Experiential and Somatopsychic Approaches to Torso Image Change

A. Ressler , S. Kleinman , in Encyclopedia of Body Image and Man Advent, 2012

What it is

DMT was adult by Marian Chace, a professional dancer in the early 1940s. Chace was involved with the Washington School of Psychiatry where she learned and too worked alongside eminent colleagues including Frieda Fromm-Reichmann and Harry Stack Sullivan. DMT is a method that uses expressive motion at its base to facilitate expression of self. Building on idiosyncratic movements, dance/movement therapists help clients experience feelings through their trunk language and identify the connection betwixt what they observe and how it parallels how they alive their lives. Using the cues and signals from their own body, dance/move therapists respond to whatever the client presents kinesthetically and emotionally. This process heightens the connection between the client and the dance/movement therapist, deepening the expression and communication occurring in the therapeutic relationship. In DMT, individuals are guided through interactions designed to help them experience and express feelings, facilitate awareness of their inner cocky, and identify and process the cloth that emerges.

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THE ARTS THERAPIES

Donna Madden Chadwick , in Developmental-Behavioral Pediatrics (Quaternary Edition), 2009

SUMMARY

Testify-based fine art therapy, dance/movement therapy, and music therapy too as drama and poesy therapy have inherent advantages in pediatric assessment and treatment (Tabular array 94-2). Distinctive because they use natural babyhood beliefs and bypass verbal language, these disciplines externalize feelings and expression through relationships in the creative process. Practitioners usually run across criteria every bit psychotherapists. Applied early in life, dance/movement therapy tin can assist expectant and new mothers to attune to their babe's motility advice. Music therapy has benefited preterm infants in the neonatal intensive care unit by decreasing weight loss and increasing nipple feeding competency. Information technology is also notably effective in early on intervention programs with children who have Downward syndrome or Williams syndrome and with girls who have Rett syndrome. Fine art therapy not merely aids in treatment of children who accept been sexually driveling but is diagnostically used during the forensic interview; drawings are admissible as bear witness in litigation. All the arts therapies offer techniques that can exist taught to the kid, parents, and caregivers for soothing use at home. Information technology is desirable for an art therapy to be named on the child's IEP considering information technology is and so funded by the schoolhouse district and the clinician becomes a treatment team member. The national associations can help consumers in locating therapists and surveying funding sources.

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Integrative Medicine in Rehabilitation

Ajit B. Pai , ... David F. Drake , in Braddom's Physical Medicine and Rehabilitation (Sixth Edition), 2021

Creative Arts Therapies

Creative arts therapies (CATs) include art therapy, music therapy, dance/movement therapy, and many other forms of expression. These modalities are used to help individuals with disease or injury to use expression and communication to improve their functioning. In persons with stroke, CAT in addition to physical therapy significantly decreased low and improved physical office and quality of life compared with physical therapy alone. 58 In addition, music therapy may improve gait, upper extremity function, advice, and quality of life. 72 For individuals on mechanical ventilators, music therapy may have a beneficial upshot on anxiety, subtract consumption of sedative and analgesic medication, and reduce respiratory rate and blood pressure. 12

The previously discussed examples are merely a sampling of the enquiry that exists for practices of the listen. Overall, meditation and CATs can be used in many clinical areas to assist with adjustment, pain symptoms, frustration, etc. The incorporation of this practise into rehabilitation programs can potentially assistance individuals with their recovery. However, more enquiry is needed to truly demonstrate the effectiveness of these modalities in a variety of weather condition that cause functional limitation.

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Complementary therapies for the crumbling patient

Carol K. Davis , in Geriatric Rehabilitation Manual (Second Edition), 2007

Mind/body interventions

These include psychotherapies, support groups, meditation, and imagery, hypnosis, dance and music therapy, art therapy, prayer, validation therapy, neurolinguistic psychology (Masin 2006), biofeedback (Bottomley 2004a), yoga (Taylor 2004) and T'ai Chi (Bottomley 2004b). These listen/trunk interventions demonstrate how movement and exact and nonverbal communication with the mind/body seem to open upwardly new pathways for thought and, therefore, unblock free energy flow or chi. A growing trunk of literature examines the effects of T'ai Chi on the ability to prevent falls in elderly people and on quality of life (Wolf et al 1997).

