Adapted Tango for Individuals with Parkinson’s Disease: Promoting Implementation in the Occupational Therapy Setting According to Clinical Practice Guidelines

Background: Parkinson’s Disease (PD) is a neurodegenerative condition in which the depletion of dopamine in the Basal Ganglia causes motor, cognitive, and psychosocial deficits, often inadequately addressed by traditional treatments. Holistic, movement-based therapies like tango are rooted in evidence to slow disease progression and increase quality of life (QoL). However, despite its inclusion in the occupational therapy clinical practice guidelines, tango remains underutilized in practice. Objective: The purpose of this Capstone project was to revise an existing adapted tango protocol (Adaptango) for individuals with PD to align with occupational therapy guidelines, examine its practical utility, and promote and assess tango’s feasibility in practice from the perspective of outpatient rehabilitation staff. ACOTE Area: This project primarily aligned with the ACOTE area of research, focused on collecting feedback from individuals with PD and clinical staff regarding the practice of Adaptango. Secondary areas included program development and evaluation through Adaptango protocol revision, and advocacy through staff education. Methods: A mixed-methods survey was conducted with seven individuals with PD who had previously participated in Adaptango, to assess perceived benefits and inform protocol revisions. Outcome measures included class structure, impact on activities of daily living (ADLs), instrumental activities of daily living (IADLs), and QoL. Responses were collected via Qualtrics and analyzed using descriptive statistics and thematic analysis. An autoethnographic narrative was also utilized to reflect on the researcher’s experience revising the protocol and evaluating its potential applicability in occupational therapy. A structured template promoted objectivity and minimized bias. The researcher participated in over 70 Adaptango classes across 12 weeks to gain proficiency and support accurate assessment. Additionally, therapy staff from four outpatient clinics participated in education sessions to promote awareness and evaluate feasibility. These sessions, lasting 30-60 minutes, included presentations and a pre/post mixed-methods survey assessing staff interest in certification, perceived barriers, and overall feasibility. Data were analyzed using descriptive statistics and thematic analysis. Results: Feedback from PD participants reflected a general appreciation for group sessions, with a desire for more individually tailored complexity. Most respondents (57%) reported connecting material from class to class, and many noted increased confidence engaging in ADLs and IADLs, with no responses below neutral across a five-point scale. All respondents claimed increased QoL. The autoethnographic narrative highlighted protocol revisions incorporating clinical guidelines, strategies for application, and emphasis on client-centeredness. Barriers identified included therapist experience with tango and dosage recommendations. Education sessions revealed additional barriers such as space limitations, equipment requirements, and a desire for comparative research. Nonetheless, all staff rated the protocol as at least somewhat feasible, with 19% considering it very feasible. Conclusions and Relevance: Despite limitations in sample sizes and time frame, the revised protocol demonstrates potential for clinical application. It may support clinicians in becoming Adaptango-certified, expanding access to individuals with PD, and enhancing client-centered practice. Additions to the protocol such as CPT codes may further legitimize the intervention, support reimbursement, and contribute to future research through real-world data collection and comparison with other movement-based therapies.