Effect of a 10-Week Traditional Dance Program on Static and Dynamic Balance Control in Elderly Adults

Classical Ballet for Women Aged Over 50 Years: Investigating Balance, Strength, and Range of Motion

Background: Regular exercise can mitigate the loss of strength, balance, and flexibility that contribute to age-related decline in physical function and mobility. However, traditional exercise interventions often report poor adherence rates. There is growing interest in classical ballet as an enjoyable exercise modality for adults in middle to late age. Classical ballet requires muscular strength, coordination, and flexibility. The current study investigated a classical ballet intervention on the balance, physical function, and range of motion of women aged over 50 years. Methods: Twenty-two healthy female participants (aged 56.2 (4.5) years (mean (SD)) completed a 10-week ballet intervention. Results: This single-arm study showed significant improvements (p<.05) in lower limb strength (measured by 5 times sit-to-stand and forward leap) and high adherence rates (95% adherence for participants who completed the intervention). No adverse events were reported. Improvements in balance were reported in the left leg only (as measured by center of pressure ellipse area in the parallel retiré condition). Conclusions: These results allude to the positive effects of ballet training on strength and balance in adults aged 50 years and over. High adherence rates suggest that ballet training was enjoyed and may thus be a long-term exercise modality for this population. Although this study was a single-arm design, it suggests promising results for future research wishing to evaluate the effectiveness of classical ballet training using randomized controlled trial designs.

Graceful gait: virtual ballet classes improve mobility and reduce falls more than wellness classes for older women

Introduction

Dance is an effective and motivating form of exercise for older women, but few studies have quantified the benefits of virtual dance classes nor, specifically, ballet. This study tested the effectiveness of virtual ballet compared to virtual wellness classes, with the goal of reaching underserved populations. It is among the first to explore the effects of virtual classical ballet on functional gait mobility, balance, and quality of life measures in older women.

Methods

Older women were recruited in two waves and randomized to two groups: a ballet class modified for older adults and a wellness-based control class. Both groups received 12 weeks of online classes, meeting twice per week for 45-min sessions. Classes were taught by a local company that offers community-based ballet classes. The same instructor led both the ballet and the wellness classes. Pre- and post-intervention assessments include gait and balance testing using wearable inertial sensors and self-report outcomes including quality of life and mood questionnaires.

Results

Forty-four older women completed the study: Ballet group (n = 21, 67.81 ± 7.3 years); Wellness group (n = 23, 69.96 ± 6.7 years). Pre- to post-intervention, both groups increased velocity on the two-minute walk test (F1,42 = 25.36, p < 0.001) and improved their time on the Timed Up and Go (F1,42 = 4.744, p = 0.035). Both groups improved balance on the Mini-BESTest (F1,42 = 38.154, p < 0.001), increased their scores on the Activities-Specific Balance Confidence Scale (F1,42 = 10.688, p < 0.001), and increased quality of life via the Short Form Health Survey (F1,42 = 7.663, p = 0.008). The ballet group improved gait variability in the backward direction (F1,42 = 14.577, p < 0.001) and reduced fall rates more than the wellness group [χ2(1) = 5.096, p = 0.024].

Discussion

Both virtual ballet and wellness classes improve select measures of gait, balance, and quality of life. The benefits seen in both groups highlight the importance of considering social interaction as a key component when developing future interventions to target mobility in older women.

The effectiveness of dance movement interventions for older adults with mild cognitive impairment, Alzheimer's disease, and dementia: A systematic scoping review and meta-analysis

OBJECTIVES

To synthesize evidence and summarize research findings related to the effectiveness and feasibility of dance movement intervention (DMI) in older adults with mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia; to systemically map existing research gaps and research directions for future practice.

METHODS

A systematic search was conducted using six electronic databases: Web of Science, PubMed, PsycINFO, MEDLINE, ScienceDirect, and Cochrane Central Register of Controlled Trials. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials (RoB 2) and The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I).

RESULTS

29 dance intervention studies (13 RCT studies) were included in the scoping review: 62% of MCI, 10% of AD, and 28% of dementia; a total of 1708 participants (Female=1247; Male=461) aged from 63.8 ( ± 5.24) to 85.8 ( ± 5.27) years old. Eight RCT studies were included in the meta-analysis; results indicated that dance interventions had a significant effect on global cognition, memory, balance, and significantly decreased depression. No significant effects were found for executive function.

CONCLUSIONS

Dance is a non-pharmacological, effective, affordable, and engaging intervention that can be used as a complementary treatment for older adults with MCI, AD, and dementia.

The effect of aerobic dancing on physical fitness and cognitive function in older adults during the COVID-19 pandemic-a natural experiment

During the Coronavirus disease (COVID-19), the physical activity of older adults is at a lower level. The study aimed to examine the effectiveness of aerobic dancing on physical fitness and cognitive function in older adults. We conducted a randomized controlled trial with 34 older adults who were assigned into an aerobic dancing group and a control group. Three dance sessions weekly for 60 ​min were scheduled for the aerobic dancing group for a total of 12 weeks. Physical fitness, blood pressure, lipids, glucose, cognitive function were assessed before and after the intervention. Baseline adjusted Analysis of Covariance (ANCOVA) was used to determine whether outcome variables varied between groups at pre-test and post-test. Effect size (Cohen's d) was calculated to determine the differences between groups from baseline to post-test. After 12 weeks, we found that the aerobic dancing group showed significant improvement in memory (portrait memory: F ​= ​10.45, p ​= ​0.003, d ​= ​1.18). The Limit of Stability (LOS) parameters in the aerobic dancing group displayed a significant increase after the intervention (right angle: F ​= ​5.90, p ​= ​0.022, d ​= ​0.60; right-anterior angle: F ​= ​4.23, p ​= ​0.049, d ​= ​0.12). Some beneficial effects were found on flexibility, grip strength, balance and subjective well-being (sit and reach: F ​= ​0.25, p ​= ​0.62, d ​= ​-0.40; grip strength: F ​= ​3.38, p ​= ​0.08, d ​= ​0.89; one-legged standing with eyes closed: F ​= ​1.26, p ​= ​0.27, d ​= ​0.50) in the aerobic dancing group. Aerobic dancing training was effective in improving memory and balance ability in older adults during the COVID-19 pandemic in China. In the future, aerobic dancing is a promising tool to encourage physical activity in older adults.

The elderly's satisfaction with physical activity programs in senior welfare centers

Introduction

Healthcare for the aging population has become a crucial issue in South Korea to maintain the elderly's quality of life, and physical activity is of primary importance for older adults. This study evaluated the exercise characteristics and satisfaction of the elderly who participated in physical activity programs provided by senior welfare centers in South Korea.

