Feasibility of a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (Dance PREEMIE)

Towards a successful teledance program for youth with cerebral palsy: A mixed-method study with the instructor's perspective

PurposeDance is a leisure time physical activity (LTPA) known to improve motor, cognitive, and psychosocial functions in youth with cerebral palsy (CP). Online exercise or tele-programs are promising in overcoming the environmental barriers of accessibility to LTPA. To ensure successful implementation, it is necessary to identify limitations specific to dance in a pediatric population. The aim was to explore the perspectives of the main stakeholders, i.e., dance instructors and youth, to implement such a program.MethodsIn a mixed-method design, feasibility indicators were assessed by participation and retention rates, the Physical Activity Enjoyment Scale (PACES), and the Children's Effort Rating Table (CERT). Semi-structured interviews were conducted before and after the intervention with youth with CP [n = 15] and dance instructors [n = 3]. Interviews were analyzed with an inductive approach.ResultsParticipation and retention rates were 86.7% ± 10.7 and 100%, and the PACES and CERT average scores were 91% ± 11 and 3.7 ± 1.3, respectively. Four themes emerged from the interviews: 1) Technology; 2) Pedagogical Approach; 3) Participant's Environment; and 4) Social Relations.ConclusionThe teledance program is feasible and enjoyable, requiring minimal equipment and travel. However, there is a need to consider and provoke social interaction, to enhance the social and relational dimension of dance.

Device-measured physical activity in adults born preterm with very low birth weight and mediation by motor abilities

Physical activity (PA) is beneficial for several health outcomes. Adults born with very low birth weight (VLBW<1500g) undertake less PA than those born at term, have poorer motor abilities and may serve as a model on early life origins of PA. We therefore examined whether motor abilities mediate the association between being born with VLBW and device-measured PA. In a joint assessment of two longitudinal birth cohorts from Finland and Norway, PA was measured by two tri-axial accelerometers in 87 adults born preterm with VLBW and 109 controls born at term. We explored the mediating role of motor abilities assessed by standardized tests on the association between VLBW and device-measured PA. To do this, we examined group differences in metabolic equivalent of task (MET) min/day of moderate to vigorous PA (MVPA), light PA and sedentary. Analyses were adjusted for cohort, age and sex. MVPA was 40.4 (95% confidence interval [CI]: 13.3 to 69.4) MET min/day lower in the VLBW group than the control group. This was in part mediated through gross motor abilities, indicated by the indirect effect on the association between VLBW and MVPA being -15.6 (95% CI: -28.5 to -5.4) MET min/day. In conclusion, adults born preterm with VLBW undertake less MVPA than controls born at term, and gross motor abilities mediate this association. Interventions targeting motor abilities should be examined as potential ways to increase PA.

The efficacy of dance interventions for the activity and participation of individuals with cerebral palsy - a systematic review and meta-analysis

PURPOSE

The aim of this review was to examine the efficacy of dance interventions for individuals with cerebral palsy (CP), measured at any level of the International Classification of Functioning, Disability and Health (ICF).

METHODS

A systematic review and meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search of peer-reviewed articles was performed using six electronic databases.

RESULTS

Fourteen studies were included in this review, nine of which were also included in the meta-analysis. The meta-analyses yielded a large overall effect for cognitive, motor, and social-emotional function outcomes, with a high degree of heterogeneity between outcome effects, attributable to differences in study design.

CONCLUSION

Although recent studies provide support for the acceptance and efficacy of dance interventions for people with CP, the systematic review revealed significant limitations in study design (only 2 randomised control trials). High-quality research that measures outcomes across all dimensions of the ICF, and particularly at the level of participation, are needed to improve the level of empirical support for dance-based interventions.

Effectiveness and Evidence Level of Dance on Functioning of Children and Adolescents with Neuromotor Impairments: A Systematic Review

OBJECTIVES

The aim of this paper is to investigate the effects of dance therapy in children with neuromotor impairments (CNI), organizing the outcomes according to International Classification of Functioning Disability and Health (ICF) domains, and to investigate if there is adequate evidence of effectiveness to recommend dance as a therapy.

METHODS

Electronic searches were conducted in December 2021. We include studies assessing the effects of dance in CNI up to 18 years. Data extraction included studies' populations, intervention features, and main outcomes. We classified outcomes according to the ICF framework. We used the Cochrane collaboration's tool, modified by effective practice and organization of care (EPOC), to assess the methodological quality. The GRADE synthesized the body of evidence.

RESULTS

Twelve studies were included, with most of them addressing the body structure and function and activity components of ICF. Only three studies addressed components of participation, and four of personal factors. All these studies reported the positive effects of dance. Nevertheless, all of them presented high risk of bias. We found very low evidence level for improvement of body structure and function and activity components.

CONCLUSION

Dance therapy presents low evidence level for improvements of body structure and function and activity in CNI. Further studies with low risk of bias and larger samples are needed.

Acceptability of Dance PREEMIE (a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age) from the perspectives of families and dancer teachers: a reflexive thematic analysis

BACKGROUND

Physical activity (PA) participation is important for children born extremely preterm or extremely low birthweight as it provides opportunities to improve motor skills and cardiovascular fitness; however there is little evidence on interventions promoting PA participation for this group, particularly at preschool age.

OBJECTIVE

This study aims to explore the acceptability, a critical component of intervention feasibility, of a novel dance participation intervention.

METHODS

Semi-structured interviews explored the acceptability of Dance PREEMIE, a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (trial registration ACTRN12619001266156), from the perspectives of dance teachers delivering the intervention (n = 6), and parents of participating children (n = 6). Data were analyzed using reflexive thematic analysis.

RESULTS

Five themes were developed: 1) placing the child center-stage: a shared motivation to promote child wellbeing and development; 2) Dance PREEMIE as a catalyst for participation; 3) child development takes time, practice and exposure; 4) the value of being informed; and 5) dance teachers as architects of the learning environment.

CONCLUSION

Dance PREEMIE was acceptable to both parents of participating children and dance teachers. Findings from this study may inform future interventions aiming to improve PA participation for children with motor impairment at preschool age.