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Huntington Disease

Anindita Deb , ... Claudia Yard. Testa , in Handbook of Clinical Neurology, 2017

Nonpharmacologic intervention

In addition to traditional pharmacologic and surgical approaches to improve symptoms in HD, there has been increasing attention toward nonmedication interventions such as concrete therapy, occupational therapy, speech therapy, trip the light fantastic toe therapy, and cognitive behavioral therapy ( Tabular array 17.2). The benefits of exercise have been demonstrated in neurodegenerative diseases such as Parkinson illness (Oguh et al., 2014). In an active study, Hard disk drive patients are being recruited for a single session of 20 minutes of walking on a treadmill to evaluate the safety, feasibility, and utility of this intervention and, secondarily, if this can improve gait and remainder (NCT02268617). A like study evaluated the consequence of dancing through video game play and plant it to be motivating while improving balance while walking (Kloos et al., 2013). In addition to cardiovascular exercise, a concurrent written report is using endurance do every bit a ways to improve muscle force and stability and will also clarify musculus tissue pathology every bit information technology relates to Hd (NCT01879267). An interesting prospective study conducted in Norway on ten early- to mid-stage Hard disk drive patients involved a ii-year intensive multidisciplinary rehabilitation program. Outcome measures included evaluation of gait, balance, cognition using the MMSE, anxiety and depression, activities of daily living, and quality of life. In the 6 patients who completed the report, there was a nonsignificant refuse in gait and remainder, no significant improvement in quality of life or anxiety and depression, only too no meaning cerebral pass up (Piira et al., 2014). Nonmedication interventions intended for motor symptoms may therefore positively impact nonmotor symptoms (Colcombe et al., 2006).

Table 17.two. Nonpharmacotherapeutic interventions for Huntington disease (HD) from 1970 to 2014

Yr Interventions
1971 Neuromuscular facilitation in the treatment of Huntington's chorea
1987 Physical therapy
1980 Physical therapy
1990 Hydrotherapy
1991 Tardily-phase HD: issue of treating specific disabilities
Hypnosis
1992 Huntington's affliction at mid-stage
1999 Velocity modulation and rhythmic synchronization of gait
2001 Linguistic and cognitive supplementation strategies, contradistinct movement trajectories and strength control during object send
2004 Bilateral globus pallidus stimulation
2007 Directed action
2012 Practice furnishings a
2013 Video game play
Abode-based do
Multidisciplinary rehabilitation
Trip the light fantastic grooming a
Physical therapy
2014 Treadmill walking a
Aquatherapy
Drumming and rhythm exercises
a
Ongoing trials.

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Body Image in Trip the light fantastic and Aesthetic Sports

S.W. Langdon , in Encyclopedia of Trunk Image and Human Appearance, 2012

Body Paradigm and Trip the light fantastic toe

The relationship betwixt dance and body paradigm is intricately linked to the sociohistorical roots of dance. For millennia, dance served as a ways to tell stories, embody cultural ethos, unify, and entertain. It was oft a key role of ceremonies and rituals, ofttimes laden with symbolic meaning. In the development of performative dance, ballet is ofttimes considered the classical form with its showtime during the European Renaissance. By the nineteenth century, information technology had become a highly structured professional fine art course. Modern dance was built-in out of a directly rejection of the highly structured/dictated grade of ballet with a goal to create thought-provoking art with a message, frequently political. Alongside the modern trip the light fantastic revolution was the development of dance/movement therapy (DMT) that used dance as a ways of healing empowerment. Trip the light fantastic has also had a place in the fitness/practice move of the twentieth century. Through time and types of dance, the multiple purposes of dance seem to differentially influence the body image of the dancers. Ranging from purely cocky-expressive to rigidly structured performative art, we find a corresponding positive to negative bear upon on body image.

Positive Aspects

Despite the stereotype of negative body prototype in dancers, the reality is that for many people, interest in dance has a positive issue on trunk image. The positive aspects of trip the light fantastic toe take iii avenues: dance as practise, trip the light fantastic toe as therapy for mentally and physically at-risk populations, and trip the light fantastic toe forms that tend to be linked with healthy levels of torso image. The underlying machinery to each of these avenues may be the enhancement of physical self-competence.