Methods

We surveyed 266 participants to learn the characteristics of the elderly's exercise participation and their satisfaction with instructors, exercise programs, and facilities provided by senior welfare centers. A total of 263 copies were analyzed using the SPSS 23.0 statistical software.

Results and discussion

The top three physical activity programs that the elderly participated in senior welfare centers were dancing (25.3%), gymnastics (24.8%), and table tennis/badminton (13.2%). There were significant differences in respondents' satisfaction according to sex, education level, spouse, family type, and monthly income per household (p < 0.05). The elderly were satisfied with programs (4.183 ± 0.483), facilities (3.881 ± 0.483), and instructors (3.604 ± 0.483) in order. Also, this study shows that user satisfaction differs depending on the demographic characteristics (gender, education, marital status, family type, economic status) and the characteristics of the exercise participation of the elderly (exercise duration, participation period).

Conclusions

In conclusion, we presented the elderly's satisfaction with physical activity programs in senior welfare centers, suggesting that the elderly need physical activity programs according to their demographic and exercise characteristics.

Effects of Insole with Toe-Grip Bar on Barefoot Balance and Walking Function in Patients with Parkinson's Disease: A Randomized Controlled Trial

The maintenance and improvement of balance and walking function in patients with Parkinson’s disease (PD) is essential. Toe dysfunction in patients with PD is related to balance and walking. Recently, insoles have been developed to improve toe function, but their effects on the physical functions of patients with PD remain unclear. In this randomized controlled study, we investigated the effects of insoles with a toe-grip bar on balance and walking function in such patients. Twenty-nine patients with PD in Hoehn and Yahr stages II−IV were randomly assigned to an intervention or control group. Patients in the intervention and control groups wore shoes having insoles with and without a toe-grip bar for 4 weeks, respectively. The center of gravity sway of standing posture (total trajectory length, envelope area, and maximum anterior−posterior center of pressure [AP-COP] distance) and walking parameters at normal and fast speeds were measured pre- and post-intervention in the rehabilitation room. All measurements were performed with the participants being barefoot. The maximum AP-COP distance and step length of the fast-walking condition were significantly improved in the intervention compared to the control group (p < 0.05). Thus, insoles with a toe-grip bar may improve balance and walking function in patients with PD.

Effects of Cha-Cha Dance Training on the Balance Ability of the Healthy Elderly

Neuro-musculo-skeletal degradations with advancing age are generally accompanied with mobility problems and poor health status, contributing to impaired physical function and increased risk of falls. In an effort to diminish a fall-related risk such as unstable balance, a variety of interventions have been studied and implemented. Yet, there have been few studies to evaluate the effect of Cha-cha dance training on postural balance or balance performance of the elderly. The Cha-cha dance is composed of moderate rhythm and symmetrical movements and is easy to master and even easier for the elderly to begin. The purpose of this study was to intervene the fitness exercise through 12-week Cha-cha dance training, evaluate its impact on the balance ability of the elderly, and provide a scientific experimental basis for the elderly to participate in the Cha-cha dance exercise. Forty healthy elderly people with no difference in balance ability were randomly divided into two groups. The Cha-cha training group (CTG, n = 20) regularly participated in Cha-cha dance class, 3 times a week, 90 min each time, for a total of 12 weeks, and the control group (CONG, n = 20) did not participate in the class and engaged to their regular daily life. Dynamic and static balance were measured at pre and post intervention. Overall, the results showed that dynamic balance and static balance in CTG were significantly improved after the intervention. In addition, the results showed that the improvement was more significant in trials in left foot than right foot, and trials in closed eyes than open eyes, respectively. In conclusion, a 12-week Cha-cha dance class or program alone can be an effective intervention to improve balance of the elderly.

The effect of dance on physical health and cognition in community dwelling older adults: a systematic review and meta-analysis

BACKGROUND

Dancing is an attractive form of exercise among older adults and may positively influence physical and psychosocial health. The aim of this systematic review was to synthesize the evidence examining the dance prescription and effectiveness of dance in community dwelling older adults.

METHODS

Eight databases were searched to identify randomized controlled trials that evaluated the effectiveness of dance programs on community-dwelling older adults from 2007 to December 2020. Data regarding participants, dance programs and outcomes of interest were extracted and narratively synthesized. A meta-analysis was performed on the outcome data where possible.

RESULTS

Twenty-two studies met the inclusion criteria, of those 15 were deemed to be fair quality and 7 high quality using the PEDro scale. Nineteen studies included in the meta-analysis found that dancing can improve mobility and endurance compared to no intervention and afforded equivalent outcomes compared to other exercise programs.

CONCLUSION

The findings suggest that dance is an effective, safe and viable activity for community-dwelling older adults..

Validation of Dance-Specific Balance Test: Evidence From Comparisons Between Dancers and Nondancers

The aim of this study was to establish the utility of the dance-specific balance test in examining the stability in postural control for dancers. Specifically, the method involves using the time taken to stabilize upon perturbation to quantify postural stability. The dance-specific balance test involved performing a four-step dance-like routine followed by a forward hop onto the force plate with one's dominant leg, ending with an attempt to sustain balance for a 30-s period. Results from the dance-specific balance test indicated that dancers stabilize faster (0.45 ± 0.11 s) than nondancers (1.09 ± 0.59 s); t(35.39) = -6.16, p < .001, Cohen's d = 1.46. Dancers are found to be faster to adapt after a perturbation than nondancers, and this suggests the usability of this tool for assessing stability in dancers.

“It Can Be Magic:” Creating Age Awareness Through Contemporary Dance

Professional dancers typically retire before age 40. Although the physical requirements for dance performance are often considered the reason for retirement, there is an increasing number dance researchers who demonstrate that the idealization of youthfulness on the stage is also a result of complex cultural, social, and economic realities and as such, in need of critique. As a group of mature women dancers who continue to perform, we aim to critique the idealization of youthfulness as a form of ageism in professional dance. In this paper, we present findings from our feminist memory-work study in which we critically reflected the rehearsals and performance of a choreography titled “Initiation.” We detail three main themes—”It Will Only Get Worse;” “It Can Be Magic;” “Once a Dancer Always a Dancer”—that emerged from our study. We conclude that we gained critical awareness of the gendered and ageist construction of dance as a performing art. As a result, we now feel empowered to continue our work as mature dance artists.

Factors of balance determining the risk of falls in physically active women aged over 50 years

BACKGROUND

Balance disorders are believed to be one of the main reasons for falls in older adults. They are related to natural processes of ageing, resulting in deterioration of information integration and processing from the vestibular, somatosensory and visual systems. The consequence is an increased number of postural sways, which are some of balance factors. Balance control in static and dynamic activities is an essential element of daily functioning of older citizens. It seems that balance assessment is essential to determine the risk of falls, as well as to determine which factors of balance have greatest impact on the risk of falls.

