What is dance therapy for Parkinson's, and what can and can't you expect? Read about the morale, social connection and safety sides of rhythm and movement work.
It is a holiday, and the radio is on in the living room. A grandfather who has been living with Parkinson's disease for years gets up from the armchair at his grandchild's insistence. His steps are short and stiff at first, but when a familiar folk dance tune begins, he lifts his arms slightly and shifts his weight from one foot to the other. A smile that has not been seen for months spreads across his face. The family talks about this moment for a long time: "When he danced, it was as if he became someone else." Dance therapy for Parkinson's and dance-based movement work have attracted growing interest in recent years, building on observations like this. In this article we look at what this approach is, what research does and does not yet support, what it means for patients and their families in terms of morale and social connection, what to keep in mind regarding safety, and the place of mental health support in this process.
Parkinson's Disease and the Emotional Burden
Parkinson's disease is a progressive neurological condition that affects the systems in the brain that regulate movement. Tremor, slowness of movement, muscle stiffness and balance problems are among its known symptoms. But the disease does not affect movement alone. Many people and their families describe the emotional side of the process as being at least as challenging as the physical side.
After diagnosis, anxiety, fear of the future, sadness and anger may be experienced. As the disease progresses, the person may face a sense of loss at no longer being able to do things they once did easily. Feeling ashamed of tremor being noticed in public, or being afraid of freezing or falling while walking, can lead a person to go out less and withdraw from social life. This withdrawal, in turn, can feed loneliness and low mood.
Symptoms of depression and anxiety can also occur alongside Parkinson's, and these are important problems that should be considered part of the condition. Dismissing these symptoms as "just old age" or "a natural consequence of the illness" can delay the person getting the support they need. When emotional symptoms are noticed and addressed, the person's participation in daily life and their adherence to treatment may also be positively affected. We discuss the emotional side of living with Parkinson's in our article on the psychology of Parkinson's patients.
What Is Dance Therapy for Parkinson's?
Dance therapy for Parkinson's is a general term covering dance and movement work accompanied by music for people living with Parkinson's disease. Quite different practices can fall under this heading:
- Dance movement therapy: A therapeutic approach, led by trained practitioners, that uses movement to express feelings and support psychological processes. The field was shaped by the work of pioneers such as Marian Chace, one of the founders and the first president of the American Dance Therapy Association, established in the USA in 1966.
- Parkinson's-specific dance groups: Group classes in which different types of dance, such as tango, ballet, folk dance or free movement, are adapted to the needs of people with Parkinson's.
- Rhythmic walking and movement work: Work in which walking and movement exercises are done to music or rhythm, often as part of a rehabilitation team's programme.
What these practices have in common is music and rhythm meeting movement. Many people with Parkinson's and their families say that moving to music can be easier and more enjoyable than moving alone. However, how far these observations can be generalised, and which kind of work benefits whom and to what extent, are questions still being researched.
Some people with Parkinson's say that, at moments when they get stuck while walking, counting a rhythm in their head or humming a familiar song makes it easier to take a step. It is best to discuss with your physiotherapist or neurologist whether everyday strategies like this suit you and how they can be used safely, because everyone's symptoms and needs are different.
If you are curious about how dance and movement therapy works in general, you can read our article on dance therapy.
What Does Research Say About Dance Therapy for Parkinson's?
Dance and rhythm-based work in Parkinson's disease is a field that researchers are increasingly interested in. Neurologic music therapy practices such as rhythmic walking are also being researched in this area. However, since we do not yet have sufficiently verified evidence to offer a reliable, systematic summary of the findings of these studies, we do not give effect sizes or firm conclusions here.
When we look at broader research on the emotional effects of dance and movement therapy, the picture also calls for caution. For example, the Cochrane review examining dance and movement therapy for depression found only three small studies and stated that the evidence was of low quality and that no firm conclusion could be drawn.
For this reason, it is realistic to say the following about dance therapy for Parkinson's:
- Dance and movement work is one of the supportive approaches being researched for people with Parkinson's, and it is considered promising.
- This work does not replace the treatment recommended by a neurologist, physiotherapy or other rehabilitation work.
- Claims that it halts the progression of the disease or treats it are not supported by evidence.
- Its clearest contributions may lie in enjoyment, morale, social connection and motivation to move; but even this varies from person to person.
Dance does not cure Parkinson's; but it can create moments in which a person feels, once again, like "someone who is more than their illness".
Morale, Connection and Identity: The Emotional Side of Dance
One of the most meaningful aspects of dance and movement work for people with Parkinson's is its emotional and social dimension:
- Enjoyment and play: Living with the illness can fill most of the day with medication times, doctor's appointments and exercise lists. Within this routine, dance can be an activity that is "wanted" rather than one that "has to be done".
- Making peace with the body: A body that trembles, slows down or freezes can create anger and a sense of estrangement. Moving to music at one's own pace can help rebuild a positive relationship with the body.
- Social connection: Group classes offer the chance to meet people who share similar experiences. The feeling that "here I'm not ashamed of my tremor" can be an important step for someone who has withdrawn from social life.
- Identity and memories: For someone who was always first up to dance the horon (a Black Sea folk dance) at weddings in their youth, or who danced the zeybek (an Aegean folk dance) on holidays, dance is a way of connecting with their own past and identity.
