Movement as medicine: Improving chronic dizziness through dance
For patients who experience chronic dizziness, everyday tasks can become daunting. Simply walking the aisles of a grocery store or boarding public transportation can cause symptoms to flare and the fear of falling to set in. A new pilot program, Dance for Dizziness, seeks to combine movement with music and provide a supportive community in which patients reconnect with their bodies and build confidence.
An idea comes to life
Movement, specifically dancing, can be the best medicine for some patients.
This concept, inspired in part by Dance for PD, was developed by Mass General Brigham Neuroscience Institute neurologists Anand Bery, MD, and Galina Gheihman, MD, and in partnership with Ana Sanchez Junkin, PT, DPT, NCS, a physical therapist at Massachusetts General Hospital, and Betsi Graves, founder and director of Urbanity Dance, with support from medical students Rachel Sturley and Christine Wakayama.
Bery, who specializes in vertigo, dizziness and balance problems, sees patients at Mass Eye and Ear.
“Dancers move, turn and spin without getting dizzy. Part of that is technique and part of that is a tolerance that is built up from practice,” he said. “That’s why when patients come to me with chronic dizziness, my prescription is to dance for 30 minutes per day. It’s even written in my clinical notes as my official recommendation. It’s a practice I inherited from a mentor at Johns Hopkins, Dr. Amir Kheradmand.”
Gheihman is a general neurologist who sees patients at Massachusetts General Hospital and Brigham and Women’s Hospital. In her practice, she has long explored ways to bring the arts into neurological recovery.
“Through traditional treatment options, we are sometimes able to modify or mitigate symptoms and sometimes even treat them, but our patients are rarely truly healed,” she said. “But through a connection with the arts and humanities, I believe we can help people come back to a full sense of their identity and self.”
As luck would have it, one of Bery’s patients came to see Gheihman. She saw Bery’s note in the patient’s medical record recommending 30 minutes of dance per day. The two, who had a mutual connection from their hometown of Toronto, ended up discussing whether dance could be adapted in a formal way for patients with chronic dizziness.
From there, they connected with Junkin and Graves to design a program specifically for patients with persistent postural-perceptual dizziness (PPPD), a condition marked by persistent, chronic, severe and function-limiting dizziness. Sturley and Wakayama joined the project as summer research assistants to help with recruitment, coordination and literature review.
“Looking back, there was real serendipity in how it all came together,” Graves said. “Each of us brought a different talent to the table: Dr. Gheihman and Dr. Bery brought expertise in neurology and PPPD treatment, and I brought my years of experience adapting dance to different diagnoses.”
Participation in dance class
Under the pilot program, Dance for Dizziness classes take place weekly at Urbanity Dance, a dance school in Boston. The participants are all patients who have lived with dizziness for an extended period and who are able to move but may have become fearful of movement because it worsens their symptoms. Modifications, such as the covering of mirrors and lowering of lights, are made to minimize symptoms and help patients feel safer in the studio.
“We know that patients with chronic dizziness often stop moving in ways that trigger symptoms,” Bery said. “This creates a reinforcing cycle: their dizziness leads to less movement, and less movement can make ordinary movement feel even more difficult. The goal of this class is to help patients gradually expand what feels possible.”
Although vestibular therapy can be an effective initial treatment in PPPD, the team intentionally designed Dance for Dizziness to feel like a dance class, not a physical therapy appointment.
“We really lean into this idea that we’re dancing, that we’re doing choreography and that we’re thinking with a different part of our brain,” Gheihman said.
Classes run for one hour and draw from a wide range of movement styles, including modern dance, ballet, tap, salsa, West African dance and even movement inspired by sports such as boxing or kayaking.
Each class is adaptive and fully modifiable. Participants may choose seated or standing movements. Classes begin with a community check-in, breathing and grounding exercises and a research-based warm-up before progressing to movements that build strength, flexibility, balance, sequencing and expression. The class later introduces more full-bodied movement, including movements that cross the midline, before returning to grounding techniques.
