Physical Benefits of Dancing for Healthy Older Adults: A Review

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.

Ballroom Dance: Linking Serious Leisure to Successful Aging

OBJECTIVE

This study explored ballroom dance as serious leisure and successful aging in a sample of community-dwelling older adults.

METHODS

Qualitative procedures were used to explore stories of ballroom dance and successful aging.

RESULTS

Participants described positive successful aging and active leisure engagement. Three themes emerged from thematic analyses: (a) Ballroom Dance as Serious Leisure: Its Dimensions; (b) Ballroom Dance: Its Link to Successful Aging; (c) The Affinity: We Love to Dance!.

CONCLUSION

The participants' ballroom dance revealed serious leisure characteristics in conjunction with their successful aging. They loved to dance, self-identified as ballroom dancers, and orchestrated their dance activities within its social world. Future research should examine the relation of successful aging to the social world of ballroom dance.

Motor-cognitive dual-task training improves local dynamic stability of normal walking in older individuals

BACKGROUND

Extreme levels of gait variability and local dynamic stability of walking are associated with risk of falling and reduced executive functions. However, it is not sufficiently investigated how gait variability and local dynamic stability of human walking develop in the course of a motor-cognitive intervention. As dancing implies high demands on (and therewith trains) executive functioning and motor control, it might increase local dynamic stability or reduce gait variability.

METHODS

32 older healthy participants were randomly assigned to either a health-related exercise group (age: mean=68.33 years, standard deviation=3.17 years; BMI: mean=27.46, standard deviation=2.94; female/male: 10/6) or a dancing group (age: mean=66.73 years, standard deviation=3.33 years; BMI: mean=26.02, standard deviation=3.55; female/male: 11/5). Based on angular velocity data of trunk kinematics, local dynamic stability and stride-to-stride variability in level overground walking were assessed prior to and after the specific intervention. The data were analysed by a blinded observer using two-way repeated measures ANOVAs. Based on one-way ANOVAs, time and group effects were determined.

FINDINGS

Regarding the variability of trunk movements, no interaction effect was observed (F 1,30=0.506, P=.482; η2=0.017). For local dynamic stability of trunk movements, an interaction effect in favour of the dancing group was observed (F 1,30=5,436; P=.026; η2=0.146).

INTERPRETATION

Our data indicate that a dancing programme (which combines cognitive and motor efforts) might increase local dynamic stability in older people.

Health benefits of cycle ergometer training for older adults over 70: a review

As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original observational and intervention studies on the relationship between cycle ergometer training and health among older patients over 70. Twenty-five studies examined interventions aimed specifically at promoting cycling for older adults over 70. These studies reported a positive effect on the prevention of cardiovascular disease, and a significant improvement in metabolic responses. Improving functional status, muscle strength and cognitive performance are also well established. Overall, this review demonstrates a positive effect of cycle ergometer training with functional benefits and positive health outcomes for older adults over 70. Based on this evidence, clinicians can now encourage older adults to profit from the health benefits of cycle ergometer training to be able to pursue their daily activities independently.

Psychophysiological responses to Salsa dance

Speculation exists whether dance provides physiological stimuli adequate to promote health and fitness benefits. Unfortunately, research to date has not addressed the affective and exertional responses to dance. These responses are of interest as positive affective and exertional responses experienced during physical activity may play an important role in predicting adherence. The present study aims to examine the psychophysiological responses of different Salsa dance styles. Ten pairs of dancers performed two different structured lessons of Salsa dance, including Typical Salsa and Rueda de Casino lessons, and a non-structured Salsa dance at a night club. Physiological responses (i.e., percent of heart rate reserve; %HRR) were continuously assessed and perceived exertion and affective valence were rated every 15 min throughout the trials. %HRR responses differed between the Salsa dance styles (%HRR from 41.3 to 51.9%), and participants were dancing at intensities near their ventilatory threshold. Specifically, Typical Salsa lesson elicited lower %HRR responses than Rueda de Casino lesson (p < 0.05), but similar %HRR responses to Salsa dance at a night club condition (p > 0.05). Surprisingly, exertional (from 8 to 11) and affective (from +3 to +5) responses were unaffected by Salsa dance styles (p > 0.05). These data support that different Salsa dance styles provide physiological stimuli adequate to promote health and fitness benefits, and perhaps more importantly, produce pleasurable experiences, which in turn might lead to an increase in adherence to Salsa dancing which likely provides exercise-like health benefits.

Feasibility of delivering a dance intervention for subacute stroke in a rehabilitation hospital setting

Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual's needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery.

