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Category: Project

Description: Background Parkinson’s disease (PD) is a neurodegenerative condition associated with the loss of dopamine producing cells in the basal ganglia resulting in motor and non-motor symptoms. As pharmacological and surgical treatments do not ameliorate all symptoms, adjunct therapies are needed to reduce symptom severity and improve quality of life. Whilst physical therapy can improve motor symptoms, benefits do not extend to psychological mood. Conversely, therapeutic approaches using music, such as rhythmic auditory stimulation and dancing can be beneficial both for functional mobility and psychological wellbeing. This may be because music, as a specialised stimulus, has both motivational and organisational properties that can improve the efficacy of interventions by a) increasing the motivation to move and continue to move (ergogenic effect), and b) providing auditory cues to regulate movement (temporal scaffolding). Aims 1) To develop a new group-based programme integrating musical activities with task-based exercises for and with people with Parkinson's. 2) To test and optimise the programme using a mixed methods. Design This is a within subjects repeated measures mixed methods design. Methods Qualitative methods include workshops (content anaylsis), semi-structured interviews (thematic analysis), weekly one-to-one feedback sessions (narrative analysis) and analysis of video recordings or sessions. Throughout the study, we will continue to collect qualitative data regarding the participant experience, their motivations and use of strategies. Quantitative methods include the integration of motion capture and pressure sensitive gait mat technology to quantify clinical measures such as general gait and the Timed Up and Go test (3 metres). A new Functional Mobility Assessment for Parkinson's has been devised for this project. Additionally, the gold-standard clinical measure, the Motor Disorders Society Unified Parkinson's Disease Rating Scale (Motor Section), is included. Self-report questionnaires are also included such as the Parkinson's Disease Quality of Life, Barcelona Music Reward Questionnaire, The Goldsmiths Music Sophistication Index, Gold-MSI Beat Alignment Test, The Goldsmiths Dance Sophistication Index, The Gait Specific Attentional Profile, The Parkinson's Disease Questionnaire on Quality of Life, The Bucknell Auditory Imagery Scale (Vividness), The Parkinson's Activities of Daily Living Scale and items from the Apathy Evaluation Scale for Parkinson’s disease and Freeze of Gait questionnaire. A new protocol, Songlines for Parkinson's' has been created by bringing together the latest research findings within an interdisciplinary and participatory medicine framework. Key stakeholders who co-created the intervention include people with Parkinson's, music, movement, physical and occupational therapists, music workshop facilitators, a choreographer, medical physician, neurologist and neuro-rehabilitation specialist, a systematic musicologist, sport scientist and music psychologist. This systematic approach is expected to not only replicate findings of other studies demonstrating therapeutic approaches using music can improve motor symptoms such as gait and balance, but also non-motor symptoms such as apathy, anxiety and general quality of life. Measures pertaining to these measurement parameters will be collected up to four times: Baseline (Time -4), Pre-intervention (0), Post-intervention (12) and Follow Up (16). An a priori power calculation based on an effect size of .4, a power level of .99, and an error probability of .05 with1 within-subjects groups with three repeated measurements suggests a total N=24 is sufficient for this study. Discussion The aim of the study is to systematically and inclusively design a new music and movement-based intervention that increases quality of life for people with Parkinson's. The inclusion of key stakeholders throughout the process is expected to increase the sustainability of the intervention by providing enhanced levels of engagement for participants and practitioners resulting in high levels of adherence, transference of skills into everyday life, as well as improved motor function and affective states. The processes involved in the development as well as the outcomes measures will make valuable contributions to applied sciences and arts research. The integration of two kinematic technologies to enable the quantification of clinical measures is also an important contribution of this project.