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Animated Edition - Winter 2008
We're still dancing
Daphne Cushnie independent dance artist based in Cumbria shows the difference dance makes to the lives of people with Multiple Sclerosis and Parkinson's Disease
Down at the village hall it's Wednesday again and we're dancing. Nothing unusual in that, you might say. Except most of the dancers have chronic degenerative neurological conditions like Multiple Sclerosis that can cause a gradual decline in baseline functions like walking and talking. They are participating in a new programme of dance movement in Cumbria specifically designed for people who suffer from this debilitating condition. This novel dance based approach is an attempt to create a clinically relevant way to alleviate some of their key mobility problems yet making it enjoyable and rewarding for those involved.

Conditions such as Multiple Sclerosis and Parkinson's disease cause chaos in the central nervous system, creating blockages in communication from brain to muscles, giving misleading signals and generally disrupting normal reflex activity. People can no longer take for granted the ability to express themselves at will or move around with relative ease. Neurodegenerative diseases are particularly distressing for the patient and their family and friends. As the condition advances they may face the deterioration of speech, swallowing, cognition and mobility, thatcan undermine any sense of hope for the future which can result in feelings of fear and helplessness, frustration and isolation. Depression is common. Equally common though, is an extraordinary stoicism and motivation to help themselves and others. Elizabeth is 66 and despite unrelenting severe pain and very limited mobility has turned up to dance almost every week for the last three years.

"We are all very supportive of each other. That is one of the big bonuses -we encourage each other to go that little bit further. Individually, we are doing what we can for ourselves, but as a group we see ourselves asa team."

These people are not giving up but there is an onus to offer the kind of support that is relevant to their needs and that they can respond to.

I work three days a week as a neurological physiotherapist, one day as a community dance artist and the remaining day engaged in attempting to establish a formal evaluation of our novel dance based approach to neurodegenerative disorders. It seems evident that there is a big gap in healthcare provision for people in this situation and that this type of community dance would effectively fill that gap. In a health service increasingly focused on cost cutting, it would also be cost effective The usefulness of dance, T'ai Chi and yoga for the elderly is well documented. This programme extends that approach to include work with older people with specific disabilities. It's an integration of some of the principles of dance practice and some of those of neurological physiotherapy. The overlap between the two fields is fertile ground, rich with possibility.

We have one well established community dance group for people with Multiple Sclerosis, now in its third year, and another for older people with Parkinson's disease, which also involves their carers/partners. All of these people have thrown themselves into group dance in a wholehearted way. In our Parkinson's group the oldest member is 88, over half of our numbers are men in their sixties and seventies, and none of them have done anything like this before.

Most of our dance is seated, with a strong emphasis on dynamic alignment and well controlled posture, sequential movement and a deep sensory awareness, using imagery and self touch. Equally important is the emphasis on learning to concentrate in a relaxed way in order to remember and sequence movement. Improvisation skills are introduced at an early stage as they form the heart of the practice.

Informing and underpinning my approach is an amazing phenomenon called neuroplasticity which is the capacity we all have to grow new nervous pathways to develop and adapt new functions and roles. It's quite possible to stimulate this rewiring through skilful sensory input and well designed dance activity.

Clearly, having Parkinson's disease or Multiple Sclerosis has an effect on smooth running of impulses. As Elizabeth, one of our group members says, "The nerve damage we have means messages don't travel through our bodies in the normal way. They have to find new pathways and that takes time. Sometimes they don't arrive at all. But we learn to do what we can and to take heart from what we can do."

Part of that learning is about recognising how when one part of the body moves the rest of the body responds, and that one can learn to develop a feel for these pathways. This is made possible via our intricate web of connective tissue or myofascia. This sensorimotor capacity may provide an alternative avenue for movement potential in people with damage to the central nervous system. Over the past three years it has been possible to observe some clinical improvements in our long-term dancers, including much better dynamic alignment of the neck, trunk and pelvis,which opens the field for much freer movement. These observations now need to be formalised as part of a National Health Service (NHS) evaluation.

It is dance, however which nourishes the person and avoids pigeonholing people according to their signs and symptoms as a medical model may unwittingly do. Dance can be label-free and liberating. It also has a natural application in encouraging more normal, effective movement patterns where movement is disordered. It cuts through habitual movement, opening up responsiveness and the possibility of wider choice.

The groups are bursting at the seams most weeks. We've showcased our work at a Day of Dance for Cumbria and we're about to make a short film to spread the word.

If it's beginning to sound like a fairy tale with a happy ending I should add that there's no magic wand to replace all the hard work still to be done to see a community dance approach accepted as a valid tool in this context. In the NHS all methods have to be validated by research. So that's the next step. Meanwhile back at the village hall we're still dancing and having such a very good time!


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Animated: Winter 2008