Background Parkinson’s disease (PD) is a common age-related neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in performing arts interventions for PD, due to the limitations of pharmacological therapies, but reviews had focused principally on dance. We performed the first systematic evaluation of the potential benefit of all active group-based performing arts interventions in PD and here present a 2-year update.

Methods In order to systematically evaluate the benefit of performing arts interventions in PD, primary searches on PsycINFO, AMED, CINAHL, EMBASE, and MEDLINE were performed in February 2020. Supplementary web searches and citation chasing were conducted. A targeted update was performed in January 2022. Included studies used any quantitative design to assess the benefit of any active group-based performing arts intervention on quality of life, functional communication, speech, motor function or cognitive status for people with diagnosed PD. Following standardised duplicate screening and data extraction, data synthesis was conducted using thematic narrative synthesis. Risk of bias was evaluated using SURE checklists (Cardiff University).

Results Primary searches identified 2669 records, of which 260 proceeded to initial full-text review following de-duplication, 129 to detailed full-text review and 67 to inclusion in the systematic review, representing 56 separate studies. The update identified 7 additional relevant studies giving a total of 63 studies. Risk of bias assessment revealed limitations across many studies. Dance was the most studied artistic modality (43 studies), followed by singing (13 studies), music therapy (5 studies) and theatre (2 studies). Narrative synthesis showed evidence for a benefit of dance, music therapy and singing on quality of life; singing on speech; dance and music therapy on cognition; and dance, music therapy, singing and theatre on motor function. There remained no evidence of benefit on functional communication. Of the additional 7 studies from the update, 5 were on dance forms, showing that the evidence base is still focused primarily on dance.

Discussion Performing arts interventions may offer benefit in PD. There were no studies directly comparing different performing arts modalities and studies on dance continue to dominate the literature. This poses challenges in assessing which performing arts modalities may be most beneficial for which outcomes. Small sample sizes, differing comparator and intervention characteristics, as well as differing disciplinary backgrounds of session leaders remain key limitations. Further research is needed with greater methodological rigour before firm conclusions can be drawn.