Tango for treatment of motor and non-motor manifestations in Parkinson's disease: A randomized control study

Objective: To determine effects of Argentine tango on motor and non-motor manifestations of Parkinson's disease. Design: Randomized control trial. Participants: Forty patients with idiopathic Parkinson's disease. Setting: Movement disorder clinic and dance studio. Intervention: Two randomized groups: group (N = 18) with 24 partnered tango classes, and control self-directed exercise group (N = 15). Main outcomes measures: The primary outcome was overall motor severity. Secondary outcomes included other motor measures, balance, cognition, fatigue, apathy, depression and quality of life. Results: On the primary intention-to-treat analysis there was no difference in motor severity between groups MDS-UPDRS-3 (1.6 vs.1.2-point reduction, p=0.85). Patient-rated clinical global impression of change did not differ (p = 0.33), however examiner rating improved in favor of tango (p = 0.02). Mini-BESTest improved in the tango group compared to controls (-0.7 +/- 2.2 vs. -2.7 +/- 5.9, p = 0.032). Among individual items, tango improved in both simple TUG time (-1.3 +/- 1.6 s vs. -0.1 +/- 2.3, p = 0.042) and TUG Dual Task score (-0.4 +/- 0.9 vs. -0.2 +/- 0.4, p = 0.012), with borderline improvement in walk with pivot turns (-0.2 +/- 0.5 vs. -0.1 +/- 0.5, p = 0.066). MoCa (0.4 +/- 1.6 vs. -0.6 +/- 1.5, p = 0.080) and FSS (-3.6 +/- 10.5 vs. 2.5 +/- 6.2, p = 0.057) showed a non-significant trend toward improvement in the tango group. Tango participants found the activity more enjoyable (p < 0.001) and felt more overall treatment satisfaction (p < 0.001). We found no significant differences in other outcomes or adverse events. Conclusion: Argentine tango can improve balance, and functional mobility, and may have modest benefits upon cognition and fatigue in Parkinson's disease. These findings must be confirmed in longer-term trials explicitly powered for cognition and fatigue. (C) 2015 Elsevier Ltd. All rights reserved.