Movement as Medicine: The Healing & Transformative Power of Dance

Movement as Medicine: The Transformative Power of Dance

by Corey Bliss

A Dance for PD® class led by Mark Morris Dance Group in Kansas City. Photo by Don Ipoc.

Regular physical activity and musical experiences are two of the most important and well-known interventions for individuals living with neurodegenerative conditions. But, what happens when you move to the music and just dance? The benefits, as it turns out, increase exponentially. 

“What's really great about dance is that it incorporates most of the elements of a standard fitness program, except that it’s about 100 times more fun because you’re doing it to music. You’re approaching it as a creative endeavor, as an art form. You’re engaging with your brain much more than you would, say, if you’re on a treadmill,” explains David Leventhal, the Director of Dance for PD®, a program of Mark Morris Dance Group for individuals with Parkinson’s disease (“PD”).  

In addition to community-based dance programs, the field of dance/movement therapy is making strides in innovative care, especially for people with Alzheimer’s, Parkinson’s, and other neurodegenerative conditions. Cecilia Fontanesi, Ph.D., is a dancer, certified movement analyst (CMA), dance/movement therapist (R-DMT), and neuroscientist who leads dance/movement therapy sessions at A Place for Us, a recreation therapy program for older adults with ADRD as part of the NYU Family Support Program.  

“Dance/movement therapy integrates the physical, cognitive, social, and emotional aspects,” she says. It examines movement as it is manifested in a therapeutic relationship. “From the therapist’s standpoint, that relationship is one in which I look at a person with curiosity, I pay attention, I attune to them, I have a readiness to respond to what they need, almost like an improvisation,” Dr. Fontanesi explains. 

“There is a virtuosity in the interplay between the arts and arts therapies,” she adds. “When they coexist and they integrate well, they are the best possible system of support overall.” 

A structured dance class is often a good starting point to tap into that support system. It is especially effective for older adults because it unites several different interventions and approaches. As Leventhal says, “it has a progressive warmup, it’s focused on learning new things, on music, and has a social element.” He outlines three key types of engagement that dance taps into for people with PD and different types of dementia: physical, social, and expressive.  

Physical Engagement 

A Dance for PD® class led by David Leventhal. Photo courtesy of Dance for PD®.

The physical benefits of dance may be obvious, but as Leventhal explains, that primary level of engagement opens the door to deeper discoveries and more meaningful outcomes. “Dance strengthens all of the motor skills and other things that older adults need to work on – balance, coordination, being aware of all of the parts of the body in space, breath, and initiating movement through the imagination. In PD, automatic movements are less reliable, and in dementia, memory is less reliable – but imagination is still there, visualization is still there.” 

For Dance for PD® participants, using imagery “is a detour around the motor blocks they can have. A physical therapist might say ‘lift your arm 45 degrees,’ whereas we might say ‘lift your arm as if you’re a swan lifting your wings.’ What does that awareness of movement quality and image do to someone who otherwise feels quite trapped in their body? It opens them up, it frees them to move in new ways. They’re not reacting so much to the mechanical goal of lifting your arm; they’re reacting to the imaginative goal, the qualitative goal,” Leventhal says. 

Amy Harris, CTRS, directs the A Place for Us program, and works closely with Dr. Fontanesi. As she shares, “I’ve always incorporated movement and music into my sessions. It helps people connect to the creative brain, which is very effective specifically for Alzheimer’s and different types of dementia. You’re intentionally incorporating the rhythmic centers of the brain, which can actually function at a higher level.” 

Social Engagement 

Dance is an inherently social endeavor. Although there are certainly many solo professional dancers and choreographers, in a therapeutic realm, it’s the dynamic connection with others that keeps older adults coming back for more. It’s a simple equation, according to Leventhal: “We’re going to do some dancing to great music with other people – that's appealing. The social dynamic is at least 50% of the success of the [Dance for PD®] class. There's a highly motivating factor of social engagement, and it really does help with social isolation.” 

For its virtual programming, Dance for PD® has added Zoom breakout rooms for participants to chat and socialize in a more intimate environment after class. With some classes having over 200 attendees, that time for personal connection is especially important. “There’s a huge benefit to people dancing together, seeing each other, and in the conversations that happen before and after class. People come to see their friends, even if they don’t feel like dancing that day,” Leventhal adds. 

Hearthstone Alzheimer’s Center visits the Rhythm Break Cares dance studio for a pre-pandemic class. Photo by Jodie Berman.

