New research shows great potential for improvisational movement to help older adults and individuals with perceived memory loss and neurodegeneration; benefits include improved balance, improved balance confidence, and improved mood.
Q: While one of you is an artist and the other a scientist, both of you are interested in how movement impacts the brain and our wellbeing. How did this research partnership come to be?
Soriano: We met at a Wake Forest University Translational Science Center funding meeting, having received funding for different projects: I was sharing some of my pilot research with Professor Emeritus of Physical Therapy Dr. Glenna Batson, looking at the ways an improvisational dance curriculum could assist in the mobility and balance of people living with Parkinson's disease. Christina was also researching health outcomes for older adults – her research more anchored to communities living with cognitive impairment.
We met and realized how important an improvisational movement intervention could be powerfully received in a community of older adults experiencing memory loss. That moment sparked a moment of exciting shared inquiry and collaboration for both of us. We wanted to develop an intervention that encourages risk-taking and autonomous movement invention, does not prize memorization, and is based on the radical idea that all movement choices are the right movement choices. Ten years later, we are still investigating why movement is a critical medicine for the brains and bodies of older adults living with neurodegenerative diseases, and their care partners.
Q: You created IMPROVment, a collective of arts and science practitioners bringing the improvisational movement curriculum you designed to communities via classes and training. What differentiates IMPROVment from other movement classes and experiences?
Soriano: IMPROVment is a movement class that is prompt-based. The movement instructor in an IMPROVment class is not presenting themselves as "the expert"; rather, they are the facilitator who simultaneously takes the class while sharing movement cues, or movement invitations with the class. The class begins seated, in chairs, and moves to standing exercises before moving across the floor in pairs and in groups.
Our class is steeped in the wild notion that every participant has a unique and powerful movement that they are capable of sharing, regardless of their past movement experiences or their cognitive status. IMPROVment classes are intended to be a safe space for people to take risks in a non-judgmental, joyful environment. We play, we laugh, we dance, we try something on and then try something else. Through our shared experimentation, we celebrate each other's individual expression and capacity for beauty.
Q: What are the short-term and long-term health benefits of taking part in improvisational movement, and what are some ways people can incorporate it into their everyday lives?
Hugenschmidt: Our early data show that relatively short-term engagement (on the scale of weeks) can lead to changes in brain networks, improved balance, improved balance confidence, and improved mood. Data from our group and others suggests that people really enjoy engaging in improvisational movement and may even prefer it over other forms of dance.
We think that improvisation is particularly useful for older adults with neurodegenerative diseases because it emphasizes non-judgment, promotes autonomy, and doesn’t require memorizing steps. It can also be easily adapted from seated to standing to moving across the floor – I’ve seen Christina teach classes that include people in wheelchairs all the way to people with no motor impairments. She likes to say that improvisation in the studio is practice for life – we never know what is coming at us. The only constant is change. A dance practice that includes improvisation can help remind people of their agency to respond and let them practice that in a fun and non-judgmental way.
Q: You are finishing up a study, “IMOVE,” which looks at how movement and social engagement/community affect overall wellbeing in older adults with perceived memory loss and neurodegeneration. What was the motivation behind this study?
Hugenschmidt: The motivation behind IMOVE was twofold: One motivation was the recognition that the benefits we saw in improvisational movement for people with Parkinson’s disease would also apply to people with Alzheimer’s disease. When people think of dementia or Alzheimer’s disease, they first think of losing memory. But as the disease spreads throughout the brain, many different functions are affected and, in fact, secondary symptoms like increased fall risk due to changes in gait and balance, and increased depression and decreased social interactions significantly decrease quality of life for the person with dementia and their care partners.
The other motivation was the recognition that dance is a unique form of movement that combines multiple factors we know are important for brain health in aging: cardiorespiratory activity, social engagement, and cognitive challenge. We wanted to design a study that would help move forward our understanding of the ‘medicine of dance.’
Q: Your team will be receiving $3 million over five years from the National Institutes of Health (NIH) for your “IGROOVE”study to research dosage in relation to movement and wellbeing, effectively studying the “sweet spot for physical and psychosocial alteration”. In testing outcomes for participants attending classes, and learning different dance styles once or a few times a week for several months, what expectations do you have for this study?
Hugenschmidt: We would like IGROOVE to set the stage for a larger, collaborative grant that would include the many wonderful researchers testing dance across the country. One barrier to such a grant right now is a lack of basic evidence about the appropriate ‘dose’ of dance to see certain outcomes. We hope this study will provide that evidence. We also hope that it provides practical information for people.
My mother asked me how many times a week she should dance to help improve her health, and I couldn’t answer her question. We hope at the end of this grant, we could say, for example, “If you want to improve your fitness, you should dance x times a week. If you want to improve your balance, you should dance x times a week.”
Q: How do you see movement and physical improvisation helping other groups, such as children, or individuals that require and use mobility assistance (i.e., wheelchairs, walkers, etc.)?
Soriano: Among the outcomes from our IMOVE study was an elegant design of taking an artistic dance practice (improvisational movement class) and "protocolizing" it for scientific research and replicability. Ideally, other research populations can take our prompts and apply them to the communities they serve. We have worked with occupational therapist PhD students at Washington University in St. Louis who have applied our movement protocol to their studies with the Parkinson's community. We worked with an undergraduate at Wake Forest who was interested in applying IMPROVment classes to children living with cerebral palsy in Ghana. She discovered increased range of motion and less spasticity in her study population. As our work grows, we would love to help adapt IMPROVment exercises for diverse populations in scientific research as well as in community class environments.
This interview was edited for clarity.
Lead image: Photo by Wake Forest University
Written and compiled by IAM Lab's Senior Communication Specialist, Zoë Lintzeris. Zoë is an Arts in Health specialist and visual artist who explores the human condition through art and neuroaesthetics.
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