New framework for rehabilitation – fusion of cognitive and physical rehabilitation: the hope for dancing

This makes so much sense that it will never be applied in your hospital. The perturbation and balancing required would probably advance your recovery more than anything else out there.
http://journal.frontiersin.org/Journal/10.3389/fpsyg.2014.01478/full?
Prabhjot Dhami¹, Sylvain Moreno^2,3 and Joseph F. X. DeSouza^1,4*

• ¹Department of Biology, York University, Toronto, ON, Canada
• ²Rotman Research Institute at Baycrest Hospital, Toronto, ON, Canada
• ³Department of Psychology, University of Toronto, Toronto, ON, Canada
• ⁴Department of Psychology, Centre for Vision Research, York University, Toronto, ON, Canada

Neurorehabilitation programs are commonly employed with the goal to help restore functionality in patients. However, many of these therapies report only having a small impact. In response to the need for more effective and innovative approaches, rehabilitative methods that take advantage of the neuroplastic properties of the brain have been used to aid with both physical and cognitive impairments. Following this path of reasoning, there has been a particular interest in the use of physical exercise as well as musical related activities. Although such therapies demonstrate potential, they also have limitations that may affect their use, calling for further exploration. Here, we propose dance as a potential parallel to physical and music therapies. Dance may be able to aid with both physical and cognitive impairments, particularly due to it combined nature of including both physical and cognitive stimulation. Not only does it incorporate physical and motor skill related activities, but it can also engage various cognitive functions such as perception, emotion, and memory, all while done in an enriched environment. Other more practical benefits, such as promoting adherence due to being enjoyable, are also discussed, along with the current literature on the application of dance as an intervention tool, as well as future directions required to evaluate the potential of dance as an alternative therapy in neurorehabilitation.

Introduction

Neurological disorders have been estimated to affect as many as a billion people worldwide, with this number expected to increase in the upcoming years (World Health Organization, 2006). Such disorders can be heterogeneous in regards to their symptoms and can include any combination of impairments related to physical and cognitive functioning, or issues with behavior, all of which can impact the basic daily living capability of individuals. Unfortunately, there are no current treatments that can address all symptoms in a meaningful manner. Surgical and pharmacological therapies for prevalent neurological disorders, such as Alzheimer’s and Parkinson’s, have been developed, but may only address a subset of symptoms, and even then, do so with limited efficacy (Ahlskog, 2011; Ahlskog et al., 2011; Intlekofer and Cotman, 2013). Adjunct conventional rehabilitative programs have been used as part of treatment regimes, although the effectiveness of such conventional therapies may also be limited (Lincoln et al., 1999; Langhammer and Stanghelle, 2000; Woldag and Hummelsheim, 2002; Bassett, 2003).

Recently, scientists have highlighted that exercise and music related activities can induce neuroplasticity, and are capable of aiding with physical and cognitive impairments across various neurological patient groups, including in those suffering from dementia and Alzheimer’s (Heyn et al., 2004; Thompson et al., 2005; Irish et al., 2006; Bruer et al., 2007; Lautenschlager et al., 2008), stroke (Duncan et al., 1998, 2003; Gordon et al., 2004; Schneider et al., 2007; Särkämö et al., 2008; Quaney et al., 2009), and Parkinson’s disease (Thaut et al., 1996; Crizzle and Newhouse, 2006; Goodwin et al., 2008; Tanaka et al., 2009; Cruise et al., 2011). However, the uses of such therapies are also faced with inherent limitations, creating the need to explore for further options.

Here, we propose dance as an intriguing alternative to physical and musical therapies as used in neurorehabilitation. As a physical activity, dance may be able to aid with physical functioning. However, other elements found in dance may contribute to it being a cognitively stimulating activity as well. This may allow dance to have a positive impact on not only physical, but cognitive functioning as well, in part due to fitting the framework of what are known as combined, or multimodal, therapies, which incorporate simultaneous physical and cognitive activity in a stimulating environment (Lustig et al., 2009; Kraft, 2012). Dance may also be able to overcome some of the more practical limitations associated with other alternative therapies. In the following sections, the current literature on the use of physical and musical activities in neurorehabilitation is discussed, along with the limitations associated with such therapies, as well as how dance can be a potential alternative in neurorehabilitation.