METHODS

The study involved physically active female students (n = 36, mean age 67,11 ± 5,35) of a University of the Third Age. We used the Balance System SD platform to assess their balance in four tests with eyes open and with eyes closed and to determine the risk of falls. We assessed the relationships between individual balance indices (overall stability index, anterior/posterior stability index, medial/lateral stability index) and the falls risk index. We also determined those factors which predicted the risk of falls the most.

RESULTS

The studied subjects had low risk of falls for their age category. In most measurements there were relationships between the risk of falls and the size of sways in the coronal plane and the overall stability index. We also found that the overall stability index calculated in measurements with eyes closed predicted the risk of falls of the studied physically active females most accurately (R² 0.391 F(1.34)=23.475; <0.000). The subjects were physically active and their falls risk index was low - this allowed us to presume that there was a relationship between these two factors. Preventive programmes should include exercise performed with eyes closed, and tests conducted with eyes closed seem to be most sensitive in determining balance disorders in physically active women.

Influence of Dance Programmes on Gait Parameters and Physical Parameters of the Lower Body in Older People: A Systematic Review

(1) Background: The regular practice of dancing benefits the physical condition, improving quality of life and minimising the adverse effects of ageing. Therefore, this review aims to evaluate the impact of dance programmes by quantifying different physical parameters of the lower body in older adults. (2) Methods: A systematic qualitative review in the English language (PubMed, Scopus, OvidSP, Cochrane and PEDro database) until mid-2020 considering the PRISMA guidelines and the PEDro quality criteria considering the following parameters of gait: stride length and width, speed. Physical parameters: flexion and dorsiflexion joint, muscle strength and range of motion were carried out. (3) Results: 9 studies with a population of 544 subjects from 5 continents and 6 types of dances were taken into account. The improvement of some parameters over others depended on the type of dance and the movements generated, having moderate positive effects on strength, agility, mobility and balance. (4) Conclusions: there is a general improvement in the functional capacity of the elderly through the practice of ballroom dancing, with specific improvement of each parameter depending on the type of dance.

Dance-based exergaming on postural stability and kinematics in people with chronic stroke - A preliminary study

INTRODUCTION

The study evaluated the feasibility, and compliance of a dance-based exergaming (DBExG) on postural stability (PS) and lower extremity (LE) kinematics, along with post-intervention changes in gait function and falls self-efficacy in people with chronic stroke (PwCS).

METHODS

Fifteen PwCS underwent DBExG for six weeks using Kinect "Just Dance 3." Pre- to post- changes were recorded during DBExG assessment on a fast-paced song (130 bpm) using an 8-camera motion capture system to assess PS (center of mass [CoM] excursions [EXs] in the anterior-posterior [AP] and mediolateral [ML] directions) and LE kinematics (hip, knee, and ankle joint angle EXs). Gait function was also assessed with gait parameters, such as gait speed, cadence, and gait symmetry on an electronic walkway. Falls self-efficacy was recorded with Falls Efficacy Scale (FES).

RESULTS

The AP and ML CoM EXs and paretic joint angle EXs significantly increased pre- to post- DBExG assessment (p < .05). Gait parameters, and falls self-efficacy measures significantly changed pre- to post- DBExG (p < .05).

CONCLUSIONS

Results exhibited the feasibility of the proposed DBExG for positively impacting postural stability, and kinematics, along with increasing gait function and falls self-efficacy among PwCS.

Postural Balance Ability and the Effect of Visual Restriction on Older Dancers and Non-Dancers

Dance has been suggested to be an advantageous exercise modality for improving postural balance performance and reducing the risk of falls in the older population. The main purpose of this study was to investigate whether visual restriction impacts older dancers and non-dancers differently during a quiet stance balance performance test. We hypothesized higher balance performance and greater balance deterioration due to visual restriction in dancers compared with non-dancers, indicating the superior contribution of the visual channel in the expected higher balance performances of dancers. Sixty-nine (38 men, 31 women, 74 ± 6 years) healthy older adults participated and were grouped into a Greek traditional dance group (n = 31, two to three times/week for 1.5 h/session, minimum of 3 years) and a non-dancer control group (n = 38, no systematic exercise history). The participants completed an assessment of one-legged quiet stance trials using both left and right legs and with eyes open while standing barefoot on a force plate (Wii, A/D converter, 1,000 Hz; Biovision) and two-legged trials with both eyes open and closed. The possible differences in the anthropometric and one-legged balance parameters were examined by a univariate ANOVA with group and sex as fixed factors. This ANOVA was performed using the same fixed factors and vision as the repeated measures factor for the two-legged balance parameters. In the one-legged task, the dance group showed significantly lower values in anteroposterior and mediolateral sway amplitudes (p = 0.001 and p = 0.035) and path length measured in both directions (p = 0.001) compared with the non-dancers. In the two-legged stance, we found a significant vision effect on path length (p < 0.001) and anteroposterior amplitude (p < 0.001), whereas mediolateral amplitude did not differ significantly (p = 0.439) between closed and open eyes. The dance group had a significantly lower CoP path length (p = 0.006) and anteroposterior (p = 0.001) and mediolateral sway amplitudes (p = 0.003) both in the eyes-open and eyes-closed trials compared with the control group. The superior balance performance in the two postural tasks found in the dancers is possibly the result of the coordinated, aesthetically oriented intersegmental movements, including alternations between one- and two-legged stance phases, that comes with dance. Visual restriction resulted in a similar deterioration of balance performance in both groups, thus suggesting that the contribution of the visual channel alone cannot explain the superior balance performance of dancers.

Insights from an early-stage development mixed methods study on arts-based interventions for older adults following hospitalisation

BACKGROUND

A period of hospitalisation can have negative consequences on physical function and autonomy for older adults, including functional decline, dependency and reduced quality of life. Older adults favour activity that focuses on social connectedness, fun and achievable skills.

OBJECTIVE

The primary aim of this early-stage development mixed methods study was to determine the feasibility and acceptability of a randomised crossover trial design and two arts-based interventions tailored for older adults recently discharged from hospital.

MATERIALS AND METHODS

Community-dwelling adults, aged 65 years and older, who reported reduced mobility and less than six weeks post discharge from hospital were invited to participate in the study. Two sites were randomised to either a four-week dance or music therapy intervention, followed by a four-week washout and subsequently to the alternate intervention. Participants and stakeholders were interviewed to share their views and perspectives of the study design and interventions developed.