Work by Harter on cocky-competence suggests that individuals accept specific areas, or domains, of their cocky-concept, including a concrete self. In going about their daily life, 1 interprets themselves in regard to competence in each domain. The activities in which one engages can directly influence the perceptions of competence; thus, i may enhance 1's sense of physical competence in physically driven activities such as trip the light fantastic. Fox built on this work and focused more specifically on physical self-competence. He and his colleagues have constitute that perceptions of one's concrete self are linked to mental as well as physical well-being. This idea of body competence is 1 aspect or correlate of body epitome.

Dance every bit an exercise falls inside this general notion of physical activity, influencing physical self-perceptions and torso image. Information technology could exist argued that by engaging in these activities, one gains not only a stronger, more physically fit torso, but also a sense of empowerment or competence from that body. The original intention may have been to lose or command weight, yet an additional benefit of a sense of physical empowerment may have been gained likewise. The link between weight control activities and body image is clearly and strongly established. While motives for practice vary and are often multifaceted, a common consequence in participating in exercise is improved physical and mental fitness. Concurrent to this fitness is an improvement in body epitome. Dance as a form of exercise is no different. People who engage in aerobics as a form of exercise and weight control tend to experience improvement in physical self-perceptions and body image. Similarly, Zumba and ballroom dance are currently being promoted every bit weight loss activities and are popular forms of exercise that have been found to improve body image too.

Considering of the known physical and mental benefits of exercise, it has been prescribed as a form of therapy for a diverseness of conditions, and enquiry has establish that exercise in full general often improves mental equally well as physical health. Every bit an extension, dance has also been used as a therapeutic tool with some at-risk populations and, when assessed, body image has as well been found to better with prescribed dance.

Dance for healing has been effectually since prehistoric times and is found across cultures with examples of shaman and tribal dancing. DMT, although non fully studied, is a burgeoning form of this kind of intervention. In the United States, influenced past the birth of modern dance and prevailing psychotherapeutic methods, a group of dancers in the 1930s switched focus from teaching trip the light fantastic to assuasive individuals to integrate 'bodymind' and thus became the founders of DMT. Growing organically from healing piece of work with patients in hospitals and psychiatric institutions, DMT integrates the disciplines of dance and psychotherapy and utilizes the body to help the mind. Information technology relies on the physicality of movement to let the client to express emotions, providing its therapeutic foundation. At its core is the intent to improve torso image, with a more complex conceptualization of the term than used traditionally in the body image literature. The accent on increasing body image is evidenced in the dissimilar interrelated aspects or foci of the therapy. Specifically, the therapy is intended to focus on experiencing body sensations, attending to the self-concept of the body, and developing and releasing sensory–motor memory. The therapy has been effectively practical to a variety of populations, including breast cancer survivors, withdrawn adolescents, middle-aged women, and psychiatric inpatients. In studies, DMT has been found to effectively raise trunk prototype in a variety of clinical cases fifty-fifty when the work did not necessarily set out to modify body image. For those with eating disorders, DMT may be peculiarly favorable as an aide arroyo. As these individuals often accept issues expressing emotion, feel disembodied, and have distorted body image, DMT can direct impact these issues. Dance in DMT acts as an expressive therapeutic tool manifested in bodily form and improving body image. Thus, we run into that nondancers who use trip the light fantastic toe as a form of exercise or therapy seem to experience an enhanced body image via body empowerment. The next section describes examples of when this outcome occurs for dancers likewise.