- Together with family members: When spouses or children join the classes, the relationship can move beyond the roles of "carer and cared for" into a space of shared enjoyment.
Unexpected feelings may also come up while dancing. No longer being able to do a step that once came easily can bring sadness, anger or shame. Some people say they could not hold back tears in the first classes. These feelings are not a sign of failure; they are a natural part of grieving for what has been lost. A safe and understanding group setting can be a place where these feelings are accepted too. It is important for participants' comfort that the practitioner or group leader is sensitive to moments like these.
For family members, this work has a value of its own as well. When a spouse who has been providing care for a long time falls into the same rhythm again with the life partner they have not danced with for years, they may remember what their relationship was like before the illness. These small moments can be a breathing space within the tiredness of caregiving and an experience that strengthens the bond.
Imagine a retired tailor who has hardly left the house for two years since his Parkinson's diagnosis. At his daughter's insistence, he agrees to join a movement group for older people run by the local municipality. In the first weeks he only moves his arms while sitting on a chair. A few months later he has become one of the group's most regular participants, and at home, too, he becomes more talkative and more curious. His symptoms do not disappear; but his life opens up a little again.
Safety: What Should You Consider Before Starting?
Before a person with Parkinson's takes part in dance or movement work, some safety issues need to be taken into account:
- Consult your doctor. Before starting dance or a new exercise programme, it is important to consult your neurologist and, if you have one, your physiotherapist. The person's balance, risk of falling and other health problems should be assessed.
- Choose a suitable setting. A non-slippery floor, adequate lighting and a bar or chair to hold on to when needed are part of a safe environment.
- It is possible to start seated. For people with balance problems, movement work done while sitting on a chair can be a good starting point.
- Respect your own pace. Fatigue is common in Parkinson's. Taking breaks, making movements smaller or not taking part that day are all completely acceptable.
- Choose suitable shoes and clothing. Non-slip shoes that support the feet well and clothes that do not restrict movement should be preferred.
- Don't be alone. Especially if you are trying things at home, having a family member with you at the beginning increases safety.
In Turkey, some municipalities may organise activities involving movement, music or dance at their centres for older people and people with chronic illnesses; some patient associations may also hold similar gatherings. If you are thinking of joining such an activity, it is a good idea to ask in advance whether it suits the needs of people with Parkinson's, whether the setting is safe and whether there is the option of taking a break when needed. Details such as the size of the group, the accessibility of the hall and whether there are stairs are also factors that can make taking part easier or harder.
At home, simple movements done with a family member to a favourite song can also be an enjoyable start: slowly opening and closing the arms, shifting weight from one foot to the other, clapping along to the rhythm or gently swaying the shoulders. Movements like these are not therapy, but small, enjoyable activities added to daily life. What matters is not how big or correct the movement is, but that those few minutes pass with enjoyment and in safety. Just clapping one day, standing up and taking a few steps the next; both are valuable.
When Should You Seek Professional Support?
Living with Parkinson's can be emotionally challenging for both the patient and their family. Talking to a mental health professional may be helpful in the following situations:
- Low mood, hopelessness or an inability to enjoy anything lasting more than two weeks
- Clearly avoiding going out or seeing people
- Intense anxiety, fear of the future or sleep problems
- Intensifying feelings of burnout, anger, guilt or helplessness in a family caregiver
- Thoughts of harming oneself or ending one's life
If the last point applies, call 112 (emergency services) without delay or go to the nearest emergency department. It is also important to share your emotional symptoms with your neurologist; some emotional symptoms may be related to the illness itself or to its treatment and may require medical assessment. Where needed, an assessment by a psychiatrist may also be requested.
How Does Psychological Support Work Alongside Parkinson's?
When living with a long-term condition such as Parkinson's, psychological support is a field that complements medical treatment. In this process, goals such as understanding one's emotional reactions to the diagnosis and to losses, learning to live with uncertainty, working on shame and avoidance behaviours, and bringing meaningful activities back into one's life can be explored.
In a cognitive behavioural approach, noticing sweeping thoughts such as "Nothing will ever be the same again" and gradually increasing the activities the person can still do and enjoy play an important role. Activities such as dance, music or walking can be part of this plan. In individual therapy, the difficulties experienced by family members can also be addressed. We describe the general psychological aspects of living with long-term illness in detail in our article on the psychology of chronic illness.
Frequently Asked Questions
Does dance therapy for Parkinson's cure the disease?
No. Dance and movement work does not treat Parkinson's disease, and it has not been proven to halt its progression. As a supportive activity, it may contribute to morale, social connection and motivation to move; but it does not replace medical treatment and physiotherapy.
Can someone who can't dance take part?
Yes. No dancing skill is expected in this work. Movements are adapted to the person's condition and can be done seated if needed. What matters is that the person feels safe and comfortable.
Which type of dance is more suitable for Parkinson's?
There is not enough evidence to say that one type of dance is superior to others. A type of dance that the person enjoys, feels comfortable with and can practise safely can be chosen. It is recommended that you consult your doctor and physiotherapist before choosing.
What should I do if my loved one doesn't want to dance?
It is best not to insist. Shame, tiredness or fear of falling may lie behind this reluctance; asking about these with curiosity can help. Suggesting small steps, such as putting on a song they love at home and simply listening together, or clapping while seated, keeps the door open without creating pressure.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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