RESULTS

The arts-based interventions were acceptable and safe for participants. Randomisation was completed per protocol and no implementation issues were identified. The outcome measures used were acceptable and feasible for this group of patients and did not lead to fatigue or excessive assessment time. Participants were positive about their experience of the programme.

CONCLUSIONS

This early development study provides a precursor and several imperative learning points to guide and inform future research in the area. Difficulties in recruitment and attrition were in part due to the barriers encountered when recruiting an incident cohort of vulnerable individuals post hospitalisation.

Static and dynamic postural stability of children girls engaged in modern dance

BACKGROUND

: Postural stability (PS) has an important role in many athletic activities. However, modern dance demands a heightened PS because of the required aesthetic quality and speed of movement. The aim of the present study was to compare the static and dynamic PS of young dancers and participants of other sporting activities.

METHOD

: A total of 101 girls (age: 7.91 ± 0.7 year) were divided into a Dance group (N = 53) and a physically active Control group (N = 48). Static PS was assessed with a two-leg standing test on a Force plate, and dynamic PS was assessed with a Körperkoordinationstest für Kinder (KTK) - a walking backwards test on a balance beam.

RESULTS

: Multivariate analysis of variance showed a general difference between the groups (F = 21.95; p ≤ 0.0001). In static PS, the Dance group was better in Total distance of center of pressure (COP) (p ≤ 0.0001; ES = -1.70), Anterior-posterior oscillation (p ≤ 0.0001; ES = -1.40), Medial-lateral oscillation (p ≤ 0.0001; ES = 1.75) and Length in function of surface (p ≤ 0.0001; ES = -0.98). Both parameters of dynamic stability, the KTK test (p ≤ 0.0001; ES = 1.28) and Motor quotients KTK test (p ≤ 0.0001; ES = 1.45), were significantly better in the Dance group.

CONCLUSION

: The results from the present study indicate that children girls who participate mostly in dance develop better static and dynamic PS than children girls who participate in other sport activities. These findings underline the importance of training modification toward the improvement of PS in dance.

Kinematic Analysis of Dance-Based Exergaming: A Cross-Sectional Study

BACKGROUND

Recent studies demonstrate improvements in both postural stability and mobility among aging populations and those with stroke who are exposed to dance-based exergaming (DBExG). However, age-related deficits and aging with cortical pathology may lead to distinct movement adaptation patterns during DBExG, which could impact therapeutic outcomes.

AIM

The aim of this study was to examine the movement kinematics (postural stability and mobility) of healthy older adults, older adults with stroke, and young adults for different paces of dance during DBExG.

METHOD

The study included 33 particpants (11 participant from each group of healthy older adults, older adults with chronic stroke, and healthy young adults) who performed the DBExG using slow- (SP), medium- (MP), and fast-paced (FP) songs with movements in the anteroposterior (AP) and mediolateral (ML) directions. Center of mass (CoM) sway area, excursion (Ex), and peaks as well as hip, knee, and ankle joint excursions were computed.

RESULTS

Results of the study revealed that CoM sway areas and Exs were greater for healthy young adults than for older adults with stroke for the SP dance (p < 0.05) and that there were significantly more AP CoM peaks for young adults than for healthy older adults and those with stroke for the FP dance (p < 0.05). Young adults also exhibited greater hip and ankle Exs than older adults with stroke (p < 0.05) for all song paces. Similarly, knee and ankle Exs were greater for healthy older adults than for older adults with stroke for all song paces (p < 0.05).

CONCLUSION

The quantitative evaluation and comparison of the movement patterns presented for the three groups could provide a foundation for both assessing and designing therapeutic DBExG protocols for these populations.

Validity of Inertial Sensors for Assessing Balance Kinematics and Mobility during Treadmill-Based Perturbation and Dance Training

Inertial sensors (IS) enable the kinematic analysis of human motion with fewer logistical limitations than the silver standard optoelectronic motion capture (MOCAP) system. However, there are no data on the validity of IS for perturbation training and during the performance of dance. The aim of this present study was to determine the concurrent validity of IS in the analysis of kinematic data during slip and trip-like perturbations and during the performance of dance. Seven IS and the MOCAP system were simultaneously used to capture the reactive response and dance movements of fifteen healthy young participants (Age: 18-35 years). Bland Altman (BA) plots, root mean square errors (RMSE), Pearson's correlation coefficients (R), and intraclass correlation coefficients (ICC) were used to compare kinematic variables of interest between the two systems for absolute equivalency and accuracy. Limits of agreements (LOA) of the BA plots ranged from -0.23 to 0.56 and -0.21 to 0.43 for slip and trip stability variables, respectively. The RMSE for slip and trip stabilities were from 0.11 to 0.20 and 0.11 to 0.16, respectively. For the joint mobility in dance, LOA varied from -6.98-18.54, while RMSE ranged from 1.90 to 13.06. Comparison of IS and optoelectronic MOCAP system for reactive balance and body segmental kinematics revealed that R varied from 0.59 to 0.81 and from 0.47 to 0.85 while ICC was from 0.50 to 0.72 and 0.45 to 0.84 respectively for slip-trip perturbations and dance. Results of moderate to high concurrent validity of IS and MOCAP systems. These results were consistent with results from similar studies. This suggests that IS are valid tools to quantitatively analyze reactive balance and mobility kinematics during slip-trip perturbation and the performance of dance at any location outside, including the laboratory, clinical and home settings.

Dance intervention effects on physical function in healthy older adults: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVE

Dancing is a form of physical exercise associated with health benefits in older adults. Regular dancing can prolong healthy aging, maintain or even improve physical function, and thus enhance their quality of life. The aim of this review was to evaluate the effects of dance intervention on physical function performance in healthy older adults in randomized-controlled trials (RCTs).

METHODS

Five electronic databases (Cochrane Library, PsycINFO, PubMed, Scopus, and Web of Science) were searched systematically until the end of June 2018 by two independent reviewers. These searches were limited to the English language and persons with average age older than 65. The tool from the Cochrane Collaboration was used to assess the risk of bias. A standard meta-analysis was performed using Review Manager Software version 5.3.

RESULTS

Thirteen RCTs from a total of 1029 older participants were included in this meta-analysis. The results showed that dance intervention significantly improved mobility function and endurance performance when compared with control groups for healthy older adults. However, gait was not significantly improved through dancing. Studies included in this review were not enough to perform meta-analysis for the effectiveness of dance on balance and general health in healthy older adults.

CONCLUSION

Overall, dance intervention was effective to improve physical function performance in healthy older adults. The results from this meta-analysis strengthen the evidence from previous individual studies. Properly organized dance intervention would be a safe and effective exercise to incorporate into daily life.

