The debate about how to evaluate arts in health projects is being furthered by a new dance programme for people with Parkinson’s disease, says Sara Houston.
There has been growing interest among community dance artists to develop specialist knowledge and understanding in order to work with specific populations. People Dancing has responded by helping set up specialist interest networks to support dance artists and the people they work with. One of these emerging networks aims to develop and nurture specialist work for people with Parkinson’s disease. Coming at the request of several independent dance artists and organisations working in this area, the network has allowed sharing of best practice and mentoring, as well as giving each artist the sense that they are part of a wider community.
Parkinson’s is a common neurodegenerative condition. It primarily affects movement, slowing it down and causing rigidity in muscles. It provokes tremor and postural instability. Far from being fazed by the possible challenges that dancing might present, many people with Parkinson’s have embraced dancing as their exercise of choice.
If using qualitative data from interviews, it is important to be able to talk to people several times to start to build up themes so that results do not rest on anecdotes
The growing popularity of dancing among people with Parkinson’s was sparked by the Brooklyn Parkinson Group, a mutual support group of people with Parkinson’s in New York. In 2001 the group approached the Mark Morris Dance Group (MMDG) and asked whether it would give them regular dance sessions. Together MMDG and Brooklyn Parkinson Group established a regular and increasingly popular dance programme. In fact, the programme became so successful that MMDG began training dance artists to facilitate dance for Parkinson’s sessions and held workshops wherever the company toured. It was a workshop in the UK in 2008 that fuelled the desire for a UK network.
Dance for Parkinson’s is allied with arts and health practices, where artists work with people who have particular health conditions or within specific health settings. Arts and health practices have come under scrutiny for the impact they might have on the participants’ health and wellbeing. There’s a common assumption that they might be therapeutic for those who take part, despite many projects focusing on artistic engagement rather than therapy. Research into the experience of engaging through the arts, and the impact that it might have on people, helps to either verify or challenge those assumptions, as well as helping to better understand the individual experiences people have.
I started researching dance for Parkinson’s by examining a 12-week pilot project run by English National Ballet. Together with Ashley McGill, we measured changes to balance, stability and posture, observed movement qualities, participant interaction and analysed the value of attending. The small study suggested that balance and stability had improved and that participants were able to move more fluidly while dancing. The class was also highly valued as a cultural activity, as a focus for socialising and as a source of mutual support. In addition, the results suggested that participants were using movement capability that they already had but had not necessarily had the confidence to use, or realised that they could use.
Scrutinising the impact of dance on people with Parkinson’s is not easy. The condition fluctuates hourly, medications prove difficult to manage and lose potency over time. Stress can aggravate symptoms and the condition gets progressively worse. All these variables and contextual factors make it difficult for anyone trying to measure impact objectively. In addition, when working with statistics, small groups, as most arts groups tend to be, do not generate enough data for generalisations. If using qualitative data from interviews, it is important to be able to talk to people several times to build up themes so that results do not rest on anecdotes. Research, in other words, may help form more knowledge and understanding about the practice or project, but it is important to acknowledge that research needs time to develop and question. It cannot stop at one study.
The Dance for Parkinson’s pilot research has led to a much longer, bigger project allowing us to delve deeper into what we think we found from the pilot. What if we tested balance, stability, posture and confidence differently? Would there be a similar result? What if we tested people with Parkinson’s who did not dance? Might that change what we thought was affected by the dancing? What if we kept on building a bank of interviews, diaries and focus group responses? Are there additional themes that come up? Does the method of delivery affect the outcomes?
The results of the second three-year study will be out soon and will contribute, irrespective of positive or negative findings, to a greater knowledge and understanding of the practice of dance in relation to Parkinson’s. In tandem, emboldened by the formation of the network, international collaborations are being forged between dance artists, and we are all working together (researchers, teachers and dancers) to establish best practice in this emerging area of work.
Sara Houston is Principal Lecturer and National Teaching Fellow at the Department of Dance, University of Roehampton, London.
Comment from Deborah Bull
We’ve seen a steady increase in the body of research linking health and wellbeing benefits to arts and cultural engagement on CultureCase, especially in relation to people living with long-term conditions. Sara’s work with people with Parkinson’s disease is a good example of how the arts can collaborate with the healthcare system to provide alternate therapeutic activities. Sara rightly offers a caution on drawing large conclusions from smaller studies. Studies, such as Dance for Parkinson’s, are important as they provide the foundations for further investigation. I very much hope that it will encourage research funding bodies to commission a larger-scale exploration of this area.
Deborah Bull is Director of Culture at King’s College London.
This article is a summary of research prepared for CultureCase, a new resource from King’s College London to provide the sector with access to academic standard research. The summary of the academic paper is available on CultureCase.