depression Scale, both of
which assess mental health (Hashimoto, Takabatake,
Miyaguchi, Nakanishi, & Naitou, 2015)

•Participants in Ballet classes for individuals with

Parkinson’s Disease reported direct
improvements in occupational performance for
GAPS IN THE LITERATURE
•Most research about dance
and PD are focused on Tango
(McNeely et al., 2015a).

•Limited qualitative research

conducted on PD (Houston, 2011).
•Limited focus on men (McNeely et al.,
2015a; McNeely et al., 2015b).

•Lack of research that includes

holistic approach of
individuals (McGill, Houston, & Lee, 2014).
INTRODUCTION
TO METHODS
•Phenomenological design to understand the
shared phenomena of participating in a
Parkinson’s Ballet class (Creswell, 2013)
 Qualitative, semi-structured focus group

•Inclusion: Participants with PD in the Grand

Rapids Ballet Parkinson’s dance class and
Dancing For Parkinson’s Ballet Program that have
participated in at least  one dance class
 Grand Rapids: 40 people for dance class; n = 6 for
focus group
 Grand Haven: 20 people for dance class; n = 4 for
focus group

•No more than minimal risk of harm according to

GVSU IRB
PROCEDURE
•Researcher attendance of dance class
•Focus group following the dance class
•Recordings transcribed by Grand
Valley Pre-OT students
•Thematic coding
•Dissemination of results
QUALITATIVE
ANALYSIS
•Thematic coding process
 Open coding (individual)
 Axial coding (individual)
 Selective coding (group)

•Audit trail - refer to flowchart

•Member checking with QL
consultant
TRUSTWORTHINESS
•Credibility Transferability
 Open structure  Two programs studied
 Audit trail/field notes  Rich quotes utilized
 Independent coding  Audit trail/field notes
 Member checking & peer
Confirmability
debriefing
 Audit trail/field notes
•Dependability  Triangulation
 Audit trail  Adds to the literature
 Saturation of data
OVERARCHING THEMES

Physical Aspects
Contextual Related to Intrinsic
Influences Occupation Factors

Class Social Movement/Ba Transfer to Mental Self

Environment influences lance Occupation Improvements Concept
RESULTS
THEME ONE: CONTEXTUAL INFLUENCES

•Class Environment
“The energy from the young kids spills over
to me, and I come in here to see and sense
the dancing energy and the music and all that
stuff. It really pumps me.”
•Social Influences
“You can draw energy and enthusiasm from
other people...the folks are generating the
same excitement.”
“And he calls us dancers. We’re not just
Parkinson’s people.”
RESULTS
THEME TWO: PHYSICAL ASPECTS
RELATED TO OCCUPATION
•Movement/Balance
“Balance alone is a major issue… you know to not
be anxious with how you're moving in the room is
very important to me…Without the class I
wouldn’t know how to do it….I personally would
have lost my balance two years ago if I turned as
quickly as we do here in class… So I feel as
though this helps me move. I feel confident
moving in a way out in public.”
•Transfer to Occupation
“For me, when I turn the light on in the basement
it mimics some of the things we do in this class.”
RESULTS
THEME THREE: INTRINSIC FACTORS
•Mental Improvements
“I’ve noticed the more I move, the better my
mood is….once you get moving, then it sets up
the rest of your day. It makes the day healthier
and happier.”
•Self Concept
“I was a very self-confident person before the PD
and continued to be until my symptoms got a lot
worse...you find yourself questioning how much
you want to talk to people….how much you want
to do, what you wanna volunteer for and
thinking, ‘You can’t do that,’...I think the class
helps you. If I can do this then I can do some of
DISCUSSION:
PREVIOUS EVIDENCE

•Previous Evidence:
• Dance as an alternative intervention
• Reduces bodily discomfort
• Increases emotional well being
• Increases Adherence to therapeutic intervention
DISCUSSION:
SIGNIFICANCE
OF THE
FINDINGS
•Primary themes:
• Contextual
Influences
• Physical aspects
related to
occupation
• Intrinsic factors
LIMITATIONS
•Inclusion criteria
•Voluntary response bias
•Differences in the structure of the
classes
•The potential response bias
elicited by the researchers
 IMPLICATIONS FOR FUTURE
RESEARCH
•Additional classes focusing
specifically on ballet
•Evidence provided by
occupational therapy
functional assessments
IMPLICATIONS FOR
OCCUPATIONAL
THERAPY
•Qualitative perspective on
the effectiveness of
interventions
•Promotes a holistic approach
to intervention
•Future roles in consultation,
activity analysis, and
evaluation of the
environment
•Person, Environment, and
Occupation
 ARE THERE
ANY
QUESTIONS
OR
COMMENTS?
REFERENCES
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Disease. Journal of Rehabilitation Research & Development, 37(5), 529-534.

Creswell, J. W. (2013). Qualitative inquiry & research design: Choosing among five approaches (3rd ed.). Los Angeles, CA: SAGE Publications,
166-168.

Crizzle, A. M., & Newhouse, I. J. (2012). Themes associated with exercise adherence in persons with Parkinson’s Disease: A qualitative study.
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Earhart, G. M. (2009). Dance as Therapy for Individuals with Parkinson Disease. European Journal of Physical and Rehabilitation Medicine, 45(2),
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