{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:10:26Z","timestamp":1784182226714,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To compare the effects of group-based music therapy, physiotherapy, and simplified dance training on gait, balance, and lower limb force production in individuals with moderate Parkinson's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty-eight participants (Hoehn &amp;amp; Yahr stages 2.0\u20133.0) were randomly allocated to music therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), physiotherapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), simplified dance training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), or control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910). All active groups completed two 60-minute group sessions per week for eight weeks. Outcome measures included static balance assessed via force-plate Centre of Pressure (CoP) metrics, the Five Times Sit-to-Stand test (5STS), and the Timed Up and Go test (TUG) with OptoJump gait analysis. Between-group differences were analyzed using baseline-adjusted analysis of covariance (ANCOVA), with Benjamini\u2013Hochberg false discovery rate correction applied within each outcome family.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant baseline-adjusted between-group effects were observed. Physiotherapy showed a lower adjusted center-of-pressure sway area than control (53% lower,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.027) and lower weight-distribution asymmetry (62% lower,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.050). Both music therapy and simplified dance training had shorter adjusted five-times sit-to-stand times than control (25% and 26% shorter,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.036), with no between-group differences in peak force or rate of force development. All three interventions had shorter adjusted Timed Up and Go times than control (\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.005), the largest difference in simplified dance training (\u22122.5 s); simplified dance training alone had a shorter adjusted turning time than control (\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.047), and music therapy alone had a lower adjusted double support time (\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.030).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Each modality produced a distinct, modality-specific pattern of benefit. Physiotherapy improved static postural control and weight-bearing symmetry; both music therapy and simplified dance training improved sit-to-stand performance; and all three improved overall mobility, with the greatest gains in dance training for gait and turning. These findings support a personalized, potentially multimodal approach to Parkinson's disease rehabilitation. The study was registered retrospectively in the World Health Organization International Clinical Trials Registry Platform (Registration No. DRKS00039213). All participants provided written informed consent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2026.1879749","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:39:44Z","timestamp":1784180384000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gait and balance outcomes of group-based music therapy, physiotherapy, and simplified dance training in patients with Parkinson's disease"],"prefix":"10.3389","volume":"7","author":[{"given":"Kirsti","family":"Pedak","sequence":"first","affiliation":[{"name":"School of Natural and Health Sciences, Tallinn University","place":["Tallinn, Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toomas","family":"Toomsoo","sequence":"additional","affiliation":[{"name":"School of Natural and Health Sciences, Tallinn University","place":["Tallinn, Estonia"]},{"name":"LTD Confido Medical Centre","place":["Tallinn, Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indrek","family":"Rannama","sequence":"additional","affiliation":[{"name":"School of Natural and Health Sciences, Tallinn University","place":["Tallinn, Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ines","family":"de Magalhaes Cardoso de Oliveira Margato","sequence":"additional","affiliation":[{"name":"LTD Confido Medical Centre","place":["Tallinn, Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Pehk","sequence":"additional","affiliation":[{"name":"Music Therapy Centre","place":["Tallinn, Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson\u2019s disease, 1990\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"17","author":"Dorsey","year":"2018","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.52403\/ijhsr.20231213","article-title":"A narrative review on strategies to assess and improve postural control in Parkinson\u2019s disease","volume":"13","author":"Sajid","year":"2023","journal-title":"Int J Health Sci Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1136\/jnnp.2007.131045","article-title":"Parkinson\u2019s disease: clinical features and diagnosis","volume":"79","author":"Jankovic","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1002\/mds.22561","article-title":"Clinical and physiological