The Mechanism of Physical Activity-induced Amelioration of Parkinson's Disease: A Narrative Review

Physical activity, together with its ameliorative effects on Parkinson's disease (PD) symptoms, remains a relatively unappreciated factor which may be beneficial for the treatment outcome. Contemporary evidence supports the positive effects of non-pharmacological approaches to PD symptom management, in particular the effects of the exercise on both, motor and non-motor symptoms. The aim of the study was to review the mechanisms of exercise-induced amelioration of PD symptoms. Methods: Electronic databases (PubMed, Web of Science and Google Scholar) were searched using the following key words: "Parkinson and physical activity" OR "Parkinson disease and exercise" OR "Parkinson disease and lifestyle factors" OR "Parkinson disease and longevity". A total of 97 studies which investigated PD genetics and various forms of exercise and their etiologic impact on PD were reviewed. The studies were subdivided into four topic groups: 1) genetics of PD, 2) exercise and the brain, 3) physical activity and PD, 4) mind-body interventions, and discussed accordingly. Adequate levels of physical activity are associated with higher quality of life in PD patients. Physical activity may have protective and stimulatory effects for better functional efficiency in higher-level cognitive networks. It can also improve balance and motor functions by improving muscle strength. Given the etiologic evidence of the beneficial effects of physical activity on PD, albeit tentative, a concerted effort to elucidate the processes and outcomes of physical activity on ameliorating symptoms of PD must be undertaken.

Thai dance exercises benefited functional mobility and fall rates among community-dwelling older individuals

Background

With dramatic increase in the number of older individuals, special efforts have been made to promote the levels of independence and reduce fall rates among these individuals.

Objective

To investigate the effects of Thai dance exercises over 6 weeks on functional mobility and fall rates in community-dwelling older individuals.

Methods

Sixty-one community-dwelling older adults were interviewed and assessed for their demographics and fall data during 6 months prior to participation in the study. Then they completed the quasi-experimental Thai dance exercise program for 50 minutes/day, 3 days/week over 6 weeks. Their functional mobility relating to levels of independence and safety were assessed prior to training, at 3-week and 6-week training. After completing the program at 6 weeks, participants were prospectively monitored for fall data over 6 months.

Results

Participants improved their functional mobility significantly after 3- and 6-week training ( p < 0.01 ) . The number of faller individuals obviously decreased from 35% ( n = 21 ) prior to training to only 8% ( n = 5 ) after training ( p < 0.01 ) .

Conclusion

The current findings further extend benefits of Thai dance as an alternative musical exercise program to promote levels of independence and safety among community-dwelling older adults.

Effects of a Virtual Reality Dance Training Program on Kyphosis Angle and Respiratory Parameters in Young Women With Postural Hyperkyphosis: A Randomized Controlled Clinical Trial

CONTEXT

Thoracic hyperkyphosis, one of the most common spinal deformities, may lead to undesirable pulmonary outcomes.

OBJECTIVE

To study, the efficacy of virtual reality exercise training on thoracic hyperkyphosis and respiratory parameters in young women.

DESIGN

Randomized clinical trial.

SETTING

Laboratory setting.

PARTICIPANTS AND INTERVENTION

Participants were randomly assigned to one of two 4-week exercise training groups: regular training (RT), which involved stretch and strength training, or virtual reality with RT (VRRT), which involved dance training with the Xbox 360 Kinect® game in addition to the exercises, which the RT group received.

MAIN OUTCOME MEASURES

The authors measured kyphosis angle with a Flexicurve ruler and recorded respiratory parameters (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]) with a spirometer in each participant at baseline and postintervention. Separate 2 × 2 repeated-measure analysis of variances were used to analyze differences between means for kyphosis angle, FEV1, and FVC. Based on the significant interactions between time and group, the paired t test was used to compare the results at baseline and postintervention, and the independent sample t test was used to compare the differences in changes between groups. Level of significance was considered at P < .05 except for paired t test that was adjusted to P < .025 for each variable in 2 groups.

RESULTS

The results showed statistically significant interactions between time and group for kyphosis angle, FEV1, and FVC. Postintervention thoracic kyphosis angle decreased and FVC increased significantly in both groups and FEV1 improved significantly in virtual reality with RT group. The improvements in thoracic kyphosis, FVC, and FEV1 in the virtual reality with RT group were significantly greater (P < .001) than in the RT group.

CONCLUSION

Dance training with the Xbox 360 Kinect game was an effective therapy in improving thoracic kyphosis angle, FVC, and FEV1 in young women with thoracic hyperkyphosis.

[Dance as an intervention to improve mobility and balance in elderly: a literature review]

The aim of the present review was to identify whether dance protocols can benefit mobility and balance in elderly. A literature review was conducted in which 927 potentially relevant studies were identified (published in Portuguese, English, French, German, Spanish or Italian). There was no publication period restriction. After reading the titles, abstracts and review of the exclusion criteria, 15 randomized controlled trials were included. Most of the studies evaluated female subjects, using heterogeneous protocols of intervention and unspecific control groups. In addition, the period of exposure to dance was generally short: 2.6 weekly practices, of 59.1 minutes each, performed through 12.1 weeks. Dance was shown to be beneficial in 77.6% of the evaluated outcomes, exhibiting a moderate effect size for static balance and functional balance; and small effect size for mobility and strength/resistance of the lower limbs. However, future studies with the use of specific control groups and adoption of longer lasting protocols are necessary to evaluate the actual size effect that dance has on the maintenance of mobility and balance in elderly.

Kinematic analysis of dance-based exergaming: effect of song pace on center of mass and joint mobility

[Purpose] To establish a quantitative kinematic assessment method for examining postural stability and physical mobility during dance-based exergaming. [Participants and Methods] Fifteen young adults participated in one session of dance-based exergaming assessment using segments from Kinect ‘Just Dance 3’ consisting of slow-, medium-, and fast-paced songs. A motion capture system was used to record full body kinematics, and a customized MATLAB code was used to compute the variables of interest, such as center of mass sway area, excursion, and peaks, as well as step count and joint excursions. [Results] Total center of mass sway area and excursion were significantly greater for slow-paced (total sway area=1,077.6 ± 209.9 cm²; total excursion=629.8 ± 380.5 cm) and fast-paced (total sway area=314.1 ± 133.6 cm²; total excursion=478.5 ± 149.0 cm) songs than for the medium-paced song (total sway area=212.9 ± 346.0 cm²; total excursion=311.2 ± 119.5 cm). Joint excursion was greater for the knee (ranging from: (slow to fast-paced songs: 55.5°–83.1°) and hip (slow to fast-paced: 40.6°–50.4°) than for the ankle (slow to fast-paced: 32.2°–46.7°) for all three dance paces. Additionally, step count was significantly, positively correlated with song pace (r=0.52). [Conclusion] The current study was able to quantify and provide normative values for postural control and joint mobility among healthy young adults during dance-based exergaming with 3 hip-hop songs of different paces from the Microsoft Kinect ‘Just Dance 3’. The results indicated that different paces (intensities) of dance songs corresponded to distinct movement kinematic trends, particularly with slow-paced song having the maximum center of mass excursion and lowest joint excursion, while fast-paced song exhibits the reverse, along with medium-paced song exhibiting the highest hip and ankle joint angle excursions, while the fast-paced song had increased knee joint angle excursions.

