Effects of binary dance rhythm compared with quaternary dance rhythm in fatigue, sleep, and daily sleepiness of individuals with Parkinson's disease: A randomized clinical trial

Moratelli, Jéssica Amaro; Alexandre, Kettlyn Hames; Boing, Leonessa; Swarowsky, Alessandra; Corrêa, Clynton Lourenço; Guimarães, Adriana Coutinho de Azevedo

doi:10.1590/s1980-657420220020621

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Acute and Chronic Effects of Exercise in Health • Motriz: rev. educ. fis. 28 • 2022 • https://doi.org/10.1590/s1980-657420220020621 copy

Effects of binary dance rhythm compared with quaternary dance rhythm in fatigue, sleep, and daily sleepiness of individuals with Parkinson's disease: A randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Aim:

People with Parkinson's disease constantly demonstrate low levels of physical activity, which is why dance has become increasingly important for the treatment of the disease. This study aimed to analyze the influence of binary and quaternary rhythm on fatigue, sleep, and daytime sleepiness in individuals with Parkinson's disease.

Methods:

31 individuals participated in this randomized clinical trial with a mean age of 66.6 ± 10.2 years, 71% were male and 29% were female, allocated into two groups, binary and quaternary, where they participated in different dance interventions lasting 12 weeks. A questionnaire was applied including personal and clinical information; Mental State Mini-Examination (MMSE), Hoehn and Yahr (H&Y), Fatigue Severity Scale (FSS), Sleep Scale for Parkinson's Disease (PDSS), and Daytime Sleepiness Epworth Scale (ESS).

Results:

The groups that participated in binary rhythm classes showed improvement in sleep quality and daytime sleepiness after 12 weeks of intervention. However, no significant differences were found in the group that participated in the quaternary rhythm classes. Moreover, it was noted that the binary group managed to raise the heart rate during the 12 weeks of intervention, given that these results were not obtained in the quaternary group.

Conclusion:

The results showed the effectiveness of binary rhythm on non-motor symptoms and heart rate increase in individuals with Parkinson's disease. Thus, it is concluded that the binary rhythm was more effective than the quaternary rhythm.

Keywords
Parkinson's disease; dance; non-motor symptoms; binary rhythm; quaternary rhythm

Steps	Description
Presentation of the binary rhythm	During the lesson movements are performed with songs of different speeds to set the students to the rhythm.
Dois para lá, dois para cá ^a a The steps names were maintained in their original language.	Characterized by two steps to one side and returning giving two steps to the other side, transferring the body weight.
Walk	Walk forward and back to back (two steps forward and two backwards).
Hinge	Opening sideways like a door, the lady will stand facing the gentleman with her hands, release one hand and take a step to the side, then returning to the starting position.
Fixation	Perform the dois pra lá, dois pra cá step, walk and hinge at different intensities and speeds of music.
Simple Spin	Leaving the basic step, the gentleman will lead the lady to perform the simple turn, the lady will perform the turn by moving forward and the gentleman will follow her movement by walking forward to her side.
Trocadilho ^a a The steps names were maintained in their original language.	The lady and the gentleman will walk to the side crossing their legs (crosses, opens) and will return to the other side in the same way.
Chuveirinho ^a a The steps names were maintained in their original language.	The lady will stand facing the gentleman with both hands, both will raise both their arms and the lady will make a half turn on the spot with her back to the gentleman, thereafter, will give another half turn, returning to the initial position.
Leque simples ^a a The steps names were maintained in their original language.	The lady and the gentleman will stand by side with their hands clasped, and they will walk forward and back with the same leg.
Double Spin	The lady and the gentleman will stand facing each other with their hands clasped, and they will walk to the left side, release their hands and make a turn on the spot.
Review	Students will review all the steps taught in class, to establish and reinforce what has been learned.
Dance Circle	The students will freely dance with each other, changing the partner, performing the steps learned in the form of a dance.