Until the 1930s, the merely forms of performative dance were classical ballet and prove dancing or light-entertainment-blazon dancing. Every bit mentioned earlier, modern dance sought to suspension out of the dictated structure of classical trip the light fantastic toe and impart greater meaning than prove dancing by dramatically irresolute the 'rules'. Freeing up the way a dancer could movement and express herself or himself was quite revolutionary. Dances became an expression of political ideologies and social unrest, usually set up to music other than classical. Acceptable moves, then, transitioned from tightly controlled specific techniques to gratuitous-grade expression. While classical ballet certainly has powerful explosive movements and a singled-out physicality, modern dance completely shifted the possibilities of dance movements. No longer was the graceful the skillful form, and muscling one's way through a slice was more appropriate than 'gliding' through it. A adroit torso, with an emphasis on being vulnerably thin, just would not exist able to perform the newer, more than athletically focused trip the light fantastic moves found in modern dance. To exist successful in mod dance, one'due south body must be more than mesomorphic than the lithe waif-like bodies of ballet. The aesthetic impression of the body grade is still important equally dance of these types also emphasizes creative appearance and is performative. The major divergence is that the body is used every bit more than than just a pretty story teller; information technology serves as a powerful messenger. Similarly, in other nonballetic forms, such as creative, belly, and street dance, the emphasis is on the power and the creative expression of the body. It is fitting, then, that these kinds of dancers tend to accept positive perceptions of their bodies. Like the empowerment experienced by nonexercisers as they become stronger from exercise and the positive effects of DMT, the nonballetic dance forms emphasize force and self-expression over pure aesthetics.

The AXIS and the CandoCo dance companies are 2 examples of gimmicky dance groups highlighting the aesthetic capacity of all bodies. They integrate able-bodied and disabled dancers in ways that change others' perceptions of body abilities. Challenging views most aesthetics and disability, it is very likely that the torso paradigm of the dancers is enhanced as well. To date, however, no enquiry has explored the body prototype of these types of integrated trip the light fantastic toe companies.

Negative Aspects: Ballet

Inside the ballet dance world, the ideal dancer body is that which is potent plenty to execute very physically challenging, large muscle group maneuvers while at the same time delicate and graceful enough in pocket-size musculus group movements. This is especially the case since the choreographer and ballet master George Balanchine inverse the paradigm toward 1 of an emphasis on extreme thinness in ballet dancers. In fact, the 'Balanchine body' has become the ideal that ballet dancers hoping for success try to accomplish ( Figure 1 ). Information technology is interesting to look a little more closely at the history of ballet and encounter the powerful changes Balanchine brought.

Figure ane. Instance of classical ballet body, copyright 2011 Matt Karas.

Ballet began during the Renaissance catamenia in Italy as a form of lavish courtly entertainment, with audition participation. Later being brought to France in the sixteenth century, the offset formal ballet performance was held. In the late seventeenth century, the five classical ballet positions were adult and standardized, giving ascent to the professionalization of the art form in the eighteenth century. The heavy, long, and highly decorated costumes used in the early 1700s reflected the pageantry and courtly roots of this form of amusement. As the technique evolved through the century, the dancers demanded more reasonable outfits that did not hinder movement. It was during this transformation, too, that the ballet shoe lost its heel and the ballet slipper was created. In the nineteenth century, fairy tale-like ballets gained popularity over the previously popular tales of aboriginal Greece. This further developed in the early twentieth century with a move toward greater musicality and using the whole trunk to show emotion. The dancer'due south trunk itself now became an important element in the telling of the ballet story.

Balanchine was inarguably the near influential strength in this later evolution. With his success and prominence in the dance world, his specific preferences for body type became the standard past which dancers were judged and go on to exist judged. Reportedly, Balanchine had a preference for dancers who were tall, short torsoed, minor breasted, small hipped, and long limbed. He supposedly told his dancers 'to swallow nothing' and that he wanted to 'see their bones'. Dancers with the 'correct body' were rewarded with more than and improve opportunities to trip the light fantastic. The trouble, of course, is that very few come to this trunk blazon naturally and those who do non are prone to finish upwardly with a poorer body image and increased likelihood of eating disorders in the attempt to get it. Prevalence of dieting behaviors in ballet dancers has been reported to be 3 times higher than in the general population. Likewise, near a quarter of ballet dancers in another study had very elevated levels of maladaptive body image and eating attitudes, which put them at run a risk for eating disorders. Natalie Portman'due south grapheme, Nina, in Black Swan, portrayed a fictionalized version of the ballet world's drive for perfection and thinness.