Characterization of the Effects of a Six-Month Dancing as Approach for Successful Aging

Aging is accompanied by a decline in multiple domains. Positive effects of dance practice on several health issues have been evaluated in young adults, while the effects of regular social dance practice on physical fitness, sexual health, and cognitive functions have not been studied yet in older experienced dancers. Thus, the aim of this study has been to investigate whether a 6-month social dance practice might influence fitness performance, sexual health, and specific cognitive functions and/or mood characteristics in older experienced dancers. Thirty experienced dancers (age: 71.2±5.1 years, 18 females/12 males) were enrolled from the dance school "NonSoloLiscio" of Catanzaro. Body composition, physical fitness, sexual health, and cognitive functions were assessed before (T0) and after (T6) intervention. After 6 months of dance practice, percent of fat mass (%FM) significantly decreased (p<0.01), while fat-free mass (FFM) significantly increased (p<0.01) in both genders. Moreover, significant main effects of time on physical fitness tests, such as chair stand test (CST) (p<0.01), gait speed (p<0.05), and timed up and go (p<0.05), were found. Sexual health was significantly higher in males than in females at T0 and no significant effects of dance on subjects' sexual health were found. Interestingly, trait of anxiety significant decreased (p<0.05) and perception of retrospective memory significantly increased (p=0.05) after training independently of gender. Our preliminary results suggest that, even in older intermediate-level dancer, the practice of social dance might positively influence body composition and also increase fitness performance, memory functions, and anxiety. In contrast, no effects on sexual health were observed after 6 months of dancing.

Effect of Creative Dance on Fitness, Functional Balance, and Mobility Control in the Elderly

BACKGROUND

In the literature on creativity in older adults, creative activities have been found to be an effective way of adapting to age-related psychological and physical changes, providing older adults with opportunities to think differently and be open to new ideas. On the other hand, physical activities play an important role in the prevention of physical decline. Thus, combining physical activity and certain creative activities, such as creative dance (CD), might help facilitate successful aging. Since the National Dance Association has expanded dance into educational and community facilities, CD programs have begun to be developed and widely used for all ages.

OBJECTIVE

We investigated the effects of a CD program on fitness, functional balance, and mobility in the elderly.

METHODS

Eighty-two community-dwelling older adults were randomly allocated to either a dance group (n = 41, age = 70.5 ± 7.89 years) or a stretching group (n = 41, age = 71.77 ± 7.78 years). Over 8 weeks, these groups participated in CD and stretching training (ST) classes, respectively, which lasted for 90 min and were held 2 days a week. The CD included tasks to explore movement elements (i.e., body, space, time, force), develop their own movement, and transform feelings or inner experiences into movement. The ST included several upper- and lower-body stretching poses. The outcome measures included the Senior Fitness Test (SFT), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), and 10-Meter Walking Test (gait speed).

RESULTS

A significant group × time interaction was found for the 30-s stand and 30-s arm curl, and for the BBS, TUG, DGI, and gait speed. Post hoc paired t tests revealed significantly increased scores for the 30-s stand, 30-s arm curl, back stretching, and chair sit and reach tests, and for the TUG, BBS, TUG, DGI, and gait speed in the CD group. The 30-s arm curl and chair sit and reach test scores significantly increased in the ST group.

CONCLUSION

CD and stretching may both benefit fitness and balance for older adults; however, CD may improve dynamic balance and mobility more than stretching. Therefore, CD may be a creative physical activity that contributes to successful aging.

Balance and functional fitness benefits of a Thai boxing dance program among community-dwelling older adults at risk of falling: A randomized controlled study

OBJECTIVE

The present study aimed at examining the effects of a Thai Boxing dance (TBD) program on balance performances and functional fitness in community-dwelling older adults at risk of falling who have no comorbidities leading to falls.

METHODS

Seventy-eight participants were randomly equally assigned either to a 4-week TBD program or to a control group receiving a fall prevention booklet. Static and dynamic balance performances, and functional fitness including lower limb muscle strength, body flexibility, and agility were evaluated before and after the intervention, and at 4-month follow-up.

RESULTS

After receiving 4-week TBD intervention, participants showed significantly greater improvements in static balance with eyes open, dynamic balance and all functional fitness when compared to the control group (p <  0.05), and these effects except for body flexibility were still maintained at 4-month follow-up (p <  0.05).

CONCLUSIONS

This study highlights TBD as an intervention for improving balance and functional fitness of community-dwelling seniors at risk of falling.

Traditional Dance Improves the Physical Fitness and Well-Being of the Elderly

Regular physical activity is considered one of the most important factors for lifestyle, for maintaining good health in older ages and increasing life expectancy. Dance is considered an activity that involves coordinating movements with music, as well as brain activation because it is constantly necessary to learn and remember new steps. Dance as a musical-kinetics skill, requires the coordination of body movements with rhythmic stimuli, developing the adaptability of the movement. One-hundred-thirty (130) elderly people aged 60 years and over (mean age 67 years old) with an average of 8 years of education, attended Greek traditional dance sessions for 32 weeks. The frequency was 2 times per week, for 75 min per session. Dances were selected from all over Greece with moderate intensity initially. During the program, they had the opportunity to try with greater intensity dances. At the beginning and after the end of intervention all the participants were evaluated by the Fullerton Senior Fitness Test for their physical fitness, the Single Leg Balance and the Handgrip Strength Test. The results showed a significant improvement in their physical fitness (Chair Stand: T = −5.459, p < 0.001; Arm Curl: T = −5.750, p < 0.001; Back Scratch: T = −4.648, p < 0.001; Sit and Reach: T = −4.759, p < 0.001; 2 min Step: T = −5.567, p < 0.001; Foot Up and Go: T = −8.599, p < 0.001) and at their static balance with eyes open (Balance 1 leg: T = −4.996, p < 0.001) and Handgrip Strength (Handgrip: T = −3.490, p < 0.001). Elderly seem to enjoy dancing as an activity while maintaining their functionality. Probably the elderly in traditional dance cause prosperity in their lives by promoting active aging.

