To evaluate the influence of dance movement therapy (DMT) on the perception of well-being and functional capacity in women with chronic fatigue syndrome (CFS). Previous studies have analysed the effects of DMT in fibromyalgia but not specifically in CFS. Seven women diagnosed with CFS attended a 4-month DMT program. All of them performed a maximal physical test before and after the DMT intervention. Their perceptions of physical and psychological well-being were evaluated with a continuous visual scale. After each session all the patients were asked to write a report at home about their impressions and feelings. Dance movement therapy had a positive effect, both qualitatively and quantitatively, on patients’ perceptions of well-being. There were no significant changes in performance on the physical test. Comparing perceptions before and after each session, the perceptions of physical well-being improved by an average of 25.8% and perceptions of psychological well-being by 22.7%. Although we did not demonstrate an improvement in functional capacity, women with CFS reported improvements in their perceptions of physical and psychological well-being after DMT program. A larger sample is required to assess the possibilities of DMT with CFS in greater depth.
Chronic fatigue syndrome (CFS) is a clinical entity characterized by disabling fatigue of at least 6 months’ duration and a series of symptoms that include musculoskeletal pain, neurocognitive disorders, sleep disturbance and intolerance physical exercise (Fukuda et al., 1994, Niloofar and Buchwald, 2003 and Prins et al., 2006). CFS is identified in around 0.5% of patients attending general practice (Jason et al., 1999, Reyes et al., 2003 and Wessely et al., 1996).
Patients with CFS may have a number of associated comorbidities that worsen their quality of life, such as dry syndrome, irritable bowel syndrome, autonomic dysfunction and particularly fibromyalgia (FM), which has a large impact on the family environment and self-rated health (Äsbring and Närvänen, 2002 and Ubago et al., 2008).
Both CFS and FM can lead to considerable difficulties in performing daily activities. The limitations can be even greater than those experienced by other patients who suffer chronic pain from other diseases (Boonen et al., 2005 and Fernández, 2000). The prognosis for functional capacity in CFS patients is poor and is a major constraint on physical and intellectual activity, causing deterioration and disability in working, personal, and social life (Cervera et al., 2005). Although cognitive behavioral therapy (Prins et al., 2001) and regular exercise (Karper & Stasik, 2003) have proved beneficial, no effective treatment is available at present.
The growing number of studies on the importance of therapy through movement and dance suggest that approaches of this kind may improve the overall condition of the patient (Aktas and Ogce, 2005, Hanna, 1995 and Sandel et al., 2005). Dance movement therapy (DMT) promotes the psychophysical integration of the individual (Stanton-Jones, 1992). In DMT, the therapist creates a supportive environment where feelings can be expressed, recognized, and communicated securely (Payne, 1992).
Dance can improve quality of life by strengthening the immune system through muscular action and through the activation of various physiological responses. It can also eliminate tension, chronic fatigue, and other disabling conditions resulting from stress situations (Ginsburgs and Goodill, 2009 and Sandel et al., 2005). One of the therapeutic aspects of DMT is the act of creating movement through improvisation. This is inherently therapeutic, since it allows the individual to experience original new ways of movement and generates a new experience of being in the world (Diamond, 2001). The important thing is to experiment with the body more freely and fully, to explore new ways of being and to gain access to feelings that cannot be verbalized (Stanton-Jones, 1992).
Certain studies have evaluated the effects of DMT on the pathological evolution of FM, with positive results. Dance movement therapy gives patients an opportunity to work on body awareness tasks and to focus on body perception (Bojner-Horwitz et al., 2003 and Bojner Horwitz et al., 2006). Developing the expressive capacity of patients with FM through the body and through non-verbal communication can help them to become aware of emotions and maladaptive mechanisms (Rodríguez-Cigaran, 2005).
In 2008, the only study reported with CFS and art therapy showed that art-making increased subjective well-being, increasing satisfaction in daily life, and boosting positive self-image, hope and contact with the outside world (Reynolds, Vivat & Prior, 2008).
Given the properties of dance and movement and their usefulness with chronic symptoms such as pain and fatigue, we propose that DMT may be successfully applied in patients with CFS. The study presented here is the first published to date on this topic.
The objectives of our intervention with DMT in women with CFS were:
1
To determine whether DMT correlates with physical and psychological well-being in CFS patients.
2
To evaluate patients’ written reports and the therapist's notes after each session.
3
To establish whether DMT correlates with physiological responses at rest, at a very low intensity effort, and at maximum intensity effort in CFS patients.