Considering ballet is an art form that relies on the advent of the dancers, in the try to command appearance, allegedly common practices past management include unannounced counterbalance-ins at dance schools/classes and appearance clauses in professional person contracts that include the threat for termination with noticeable weight gain. Explicit negative feedback from dance teachers, directors, and ballet operation critics serve to reinforce the importance of a very thin trunk'south role in the success/accomplishment of a dancer. Given the substantial time and free energy that many young girls, in item, devote to pursue dreams of a career in dance, the affect on body image is not hard to imagine. Assuming the clear bulletin is that thinness equals success, girls who want to be successful feel the bulldoze to be thin and internalize it. The thin-ideal internalization is a known indicator of poor body epitome and can be pursuant to eating disorders. Opportunities to reinforce this ideal are aplenty, given the extensive hours of practice/rehearsal in which a typical dancer engages. Beginners and intermediate dancers tend to trip the light fantastic toe one–v   h per week, and more experienced and professionals often dance ii–vii   h per twenty-four hours. Equally the number of hours of trip the light fantastic toe increases, the capability to have a social life outside of dance and a more than balanced perspective diminishes. When i's earth is so limited in scope, the prevailing norms can become much more powerful. Ballet that is well washed creates an effortlessly looking art – an art that, contrary to this image, is highly physically demanding at many levels.

Eating disorders

With the extreme focus on thinness in the enveloping environment of ballet, it is not surprising that rates of disordered eating and eating disorders are higher than in the nonballetic population. Renowned ballet dancers Evelyn Hart and Gelsey Kirkland take spoken publicly virtually the reinforcing downward spiral of their anorexia. Heidi Guenther, a 22-year-old ballet dancer, is idea to accept died from complications due to anorexia. If ballet success is only defined as and experienced by those of extreme thinness, the motivation to accomplish that body platonic is strong. Unfortunately, this body type which has been put forth as the goal is usually obtainable for most bodies by bereft caloric intake. Obtaining or maintaining this trunk type is exceptionally difficult as bodies are naturally inclined to want to survive rather than starve. Restricting calories when a body demands more is a symptom of anorexia nervosa. For some, restrained eating is not a sustainable practise and may be followed by rampage eating, another form of disordered eating. Bulimia nervosa is characterized by the effort to limit caloric intake by purging through vomiting or do. This is besides not salubrious and occurs at higher rates among ballet dancers. These behaviors may seem similar rational and good choices within a subculture that is and so excessively focused on a thin ideal, simply they are ultimately maladaptive and can have serious long-term negative health consequences. Amenorrhea, middle arrhythmia, electrolyte imbalance, seizures, tooth decay, osteoporosis, aridity, and even death can upshot from sustained caloric restriction. 1 of the ironic consequences of restrained eating for dancers is the loss of musculus mass and consequent loss of musculus strength, making practise and performance significantly more difficult.

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Using Dance in Hand Therapy

Marietta Tartaglia , in Fundamentals of Hand Therapy (Second Edition), 2014

Case Study

Example Report 18-1

A female patient was attending manus therapy after sustaining a correct distal radius fracture, status mail open reduction and internal fixation (ORIF), with allodynia of her correct wrist and hand radiating to the index finger where maximal hypersensitivity was experienced. She displayed proximal upper extremity guarding, holding her wrist in neutral and alphabetize finger extended. Wrist extension was painful, and tactile stimulation to her alphabetize finger was aversive. The patient often expressed that physical connection was important to her, and the hypersensitivity and pain associated with her injury prevented her from engaging in many of the activities she once enjoyed, especially horseback riding. Trip the light fantastic toe therapy was offered as a means to help recover wrist extension, desensitize the index finger, recondition the right upper extremity, and to give her a sense of the physical connection she felt she had been missing.

Trip the light fantastic toe sessions began with simple exercises to teach her how to find her eye every bit well equally to feel her weight distributed through her feet on the ground (see Fig. eighteen-1). In addition, a large emphasis was placed on creating a connection with her hands through her elbows and shoulders to her center as a means of straight communicating with both her partner and her own center. The patient's married man was nowadays for the sessions and was able to assist her likewise as discuss the similarities betwixt dance and horseback riding (run across Fig. 18-2).

Once the relevant dance frame and connection points had been established, a few basic trip the light fantastic toe steps were presented. Equally the patient learned to motility her feet in time with the music and in connection with the signals provided through her hands from the leader, she became filled with joy and laughter. She began to lose the guarding behavior that she had previously demonstrated and began to flex, extend, and rotate her proximal upper extremity, elbow, forearm, and wrist. She tolerated tactile stimulation to her index finger without guarding while dancing with a partner to the music. This patient was now flourishing under the subtle guidance of human bear on and interaction. Dance therapy was a safe, advisable, and therapeutic substitute for the connection she felt she had been missing in her daily life after the onset of the injury.