"If you can breathe, you can dance": Fine lines contemporary dance for mature bodies in Melbourne, Australia

Older women ballet and contemporary dancers resist the pervasive stereotypes of the dancing body as young, graceful, and athletic. They embody and enact a generative habitus, resisting cultural socialization that would deny them voice, visibility, and validation. This study explores the understandings of a group of older women dancers who are members of the Fine Lines contemporary dance ensemble for mature bodies, Melbourne, Australia. The data for this phenomenological study were gathered in 2017 and employ Interpretative Phenomenological Analysis as an analytic strategy. Our findings are reported under three overarching themes: Dance as a Community, Older Women Dancing, and Learning: Choreography and Improvisation.

Functional Re-organization of Cortical Networks of Senior Citizens After a 24-Week Traditional Dance Program

Neuroscience is developing rapidly by providing a variety of modern tools for analyzing the functional interactions of the brain and detection of pathological deviations due to neurodegeneration. The present study argues that the induction of neuroplasticity of the mature human brain leads to the prevention of dementia. Promising solution seems to be the dance programs because they combine cognitive and physical activity in a pleasant way. So, we investigated whether the traditional Greek dances can improve the cognitive, physical and functional status of the elderly always aiming at promoting active and healthy aging. Forty-four participants were randomly assigned equally to the training group and an active control group. The duration of the program was 6 months. Also, the participants were evaluated for their physical status and through an electroencephalographic (EEG) examination at rest (eyes-closed condition). The EEG testing was performed 1–14 days before (pre) and after (post) the training. Cortical network analysis was applied by modeling the cortex through a generic anatomical model of 20,000 fixed dipoles. These were grouped into 512 cortical regions of interest (ROIs). High quality, artifact-free data resulting from an elaborate pre-processing pipeline were segmented into multiple, 30 s of continuous epochs. Then, functional connectivity among those ROIs was performed for each epoch through the relative wavelet entropy (RWE). Synchronization matrices were computed and then thresholded in order to provide binary, directed cortical networks of various density ranges. The results showed that the dance training improved optimal network performance as estimated by the small-world property. Further analysis demonstrated that there were also local network changes resulting in better information flow and functional re-organization of the network nodes. These results indicate the application of the dance training as a possible non-pharmacological intervention for promoting mental and physical well-being of senior citizens. Our results were also compared with a combination of computerized cognitive and physical training, which has already been demonstrated to induce neuroplasticity (LLM Care).

Effects of dancing compared to walking on cardiovascular risk and functional capacity of older women: A randomized controlled trial

INTRODUCTION

Aging is characterized by reductions in lean mass simultaneously to increases in visceral adipose tissue, elevating cardiovascular risk (CVR) and physical dependence. Dancing has been recommended for improving fall-risk and CVR, however, comparisons with traditional exercises are limited. This study aimed to compare the effects of dancing with walking on CVR and functionality of older women.

METHODS

Thirty sedentary women (65 ± 5 years, BMI 27 ± 4 kg/m²) were randomized into three groups (n = 10/group): dancing, walking or stretching (active control). All interventions lasted 8 weeks (60 min sessions): dancing/walking 3×/week, stretching 1×/week. Dancing: several styles, no partner. Walking: treadmill, 60% peak oxygen consumption (VO₂peak). Stretching: large muscle groups, no discomfort. Before and after interventions assessments: VO₂peak (primary outcome), total cholesterol, HDL-C, LDL-C, glucose, insulin, CRP, TNF-α, waist and hip circumferences, visceral adipose tissue (VAT), muscle thickness, maximal muscle strength/power, static and dynamic balance, gait ability, flexibility, chair-raise and level of physical activity (PA).

STATISTICS

generalized estimating equations, post-hoc LSD (p < 0.05), SPSS 22.0.

RESULTS

(Mean-CI): (before vs after): group vs time interaction showed increases in VO₂peak (mL·kg^-1·min^-1) for dancing 23.3 (20.8-25.8) vs 25.6 (23.4-27.8), and walking 23.4 (21.3-25.5) vs 27.0 (25.4-28.6), with no differences for stretching 23.5 (21.3-25.7) vs 23.0 (21.0-24.9). Lower body muscle power and static balance also improved for dancing and walking, but not for stretching. Main time effect showed improvements in CRP, TNF-α, LDL-C, HDL-C, VAT, waist, hip, chair raise, flexibility and level of daily PA for all groups.

CONCLUSION

Dancing induced similar increases in VO₂peak, lower body muscle power and static balance as walking, while the stretching group remained unchanged. Pooled effects showed improvements in body composition, lipid and inflammatory profile, which are supported by increased PA levels.

TRIAL REGISTRATION

NCT03262714.

Effects of Thai traditional dance on balance performance in daily life among older women

BACKGROUND

Previous research indicates that dance training may improve balance among older adults.

AIMS

This study investigated the effects of Thai traditional dance on balance performance among older women.

METHODS

Forty-three women aged 60-80 years, with mean scores between 45 and 52 points on the Berg Balance Scale (BBS), were recruited and randomly assigned into two groups: a Thai traditional dance group (TTDG) (n = 22) and a control group (CG) (n = 21). TTD program comprised three dance sessions of 30-60 min per week over the course of 12 weeks while the CG kept their normal daily activities. Balance performance was assessed using standardized tests including the NeuroCom Balance Master^® System (Version 9.2), the Timed Up and Go Test (TUG) and the BBS.

RESULTS

The results revealed that overall balance was better for those in TTDG compared to the CG. There was a significantly lower sway velocity and faster weight transfer in the Sit-to-Stand Test (p ≤ 0.001) for those in the dance group. TTDG had quicker turn time in the Step Quick Turn Test (p ≤ 0.001), improved Step Up Over Test and Walk Across Test, faster movement time, walking speed, and a better score in the TUG after training (p ≤ 0.001).

DISCUSSION

A 3-weekly Thai traditional dance intervention significantly improved balance and mobility among older community-dwelling women as compared to normal daily activities.

CONCLUSION

Thai traditional dance could potentially prevent age-related mobility and balance decline and its related fall risk.

Dancing in time: feasibility and acceptability of a contemporary dance programme to modify risk factors for falling in community dwelling older adults

BACKGROUND

Falls are a common cause of injury in older adults, with the prevention of falls being a priority for public health departments around the world. This study investigated the feasibility, and impact of an 8 week contemporary dance programme on modifiable physical (physical activity status, mobility, sedentary behaviour patterns) and psychosocial (depressive state, fear of falling) risk factors for falls.

METHODS

An uncontrolled 'pre-post' intervention design was used. Three groups of older (60 yrs.+) adults were recruited from local community groups to participate in a 3 separate, 8 week dance programmes. Each programme comprised two, 90 min dance classes per week. Quantitative measures of physical activity, sedentary behaviour, depression, mobility and fear of falling were measured at baseline (T1) and after 8 weeks of dance (T2). Weekly attendance was noted, and post-study qualitative work was conducted with participants in 3 separate focus groups. A combined thematic analysis of these data was conducted.