“We try to end each class with something joyful and a moment of reflection to build community,” Graves said. “That might be a short, choreographed sequence or a chance for participants to share how they are feeling.”
Because dizziness symptoms vary from person to person, the class emphasizes pacing and safety. Graves worked closely with Gheihman, Bery and Junkin for roughly six months to develop and trial a dance curriculum grounded in research, with the goal of maximizing benefit while minimizing risk.
Reconnecting with the body
Xander has lived with PPPD for years and was initially nervous about the idea of participating in a class that involved so much movement. But those fears were quickly dispelled.
“The best part is walking into the studio. There’s so much intention around it being a safe, welcoming haven. I wasn’t expecting that,” they said about the gentle and reassuring structure of the class. “I used to think dance was a thing one performed for an audience. I’m coming to see that dance is something else: a way to build connection with my body and my subconscious. It’s changing my life. Brain/body connection, something I never understood, now has meaning.”
Graves has always believed that dance should be accessible to everyone, regardless of physical ability, diagnosis or prior experience.
“If you’re human, you’re a mover and you’re a dancer,” she said. “Too often, the physical and mental health benefits of dance are available only to those with training or specific access, and I don’t think that should be the case.”
She also believes the benefits of dance extend beyond the studio. She recalled how one participant shared that they had begun using movements and techniques from class in daily life, including breathing movements while anxious on a bus and recalling a dance from class to ease worry and instability while walking.
Why movement is the best medicine
Chronic dizziness can change the way the brain uses sensory information for balance.
“Balance depends on multiple inputs, including vision, the inner ear and joint sense from the feet,” Bery said. “When the inner ear balance system is not functioning as expected, the brain may become more dependent on vision, which can make visually busy environments, such as grocery store aisles, especially difficult to navigate without symptoms.”
Dance offers a way to practice movement in a gradual, structured and supported way.
“We’re trying to recalibrate those inputs that are going in,” Bery said. “When you’re moving and looking around, you’re teaching your brain that this is what the input from the inner ear, that’s what that signal is, and this is what your eyes are telling you.”
The class also helps patients build tolerance to movement. Bery compared it to returning to the gym after several months away: the first session may be difficult, but gradually, the body builds capacity.
“We’re encouraging them to move and we’re teaching them movement is safe,” he said.
Gheihman described the work as similar to exposure therapy for treating phobias.
“These patients may have developed what is a reasonable fear of movement after experiencing falls, injuries or symptom flare-ups,” she said. “The class creates a controlled environment where participants can gently challenge that fear while staying connected to support.”
Just keep dancing
The Dance for Dizziness pilot is being studied for safety, feasibility and early signs of benefit. Participants completed questionnaires about their symptoms and goals before the program began. After their last class, they completed follow-up questionnaires and were asked to join a focus group session to understand their experiences in the class.
At this stage, the team is especially interested in if participants can attend, if the class is safe and if there are any adverse events. Because dizziness is highly subjective, the measures allow patients to identify their own symptoms or goals and track how those change over time after the dance classes.
The long-term vision is larger. Bery said the team hopes to build on lessons from the pilot and pursue a bigger study, potentially including comparison against standard of care treatment, optimizing “dose” (frequency and duration of classes) and incorporating more objective measures such as balance testing or smart device data to track movement before, during and after the program.
“We look at a program like Dance for PD that has so much evidence now behind it, such rigor and also scale right across the country, across the world,” said Bery. “We look at that and we’re like, ‘Wow! There are lots of dizzy patients out there.’ We really feel that they could benefit. That would be the dream.”
The team is also considering future options for accessibility, including virtual programming. Gheihman said there is already interest in a virtual version, though the team chose to begin in person because of the value of a shared studio environment for building community and supporting social engagement among patients living with PPPD.
For now, the pilot has offered a glimpse into what can happen when clinical care, rehabilitation, dance and community come together.
“If dance can improve one person’s life, it’s worth it,” said Graves. “And if we can help someone feel a little less isolated with their condition, a little less alone with their challenge, well, that’s the magic, isn’t it?”