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Approaches to Agreement Breast Cancer

Ramadevi Subramani , Rajkumar Lakshmanaswamy , in Progress in Molecular Biology and Translational Science, 2017

3.2 Mind–Torso Interventions

Listen–trunk therapies explore the relationships betwixt the mind, body, spirit, and behavior upon the belief that the mind can regulate bodily functions and symptoms. Many of the techniques involved in these therapies to relax the mind and body are ultimately intended to promote good wellness and treat diseases. Mind–body interventions include therapies, such as meditation, animate, yoga, hypnosis, biofeedback, t'ai chi, and visual imagery, which human action as effective treatments for anxiety and depression in patients with cancer. 51 Interestingly, various types of art therapies, such as music therapy and dance and movement therapies, the latter being a part of mind–body intervention, showed benign effects on feet in patients with breast cancer. 52 Nevertheless, the study with thirteen trials using a full of 606 patients besides demonstrated that the art therapy didn't have positive furnishings on depression in breast cancer patients. 52 Furthermore, the study concluded that music interventions may accept beneficial effects on feet, pain, mood, and quality of life in cancer patients, and may take a minimal issue on heart rate, respiratory rate, and blood pressure level. 52 Another article showed the benign effects of music intervention on cancer-related fatigue and pain. 53 In addition, other forms of heed–body interventions, such as meditation, relaxation, imagery and hypnosis, and cognitive behavioral therapies also alleviated three cancer-related symptoms: fatigue, pain, and sleep disturbance. 53 However, to date, no systemic review has analyzed the existing data on different types of art therapies specially in chest cancer women. Most patients prefer this intervention due to the low physical and emotional take a chance associated with it. Additionally, the handling cost is relatively low, allowing more patients to actively participate in the treatment.

Mind–body interventions are mostly suggested to care for vasomotor symptoms, such every bit hot flashes and night sweats in good for you menopausal women and chest cancer survivors. Moreover, 26 randomized controlled trials were conducted using mind–trunk interventions, such equally yoga (n  =   5), hypnosis (due north  =   3), mindfulness (n  =   2), relaxation (north  =   vii), paced breathing (due north  =   iv), reflexology (n  =   1), and cognitive behavioral therapy (northward  =   iv). A contempo study reported that cognitive behavioral therapy and relaxation therapies were consistent in their efficacy for treating vasomotor symptoms in breast cancer patients. Animate, relaxation techniques, and cognitive behavioral therapies can be beneficial in the treatment of vasomotor symptoms. Yoga has demonstrated positive impact on reducing fatigue in chest cancer patients and survivors. 54

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Exercise on Brain Health

Margaret K.Y. Mak , Irene Due south.Yard. Wong-Yu , in International Review of Neurobiology, 2019

four.9 Trip the light fantastic

Trip the light fantastic toe as a therapeutic intervention for people with Parkinson's affliction has gained more attending recently. Dance is a sequential movement performed to music. Argentina Tango dance was most studied, followed past Irish dance, flit, ballet, etc. During the dance practise, PD participants were guided by a healthy partner. Most trip the light fantastic therapy lasted for 12–13 weeks ( Hackney & Earhart, 2009; Hackney, Kantorovich, Levin, & Earhart, 2007; Romenets, Anang, Fereshtehnejad, Pelletier, & Postuma, 2015), two of them lasted for 6 months (Volpe, Signorini, Marchetto, Lynch, & Morris, 2013) and 12 months (Duncan & Earhart, 2012). Ten-week of Irish set up dancing showed an comeback in QoL (Shanahan et al., 2017). Tango dance was found to improve residual performance (Hackney & Earhart, 2009; Hackney et al., 2007), aerobic endurance measured by 6-min walk exam altitude (Hackney & Earhart, 2009), and reduced freezing of gait (Hackney & Earhart, 2009; Hackney et al., 2007). A longer training menses of 6–12 months reduced improved UPDRS-Iii scores (Duncan & Earhart, 2012; Volpe et al., 2013).