Steps	Description
Presentation of the quaternary rhythm	During the lesson, movements are performed to songs with different speeds to accustom the students to the rhythm.
Shift dialing	Take a 4-step/stroke walk back and forth at a slow pace.
Basic step forward / backward	Requires one step forward, two steps on the spot and one step back.
Basic side step	Requires a side step, two steps on the spot and one step back to the starting position.
Basic step forward / back and side	Combine the two previously learned steps, characterized by front / back / side / side.
Spin in place	Side by side, lady and gentleman start with the basic step forward / backward for a spin around the axis itself, marking with the same foot forward and back after the turn.
Practice the rhythm	Perform shifts with the learned steps of songs of different speeds and speeds.
Lady's turn	Leaving the basic step back, the lady performs a turn after marking the step forward around the shaft itself, the arm should be above the body with the aid of the gentleman.
Leading	Leaving the basic step, the gentleman must place his arm around the lady's waist leaving it to his side and lead it to the other side.
Turn the lady with displacement	Leaving the basic step, the gentleman takes a step to the side so that the lady is beside him, the lady moves away so that both have their arms extended and then returns curling the gentleman's arm around the body itself.
Step sequence	Students repeat the previously learned steps one after the other, initially at a leisurely pace, until they can perform to the rhythm of the song.
Review of steps	A review of all the steps learned to enhance learning
Crusade	With the aid of the gentleman, the lady crosses her feet toward the gentleman's, crossing in four times one foot at a time.
Choreographic design	Students execute steps learned in sequence with different pairs.

	Total n (%)	Binary group n (%)	Quaternary group n (%)	p^⋆ ⋆ Fisher Exact Test p values. # Since no differences were found in the pre and post-period of each group in these variables, it was decided to keep only the data regarding the pre-intervention period.
Sex				0.856
Male	22 (71.0)	13 (72.2)	9 (69.2)
Female	9 (29.0)	5 (27.8)	4 (30.8)
Severity of the disease				0.435
Light	13 (42.0)	8 (44.4)	5 (38.5)
Moderate	17 (54.8)	10 (55.6)	7 (53.8)
Severe	1 (3.2)	-	1 (7.7)
Schooling				0.194
Elementary School	18 (58.1)	10(55.6)	8 (61.5)
High School	9 (29.0)	7 (38.9)	2 (15.4)
Higher Education	4 (12.9)	1(5.6)	3 (23.1)
Marital Status				0.597
With Companion	21 (67.7)	12 (66.7)	9 (69.2)
Without Companion	10 (32.3)	6 (33.3)	4 (30.8)
Concomitant Diseases				0.394
Not	14 (45.2)	9 (50.0)	5 (38.5)
Yes	17 (54.8)	9 (50.0)	8 (61.5)
Initial Manifestation				0.584
Tremor	16 (51.6)	10 (55.6)	6 (56.8)
Bradykinesia	4 (12.9)	2 (11.1)	2(11.1)
Rigidity	6 (19.4)	3(16.7)	3(16.7)
Gait	5 (16.6)	3(16.7)	2(15.4)
Sleeping medicine				0.583
Not	22 (71.0)	13 (72.2)	9 (69.2)
Yes	9 (29.0)	5 (27.8)	4 (30.8)
Medication Use				0.305
Not	2 (6.5)	1(5.6)	1(7.7)
Yes	29 (93.5)	17(94.4)	12(92.3)
BMI				0.468
Eutrophic	20 (64.5)	11 (61.1)	9 (69.2)
Overweight	11 (35.5)	7 (38.9)	4 (30.8)

	Binary group mean ± SD				Quaternary group mean ± SD
Variables	Pré	Post	Intragroup effect p value⋆	d	Pré	Post	Intragroup effect p value⋆	d	Intergroup effect p value^# # p value for comparison between BG and QG in the post-intervention period;	Interaction effect p value^## ## p-value of interaction between group versus time. We used the Anova two-way with repeated measures and Bonferroni's correction.
Fatigue	28.6(18.5)	25.5(13.7)	0.057	0.190	34.0(17.0)	31.0(14.7)	0.122	0.188	0.284	0.947
Sleep quality	111.5(19.9)	122.1(20.3)	0.002	0.527	104.5(16.8)	101.8(20.7)	0.459	0.143	0.011	0.008
Daytime sleepiness	9.72(5.08)	7.88(5.00)	0.001	0.365	10.61(6.14)	10.30(5.17)	0.543	0.054	0.174	0.098

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[1] Associate Editor: Cristine L Alberton0000-0002-5258-9406. Universidade Federal de Pelotas, Pelotas, RS, Brazil. E-mail: cristine.alberton@ufpel.edu.br.