assessments for elucidating falls risk in Parkinson\u2019s disease","volume":"24","author":"Latt","year":"2009","journal-title":"Mov Disord"},{"key":"B5","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1002\/mds.25404","article-title":"Three simple clinical tests to accurately predict falls in people with Parkinson\u2019s disease","volume":"28","author":"Paul","year":"2013","journal-title":"Mov Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s40263-012-0012-3","article-title":"Postural instability in patients with Parkinson\u2019s disease: epidemiology, pathophysiology and management","volume":"27","author":"Kim","year":"2013","journal-title":"CNS Drugs"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1007\/s13311-020-00889-4","article-title":"Medical management and prevention of motor complications in Parkinson\u2019s disease","volume":"17","author":"Aradi","year":"2020","journal-title":"Neurotherapeutics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s11910-018-0828-4","article-title":"Managing gait, balance, and posture in Parkinson\u2019s disease","volume":"18","author":"Deb\u00fb","year":"2018","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1007\/s00702-024-02813-y","article-title":"Neuroplasticity in Parkinson\u2019s disease: effects of physical activity and treatment","volume":"131","author":"Popescu","year":"2024","journal-title":"J Neural Transm"},{"key":"B10","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1016\/S1474-4422(13)70123-6","article-title":"Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson\u2019s disease","volume":"12","author":"Petzinger","year":"2013","journal-title":"Lancet Neurol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"515","DOI":"10.3390\/antiox12030515","article-title":"The central role of mitochondrial fitness on antioxidant and neuroprotective effects of exercise in neurological diseases","volume":"12","author":"Burtscher","year":"2023","journal-title":"Antioxidants"},{"key":"B12","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1177\/1545968320952799","article-title":"Physiotherapy in Parkinson\u2019s disease: a meta-analysis of present treatment modalities","volume":"34","author":"Radder","year":"2020","journal-title":"Neurorehabil Neural Repair"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21608\/bptrs.2024.279839.1032","article-title":"Effect of physiotherapy on gait and balance for patients with Parkinson\u2019s disease: a review article","volume":"2","author":"El-Shanawany","year":"2024","journal-title":"Bull Phys Ther Res Stud"},{"key":"B14","doi-asserted-by":"publisher","first-page":"pzae014","DOI":"10.1093\/ptj\/pzae014","article-title":"Effects of group exercise on motor function and mobility for Parkinson disease: a systematic review and meta-analysis","volume":"104","author":"Palm","year":"2024","journal-title":"Phys Ther"},{"key":"B15","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1186\/s12883-020-01938-3","article-title":"A systematic review of active group-based dance, singing, music therapy and drama therapy for quality of life, symptoms, motor function, mood, cognitive function, and falls in people with Parkinson\u2019s disease","volume":"20","author":"Barnish","year":"2020","journal-title":"BMC Neurol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0281204","DOI":"10.1371\/journal.pone.0281204","article-title":"Physical activity based on dance movements as complementary therapy for Parkinson\u2019s disease: effects on movement, executive functions, depressive symptoms, and quality of life","volume":"18","author":"Duarte","year":"2023","journal-title":"PLoS One"},{"key":"B17","doi-asserted-by":"publisher","first-page":"875178","DOI":"10.3389\/fneur.2022.875178","article-title":"Rhythmic cueing, dance, resistance training, and Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"13","author":"Karpodini","year":"2022","journal-title":"Front Neurol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1188855","DOI":"10.3389\/fnagi.2023.1188855","article-title":"Unleashing the potential of dance: a neuroplasticity-based approach bridging from older adults to Parkinson\u2019s disease patients","volume":"15","author":"Meulenberg","year":"2023","journal-title":"Front Aging Neurosci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"940419","DOI":"10.3389\/fneur.2022.940419","article-title":"Rhythmic auditory stimulation promotes gait recovery in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"13","author":"Ye","year":"2022","journal-title":"Front Neurol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1177\/0269215518788615","article-title":"Rhythmic auditory stimulation for reduction of falls in Parkinson\u2019s disease: a randomized controlled study","volume":"33","author":"Thaut","year":"2019","journal-title":"Clin Rehabil"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.3390\/ijerph20021046","article-title":"Effects of music-based interventions on motor and non-motor symptoms in patients with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"20","author":"Lee","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1679881","DOI":"10.3389\/fneur.2025.1679881","article-title":"Effectiveness