Why Trip the light fantastic toe is effective? Dance tin also promote a range of cueing strategies. The strong beat music especially that accompany Tango dance provides auditory cues, which assist to promote initiation and execution of movement. Visual cues where an private coordinates steps with a partner or follows the footstep of the partner, helps to increase the pace size, and to link up motion sequences. Motor preparation using external cues could assist in reducing freezing of gait. Dance involves a lot of stepping, turning and walking in different directions. Tango requires frequent motility initiation and abeyance, spontaneous changes of directions and motility speed. These may target movement initiation, turning and movement speed. In contrast, ballet challenges forcefulness and flexibility to emphasize posture, body alignment and straightening and stretching of arms and legs, as well equally whole body coordination. Practice dancing regularly would lead to improvements in postural control, walking stability and aerobic endurance.

Studies have demonstrated that people with PD were motivated to attend dance classes regularly, had a high rate of compliance with a low dropout rate and frequently continued with the activity afterward the study period (Duncan & Earhart, 2012; Volpe et al., 2013). When participants enjoy the dance and they can develop this into their exercise habits. This may explain the reduction of MDS-UPDRS motor score subsequently 6- to 12-calendar month training and this implies a slow-downwards of the progression of PD. To summarize, dancing is feasible and enjoyable complimentary exercise which may amend balance and motor symptoms in people with PD.

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Reflecting on and adapting the service

David Peters MBChB DRCOG MFHom MLCOM , ... Sue Morrison MA FRCGP , in Integrating Complementary Therapies in Primary Care, 2002

The GPs' experience

Some comments from the GPs involved in the MHC project were as follows:

I have worked aslope alternative and complementary therapists in one fashion or some other since I start became a GP primary in 1976. I have e'er valued having access to the widest possible range of treatment options for my patients, for my family and friends, and for myself.

I welcome treatments that are safety and constructive and conventional medical and surgical treatments are of course often neither safe nor effective. I welcome likewise the mental attitude that is ofttimes (though non always) inherent in alternative and complementary therapies, an attitude that embraces holism, respect for the individual, the subtleties and complexities of illness, and the demand for listening and fourth dimension. Many of these approaches draw on vast bodies of knowledge and experience.

I regularly refer to osteopathy, acupuncture, homeopathy, naturopathy and massage therapy. I accept likewise seen people do good from a range of other therapies, from Alexander technique, dance therapy and herbal treatments to qigong, tai chi and yoga. Often these treatments complement conventional treatments; sometimes they are true alternatives.

I try to combine open-mindedness with a salubrious scepticism well-nigh both conventional and culling treatments. Toll is ever a consideration. I back up the current bulldoze towards evaluating all treatments and regulating all practitioners as long every bit the evaluation and regulation are off-white and well informed.

The wide range of approaches to helping human distress is endlessly fascinating. Cross-fertilization between different approaches is increasingly common. I cannot now imagine working without having access to such a broad palette of possibilities. In purely practical terms both staff and patients seem to benefit.

Richard Morrison

The chance to develop a way of auditing our CT service seemed like a very exciting idea at the time. It was obvious that we should be making some effort to appraise patients' perceptions and practitioners' perceptions about the use of complementary therapy in the principal care setting.

But I plant it surprisingly difficult to get going with the paperwork. It took me a long time to familiarize myself with what I now feel to exist a very simple procedure. We started the projection at a time of increased force per unit area in the consultation. Increasing utilize of the reckoner and generally less fourth dimension meant that we are under enormous pressure to fit everything in within a ten infinitesimal consultation and having to think about criteria for referral and then asking the patient to fill in the MYMOP form felt similar one thing too many. Although I wasn't e'er witting of information technology, I am sure for a while this project actually reduced my referral rate to complementary therapy because of these factors.

Now I am in a different place. Having rather obsessively learnt how to use the tool and make a quick and efficient referral, I am somewhat dismayed to discover that my colleagues are using it erratically, and not only that but as ever there are resources constraints which make information technology very difficult to get the maximum analysis and use out of the data that we take so laboriously collected.

Sue Morrison

I think my knowledge was very minimal, my knowledge has increased because of speaking with the complementary therapists and asking if a particular matter would be useful if it was referred and if information technology was treated. Nosotros produced some leaflets about the therapies which I think are fantastic and I observe useful to give to people to look at before they come back to me.

Banana GP

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