RESULTS

Of the 38 (Mean Age = 77.3 ± 8.4 yrs., 37 females) who attended the dance sessions, 22 (21 females; 1 male; mean age = 74.8, ±8.44) consented to be part of the study. Mean attendance was 14.6 (±2.6) sessions, and mean adherence was 84.3% (±17). Significant increases in moderate and vigorous physical activity were noted, with a significant decrease in sitting time over the weekdays (p < 0.05). Statistically significant decreases in the mean Geriatric Depression Scale (p < 0.05) and fear of falling (p < 0.005) score were noted, and the time taken to complete the TUG test decreased significantly from 10.1 s to 7.7 s over the 8 weeks (p < 0.005). Themes from the focus groups included the dance programme as a means of being active, health Benefits, and dance-related barriers and facilitators.

CONCLUSIONS

The recruitment of older adults, good adherence and favourability across all three sites indicate that a dance programme is feasible as an intervention, but this may be limited to females only. Contemporary dance has the potential to positively affect the physical activity, sitting behaviour, falls related efficacy, mobility and incidence of depression in older females which could reduce their incidence of falls. An adequately powered study with control groups are required to test this intervention further.

Balance and Muscle Strength in Elderly Women Who Dance Samba

Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group—elderly participants of the carnival parades in the “Wing of Baianas”, and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength.

The effect of dance therapy on the balance of women over 60 years of age: The influence of dance therapy for the elderly

Dance therapy is a physical activity that can lead to balance improvement in older adults. The aim of the study was to evaluate the effects of dance therapy on balance and risk of falls in older women. Twenty-four older women (mean age 66.4 years old) attended dance sessions for three months. Pretest/posttests were completed using the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test M-CTSIB. Results showed the Limits of Stability Test was significantly higher (17.5%) after dance classes. Regular use of dance therapy shows promise in improving balance by increasing the limits of stability.

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

BACKGROUND

The prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i) reducing the number of falls and ii) improving physical and cognitive fall-related risk factors.

METHODS AND FINDINGS

A parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters) around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters) were offered twice weekly one-hour social dancing classes (folk or ballroom dancing) over 12 mo (80 h in total). Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters) were advised to continue with their regular activities.

MAIN OUTCOMES

falls during the 12 mo trial and Trail Making Tests.

SECONDARY OUTCOMES

The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength) and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12) Survey. Data on falls were obtained from 522 of 530 (98%) randomised participants (mean age 78 y, 85% women) and 424 (80%) attended the 12-mo reassessment, which was lower among folk dance participants (71%) than ballroom dancing (82%) or control participants (82%, p = 0.04). Mean attendance at dance classes was 51%. During the period, 444 falls were recorded; there was no significant difference in fall rates between the control group (0.80 per person-year) and the dance group (1.03 per person-year). Using negative binomial regression with robust standard errors the adjusted Incidence Rate Ratio (IRR) was 1.19 (95% CI: 95% CI = 0.83, 1.71). In exploratory post hoc subgroup analysis, the rate of falls was higher among dance participants with a history of multiple falls (IRR = 2.02, 95% CI: 1.15, 3.54, p = 0.23 for interaction) and with the folk dance intervention (IRR = 1.68, 95% CI: 1.03, 2.73). There were no significant between-group differences in executive function test (TMT-B = 2.8 s, 95% CI: -6.2, 11.8). Intention to treat (ITT) analysis revealed no between-group differences at 12-mo follow-up in the secondary outcome measures, with the exception of postural sway, favouring the control group. Exploratory post hoc analysis by study completers and style indicated that ballroom dancing participants apparently improved their gait speed by 0.07 m/s relative to control participants (95% CI: 0.00, 0.14, p = 0.05). Study limitations included allocation to style based on logistical considerations rather than at random; insufficient power to detect differential impacts of different dance styles and smaller overall effects; variation of measurement conditions across villages; and no assessment of more complex balance tasks, which may be more sensitive to changes brought about by dancing.

CONCLUSIONS

Social dancing did not prevent falls or their associated risk factors among these retirement villages' residents. Modified dance programmes that contain "training elements" to better approximate structured exercise programs, targeted at low and high-risk participants, warrant investigation.

TRIAL REGISTRATION

The Australian New Zealand Clinical Trials Registry ACTRN12612000889853.

The impact of a vestibular-stimulating exercise regimen on postural stability in women over 60

Background/Objective

The aim of this study was to assess whether a program of exercise specifically designed to target the vestibular organ improved the postural stability of female participants over 60 years old.

Methods

Twenty-eight healthy female volunteers aged from 60 years to 76 years were assigned to a group (n = 15) engaging in vestibular-stimulating exercises, or to a control group (n = 13) engaging in traditional training exercises. Training sessions (∼45 minutes each) occurred twice a week over the course of 3 months. The following parameters were analyzed before and after training for both groups: stabilogram ellipse area and radii, total length of stabilogram, and visual-inspection indicator (eyes open).

Results

Results in terms of stabilogram ellipse area and radius without visual control (eyes closed) revealed statistically significant differences in the experimental group between the values before and after the training regimen (74.8 ± 51.6 - 54.5 ± 42.5 for area of ellipse, 6.6 ± 2.8 - 5.8 ± 2.8 for axis minor, 13.2 ± 4.3 - 11.1 ± 3.3 for axis major, respectively). No significant changes were observed in the control group.

Conclusion

Exercises stimulating the vestibular organ, such as those described herein, should be a part of efforts to improve balance in older people.

The Effects of Eight-Month Physical Activity Intervention on Vigilance Performance in Adult Obese Population

We aim to analyze the effects of an 8-month physical activity intervention on cardiorespiratory fitness, body mass index (BMI), and vigilance performance in an adult obese population. We conducted an 8-month physical activity intervention based on dance and rhythmic activities. The weekly frequency was 2 sessions of 1 hr per day. Training sessions were divided into 3 phases: a 10-min warm-up, 40 min of dance and rhythmic activities, and 10 min to cool-down. To assess cardiorespiratory fitness, participants performed a modified version of the 6-min walk test from the Senior Fitness Test battery (Larsson & Mattsson, 2001; Rikli & Jones, 1999). Vigilance performance was measured by means of the psychomotor vigilance task (PVT). Two measurements were performed immediately before and after the intervention. The results revealed that participants improved their cardiorespiratory fitness, BMI, and vigilance performance after the intervention. All in all, findings contribute new empirical evidence to the field that investigates the benefits of physical activity intervention on cognitive processes in obese population.