and applications of neurologic music therapy in motor and non-motor rehabilitation for older adults with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"16","author":"Li","year":"2025","journal-title":"Front Neurol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"11618","DOI":"10.3390\/ijerph182111618","article-title":"Music therapy and Parkinson\u2019s disease: a systematic review from 2015 to 2020","volume":"18","author":"Sotomayor","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B24","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1212\/wnl.17.5.427","article-title":"Parkinsonism: onset, progression and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1016\/j.apmr.2011.04.008","article-title":"Five times sit-to-stand test performance in Parkinson\u2019s disease","volume":"92","author":"Duncan","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"key":"B26","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1093\/ptj\/81.2.810","article-title":"Reliability of measurements obtained with the timed \u2018up & go\u2019 test in people with Parkinson disease","volume":"81","author":"Morris","year":"2001","journal-title":"Phys Ther"},{"key":"B27","volume-title":"Handbook of Neurologic Music Therapy","author":"Thaut","year":"2014"},{"key":"B28","volume-title":"Receptive Music Therapy: Techniques, Clinical Applications, and New Perspectives","author":"McFerran","year":"2022"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1215495","DOI":"10.3389\/fnagi.2023.1215495","article-title":"Effectiveness of different exercises in improving postural balance among Parkinson\u2019s disease patients: a systematic review and network meta-analysis","volume":"15","author":"Wang","year":"2023","journal-title":"Front Aging Neurosci"},{"key":"B30","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.jbmt.2023.04.046","article-title":"Dance as a neurorehabilitation strategy: a systematic review","volume":"35","author":"Aldana-Ben\u00edtez","year":"2023","journal-title":"J Bodyw Mov Ther"},{"key":"B31","doi-asserted-by":"publisher","first-page":"S114","DOI":"10.1016\/S1353-8020(11)70036-0","article-title":"Rehabilitation, exercise therapy and music in patients with Parkinson\u2019s disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life","volume":"18","author":"De Dreu","year":"2012","journal-title":"Parkinsonism Relat Disord"},{"key":"B32","doi-asserted-by":"publisher","first-page":"6846267","DOI":"10.1155\/nri\/6846267","article-title":"Effect of vestibular-oriented balance training on postural control and risk of fall in patients with Parkinson\u2019s disease","volume":"2025","author":"Khallaf","year":"2025","journal-title":"Neurol Res Int"},{"key":"B33","doi-asserted-by":"publisher","first-page":"20643","DOI":"10.1038\/s41598-025-07009-2","article-title":"Supervised aerobic-strength exercise reduces postural sway and improves dual-task gait in Parkinson\u2019s disease","volume":"15","author":"Marti\u0161","year":"2025","journal-title":"Sci Rep"},{"key":"B34","doi-asserted-by":"publisher","first-page":"CD013856","DOI":"10.1002\/14651858.CD013856.pub2","article-title":"Physical exercise for people with Parkinson\u2019s disease: a systematic review and network meta-analysis","volume":"1","author":"Ernst","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"B35","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1123\/japa.2019-0255","article-title":"Effect of dance on postural control in people with Parkinson\u2019s disease: a meta-analysis review","volume":"29","author":"de Almeida","year":"2021","journal-title":"J Aging Phys Act"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1226876","DOI":"10.3389\/fbioe.2023.1226876","article-title":"Margins of postural stability in Parkinson\u2019s disease: an application of control theory","volume":"11","author":"Rahmati","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1177\/1089313X241242632","article-title":"Can dance improve turning in people with Parkinson\u2019s disease?","volume":"28","author":"Nogueira Haas","year":"2024","journal-title":"J Dance Med Sci"},{"key":"B38","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1136\/jnnp.2009.173740","article-title":"The instrumented timed Up and Go test: potential outcome measure for disease modifying therapies in Parkinson\u2019s disease","volume":"81","author":"Zampieri","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1002\/mds.26510","article-title":"Nonmotor features of Parkinson\u2019s disease subtypes","volume":"31","author":"Marras","year":"2016","journal-title":"Mov Disord"}],"container-title":["Frontiers in Rehabilitation Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2026.1879749\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:39:45Z","timestamp":1784180385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2026.1879749\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":39,"alternative-id":["10.3389\/fresc.2026.1879749"],"URL":"https:\/\/doi.org\/10.3389\/fresc.2026.1879749","relation":{},"ISSN":["2673-6861"],"issn-type":[{"value":"2673-6861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"article-number":"1879749"}}