Rhythm Break Cares is a nonprofit that offers dementia-friendly programs rooted in ballroom and social dance. Each program incorporates the elements of music, movement, and touch to engage with older adults and create lasting connections. Although the ‘touch’ factor is temporarily on hold due to the pandemic, it’s an especially important aspect of creating an inviting social environment. 

“Partner dancing is unique is because it’s actively with other people. There’s a social and emotional aspect to the connection,” explains Charlene Wang, Rhythm Break Cares’ Managing Director. Although their programming is fully virtual for the time being, Wang and her team of instructors – who are all trained in Teepa Snow’s Positive Approach to Care for individuals with ADRD – have found their participants to be quite resilient. “They can still interact with us and move with us in the same way as when we were together, so that’s really encouraging,” Wang explains.  

The high adherence rate of dance as an intervention is significant, especially for older adults who struggle to motivate themselves. “People start with it, and they stick with it for years,” Leventhal says. “You can really do it at your own level, so as your condition progresses, you can still be in the class. You’re not shut out.” 

“Regularity is key,” explains Wang. “If [clients are] able to engage, having sessions 2-4 times a month creates even more opportunity for them to develop and grow. We always try to encourage that consistency.” 

Expressive Engagement 

Of course, dance is much more than simply moving in space to music. Expressive engagement comes from “the performative part of what being a dancer is,” as Leventhal explains. “There’s the technique that we work on with motor skills, but then we encourage people in our classes to really perform their movements, to think about projecting to the back of the balcony.” 

“That projective sense is really critical,” Leventhal says, and it is a particularly effective technique for individuals with PD. As the disease progresses, “a person’s movements become smaller and tighter over time. People think they’re moving big, but they’re not. They think they’re projecting with their voices, but they’re speaking in a whisper.” With the encouragement to move bigger, to ‘shout out through their bodies,’ in a sense, participants come to a place where they’re moving the way they used to move. “You have to overshoot – you have to move bigger to get to a place where it’s a more normal range of motion,” Leventhal explains. 

A group class with Dances for a Variable Population. Photo by Meg Goldman Photography.

Naomi Goldberg-Haas is the founder of Dances for a Variable Population, a nonprofit that offers free creative movement-based classes for older adults both with and without neurocognitive conditions. “We firmly believe that every movement is good. There is no bad movement,” she says. “People feel very self-conscious about moving, but they shouldn’t. Part of our work is making [people] feel safe, and giving them a safe space to explore their own movement, and connect it to the mind and their emotions. It’s about ending up in a different place from where you started.” 

Put simply, “dance builds mutual understanding,” as Dr. Fontanesi says. “The therapeutic relationship is approaching the person holding the belief that it’s perfectly valuable who they are in the present time. Through our movement interaction, we get to know each other. It’s not a one-way street. I’m not teaching you how to dance, we are speaking the language of movement – through which we can feel alive together, we can unlock the resources of creativity, emotional expression, care for one another, mutual support, and the experience of being in your body.” 

Research Revolution 

Despite the overall popularity of dance and the holistic benefits it provides, scientific research has lagged behind the anecdotal, yet consistent, evidence of successful progress that Leventhal, Fontanesi, Wang, Goldberg-Haas, and others have seen in their programs. 

Although there are now 40 peer-reviewed studies on the applications of dance to Parkinson’s Disease treatment, the research is primarily focused on motor improvements like gait, walking speed, balance, and tremor reduction. But the momentum is starting to shift, according to Leventhal. “There is now a growing literature on some of the non-motor benefits – depression, mood, self-confidence, and self-efficacy,” he says. A recent study in Australia based on the Dance for PD® model looked specifically at cognitive effects, with participants showing improvement in episodic memory and executive function, and a reduction in anxiety and depression. 

Rhythm Break Cares is partnering with Dr. Joe Verghese at the Einstein College of Medicine for a formal study on the benefits and effects of social dancing on people living with ADRD. It will expand upon Dr. Verghese’s previous research on the overall benefits of leisure activities, and will measure outcomes in five areas: lifestyle changes, gait, balance, a modified Katz ADL (Activities of Daily Living) Index, and a geriatric depression scale.  

“Once we have that information about how [social dancing] affects different areas of the brain, we plan to look at how can we use that information to fight ADRD. That’s really what we’re working towards,” says Wang. 

“Now we have a chance to know scientifically what we’ve always felt,” she adds. “It helps to have data behind it, but it’s still a heart thing.” 

A Dances for a Variable Population performance. Photo by Meg Goldman Photography.