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The following thesis aims to understand the physical, mental, emotional, and social benefits of a weekly ballet class for people living with Parkinson’s. Although dance has shown to be a beneficial activity for this group of people, recent research has placed a strong emphasis on the physical benefits. There is a lack of research looking at how participation in dance may also impact upon activities of daily living and level of participation in society. The present thesis proposes a new framework for dance for Parkinson’s research that places equal emphasis on these factors while also recognising how personal and environmental contextual factors may play a role in how the dance classes are experienced. To assess changes across a two-year time period the study used a mixed methods approach and used a control group of people with Parkinson’s who did not take part in dance. Quantitative assessments included biomechanical measures of gait (step and stride variability, trunk coordination, and trunk range of motion), the Unified Parkinson’s Disease Rating Scale (UPDRS), the Activities-Specific Balance Confidence (ABC) scale, and the Dance for Parkinson’s Questionnaire (DPQ). Qualitative assessments included one-to-one semi-structured interviews, focus group discussions, informal conversations with participants, and observation of the ballet classes. Quantitative results demonstrated a lack of significant physiological change when assessing the group as a whole. However, individual case studies revealed that some dancing participants saw clinically meaningful change across time with respect to variables assessing physical functioning. Qualitative data demonstrated that participants valued the ballet classes for a variety of reasons. Comments from interviews and group discussions showed that the social inclusion, the level of enjoyment gained from moving to music, the cultural and educational experiences were all reasons why participants continued to attend the classes and gain benefit from them. Although the present thesis did not demonstrate significant physical benefit from the weekly ballet classes, qualitative data suggests that participants gained important psychological, social, and emotional benefit as a result of participating in this programme.

abstract: Injuries and death associated with fall incidences pose a significant burden to society, both in terms of human suffering and economic losses. The main aim of this dissertation is to study approaches that can reduce the risk of falls. One major subset of falls is falls due to neurodegenerative disorders such as Parkinson’s disease (PD). Freezing of gait (FOG) is a major cause of falls in this population. Therefore, a new FOG detection method using wavelet transform technique employing optimal sampling window size, update time, and sensor placements for identification of FOG events is created and validated in this dissertation. Another approach to reduce the risk of falls in PD patients is to correctly diagnose PD motor subtypes. PD can be further divided into two subtypes based on clinical features: tremor dominant (TD), and postural instability and gait difficulty (PIGD). PIGD subtype can place PD patients at a higher risk for falls compared to TD patients and, they have worse postural control in comparison to TD patients. Accordingly, correctly diagnosing subtypes can help caregivers to initiate early amenable interventions to reduce the risk of falls in PIGD patients. As such, a method using the standing center-of-pressure time series data has been developed to identify PD motor subtypes in this dissertation. Finally, an intervention method to improve dynamic stability was tested and validated. Unexpected perturbation-based training (PBT) is an intervention method which has shown promising results in regard to improving balance and reducing falls. Although PBT has shown promising results, the efficacy of such interventions is not well understood and evaluated. In other words, there is paucity of data revealing the effects of PBT on improving dynamic stability of walking and flexible gait adaptability. Therefore, the effects of three types of perturbation methods on improving dynamics stability was assessed. Treadmill delivered translational perturbations training improved dynamic stability, and adaptability of locomotor system in resisting perturbations while walking. / Dissertation/Thesis / Doctoral Dissertation Biomedical Engineering 2019