An innovative treatment for chronic post-traumatic headaches
Dancing the tango may provide patients with cancer a medication-free roadmap toward neurological recovery. The innovative therapy helps reduce lingering symptoms caused by chemotherapy.
Lise Worthen-Chaudhari, PhD, a researcher in the Department of Physical Medicine and Rehabilitation at The Ohio State University Wexner Medical Center, received a $3.8M, five-year grant from the National Institute on Aging, part of the National Institutes of Health, for her multicenter trial, Dance-Based Avenues to Advance Nonpharmacologic Treatment of Chemotherapy Effects (DAANCE).
“What I want to test is if we can stimulate neurologic recovery after trauma from chemotherapy. Can we make it better?” Dr. Worthen-Chaudhari says.
Existing data show that music and exercise can help prevent neurologic degeneration, she says.
Can a tango date improve neuropathy symptoms?
The goal of the DAANCE study is to improve quality of life for people with cancer experiencing chemotherapy-induced neuropathy (CIN), a condition that can occur anywhere in the body but most often affects hands, feet and limbs. DAANCE will test the effects of partnered Adapted Argentine Tango as an ideal physical activity for restoring mobility and alleviating symptoms through musically entrained movement.
This population often seeks solutions for the burning and tingling symptoms in the hands and feet, but oncologists currently have limited treatment options to offer, Dr. Worthen-Chaudhari says. She serves as director of Ohio State’s Motion Analysis and Recovery Biomechanics Lab.
At the same time, many patients no longer want to add new medicines to their regimen.
As a former professional dancer, Dr. Worthen-Chaudhari wondered, ‘Why couldn’t rehab look more like a date night?’
She designed her study for breast cancer survivors experiencing CIN who are at least three months past their last chemotherapy treatment. According to a project abstract she and her colleagues developed, up to 80% of breast cancer survivors experience chemotherapy-induced neuropathy that causes pain, falls, difficulty walking and diminished quality of life.
The Ohio State study site will be active in early 2025. A second site at Yale University is projected for fall 2025. Maryam Lustberg, MD, a former colleague at the Ohio State Wexner Medical Center, is the co-investigator at Yale.
Each site seeks to enroll 70 participants. Baseline data will be collected for everyone taking part to get a snapshot of how they feel and perform on good and bad days. Then patients will be randomized into two groups.
One group will take part in eight weeks of tango lessons adapted for people with movement concerns and neuropathy symptoms. A second group will go on a wait list for four weeks, before getting the opportunity to take tango classes. Researchers will follow participants for six months after the eight weeks of tango to monitor their symptoms.
Dr. Worthen-Chaudhari says, “We are interested in the effect of the tango on alleviation of neuropathic sensations in the feet and hands as well as on improving physical health.”
The DAANCE team hopes to answer these questions:
- Did neuropathy symptoms get better and stay better?
- Did neuropathy symptoms get better and then get worse?
- Do improvements get lost over time, or are they maintained?
Early data show impact of movement, music without medication
The DAANCE study furthers Dr. Worthen-Chaudhari’s research on how movement and music can improve neurologic damage, without the need for medications.
She’s completed pilot studies funded by the Chronic Brain Injury program, Pelotonia and an R21 grant from the National Institutes of Health.
Preliminary data show that a tango intervention can lead to improvements in:
- Balance
- Cognitive function
- Motor function
- Neuropathy symptoms
Research from other institutions that tested the use of adapted tango in people with Parkinson’s disease found improvements in balance and cognition.
Dr. Worthen-Chaudhari designed the DAANCE study to track improvements noted in earlier studies among breast cancer survivors with CIN on a large sample size.
“There are a lot of people working on this topic, but for me to get to be a dance artist embedded in an academic medical center studying biomechanics and doing motion capture – that is unusual,” Dr. Worthen-Chaudhari says.
Potential benefits of dance training
There are many experimental aims Dr. Worthen-Chaudhari hopes to explore in the future, to build upon the DAANCE trial and position it as an emerging nonpharmacologic therapeutic option.
- Neurologic Dance Training. One idea is to create a certified neurologic dance training professional option. This would teach community dance experts how to provide dance movement training as adjunctive support for physical, occupational or recreational therapy treatment. For patients, this would be an alternative to the traditional home exercise program prescribed by physical therapists. Patients could do a dancing date night once or twice a week instead of home exercise. Scientifically, what Dr. Worthen-Chaudhari wants to know is if dance training changes brain activity and neurologic motor activity to increase automaticity or the ease of activities in daily life.
- Biomarkers. Another future research aim Dr. Worthen-Chaudhari wants to explore involves looking for biomarkers in brain activity and the blood that impact inflammation, neuroplasticity and neurotoxicity changes caused by chemotherapy. Such discoveries could open the door for treatment targets.
