INDIANAPOLIS, Indiana — Physical activity is beneficial for patients with multiple sclerosis (MS), but what may be even better than walking and cycling is dancing.

Learning partnered dances, such as the waltz or salsa, can be the perfect mix of activities that target deficits in MS — cognition, fatigue, balance, and depression — researchers say.

A "huge body of literature" shows that dancing can be beneficial to patients with chronic diseases, such as Parkinson's disease, and those who have had a stroke, said Alexander Ng, PhD, Program in Exercise Science, Marquette University, Milwaukee, Wisconsin. "With this background, I think the question is, why not for MS?"

Dr Ng presented results of a small study during the Consortium of Multiple Sclerosis Centers (CMSC) 2015 Annual Meeting, where other similar research was also discussed.

Growing Science

The studies are small, but the science behind the intervention is growing and the use of dance is becoming increasingly popular.

Dr Ng and colleagues' study included 12 ambulatory patients with MS who could walk 25 feet and stand for 5 minutes. Some required ambulatory assistance, such as a cane or walker.

The program included two hour-long sessions per week that were led by a professional dance instructor. Sessions included instruction and practice. Partners were provided if necessary.

The types of dance included rumba, foxtrot, waltz, tango (ballroom), swing, salsa, and merengue. To accommodate the needs of patients, water was provided and there were fans and chairs in the room.

Patients had to participate for at least 8 of the 10 weeks of the program (16 sessions). Control patients received usual care.

Dr Ng and his colleagues found improvements that were statistically significant or almost significant on several physical and cognitive measures with the dance program. For example, the median score on the Fatigue Impact Scale improved from 30 to 22 (P = .07), the median Beck Depression Inventory score from 5 to 1 (P = .07), and the Dynamic Gait Index from 22 to 23 (P = .02).

The mean Timed Up and Go test score decreased from 10.3 to 8.9 seconds (P = .003), and the mean 9 Hole Peg test result decreased from 22.6 to 21.3 seconds (P = .04). There was a trend toward improvement in the 25 foot walk test, and the Paced Auditory Serial Addition Test increased from 43 to 48 (P = 0.05).

These measures did not change among the seven patients in the control group.

Partnered dancing has many advantages over regular physical activity, Dr Ng told Medscape Medical News. Because it involves a partner, the patient has a built-in "ambulatory aid," he said.

"It allows patients to do more movements for longer periods, or different ones than they would be able to do by themselves."

There are also the benefits of the brain and motor system working together, said Dr Ng. "In contrast to, say, bicycling or walking, there is a very complex series of challenges, multitasking if you will, from learning a new movement pattern, memorizing it, being able to recall it when appropriate, and responding to your partner whether you're following or leading."

The music, which can be upbeat and uplifting, adds another positive element.

As well, there's the social aspect. Dr Ng said the sessions were a lot of fun and participants regularly shared a few laughs. One woman said she hadn't danced with her husband for years.

Not everyone will enjoy partnered dancing, but for those who do, it's a great "back door entry into physical activity," according to Dr Ng. Physicians, he said, should be aware of the benefits.

"Because of the wide range of disabilities among people with MS, healthcare professionals need to know what the options are, what the resources are, and if possible have some knowledge about exercise. They don't need an exercise physiology degree, but at least know some basic principles."

Science of Salsa

In a separate presentation, Albert Lo, MD, PhD, associate professor, neurology, Brown University, director of neuroscience research, Mandell MS Center, Hartford, Connecticut, talked about his small uncontrolled study of eight patients who learned various types of salsa (there are several).

His research showed significant improvements on the MS Walking Scale-12, Timed Up and Go test, and Dynamic Gait Index (all P < .05). He stressed that the dance sessions were well tolerated. Dr Lo is planning a larger study, funded by the National Multiple Sclerosis Society, which will include as many as 70 patients.

Physical activity is hugely important for patients with MS, noted Dr Lo. Having a low fitness level is a better predictor of mortality than obesity or hypertension, and patients with MS are at even higher risk.

While 40% of adults don't meet American Heart Association guidelines for regular physical activity, 64% of those with MS don't meet these guidelines, he said.

Dr Ng's study was funded by the Greater Milwaukee Foundation.

Consortium of Multiple Sclerosis Centers (CMSC) 2015 Annual Meeting. Poster QL13. Presented May 29, 2015.

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