Effects of dance on upper extremity activities in underserved adults

PURPOSE

This secondary analysis examined the immediate and maintaining effects of a 12-week line-dancing intervention on upper and lower extremity activities in underserved adults who receive care from a nurse-managed clinic (NMC).

DATA SOURCES

This one-group, repeated measures, feasibility study consisted of 40 participants recruited from an urban apartment complex that housed a NMC. Of the 40 participants, 21 participants completed the 12-week line-dancing intervention. Physical function of the upper and lower extremities was measured with the Late Life Function and Disability Instrument at baseline, 12, and 18 weeks to determine the maintaining effects.

CONCLUSIONS

Age ranged from 45 to 87 years (M = 63; SD = 7.8), body mass index (BMI) was 33.4 (SD = 7.8), 92% were female, and 75% were African American. At baseline, participants showed limitations in all aspects of physical function. Significant improvements in upper and lower extremity activities were noted at 12 weeks and maintained at 18 weeks.

IMPLICATIONS FOR PRACTICE

Although line-dancing mainly involves the lower body, there were significant improvements in upper extremity activities at 12 weeks, which were maintained at 18 weeks. The maintaining effects support line-dancing as an intervention to improve upper and lower extremity activities needed for independent living. NMCs are important settings for health promotion interventions in underserved adults.

A comparison of dance interventions in people with Parkinson disease and older adults

It is important for our aging population to remain active, particularly those with chronic diseases, like Parkinson disease (PD), which limit mobility. Recent studies in older adults and people with PD suggest dance interventions provide various motor benefits. The literature for dance in PD is growing, but many knowledge gaps remain, relative to what is known in older adults. The purpose of this review is to: (1) detail results of dance intervention studies in older adults and in PD, (2) describe limitations of dance research in these populations, and (3) identify directions for future study. Generally, a wide variety of dance styles have been investigated in older adults, while a more limited subset has been evaluated in PD. Measures vary widely across studies and a lack of standardized outcomes measures hinders cross-studies comparisons. Compared to the dance literature in older adults, there is a notable absence of evidence in the PD literature in outcome domains related to cardiovascular health, muscle strength, body composition, flexibility, and proprioception. As a whole, the dance literature supports substantial and wide-ranging benefits in both populations, but additional effort should be dedicated to well-designed comparative studies using standardized outcome measures to identify optimal treatment programs.

New framework for rehabilitation - fusion of cognitive and physical rehabilitation: the hope for dancing

Neurorehabilitation programs are commonly employed with the goal to help restore functionality in patients. However, many of these therapies report only having a small impact. In response to the need for more effective and innovative approaches, rehabilitative methods that take advantage of the neuroplastic properties of the brain have been used to aid with both physical and cognitive impairments. Following this path of reasoning, there has been a particular interest in the use of physical exercise as well as musical related activities. Although such therapies demonstrate potential, they also have limitations that may affect their use, calling for further exploration. Here, we propose dance as a potential parallel to physical and music therapies. Dance may be able to aid with both physical and cognitive impairments, particularly due to it combined nature of including both physical and cognitive stimulation. Not only does it incorporate physical and motor skill related activities, but it can also engage various cognitive functions such as perception, emotion, and memory, all while done in an enriched environment. Other more practical benefits, such as promoting adherence due to being enjoyable, are also discussed, along with the current literature on the application of dance as an intervention tool, as well as future directions required to evaluate the potential of dance as an alternative therapy in neurorehabilitation.

Participatory arts for older adults: a review of benefits and challenges

This article reviews the scientific literature on the enhancement of healthy aging in older adults through active participation in the arts. Methodologies and conclusions are described for studies of dance, expressive writing, music (singing and instrumental), theatre arts, and visual arts including documentation of mental/physical improvements in memory, creativity, problem solving, everyday competence, reaction time, balance/gait, and quality of life. In addition to these gains in measures of successful aging, the article also provides (in a Supplementary Appendix) some selected examples of arts engagement for remedial purposes. Finally, it offers suggestions for expanding inquiry into this underinvestigated corner of aging research.

Implementing a novel dance intervention in rehabilitation: perceived barriers and facilitators

PURPOSE

To identify clinicians' perceptions regarding the facilitators and barriers to the use of dance in rehabilitation.

METHODS

This study used a qualitative descriptive design. Three focus groups were conducted with clinicians across three purposively selected rehabilitation centers. Data were analyzed using thematic content analysis.

RESULTS

Fourteen allied health-care professionals (six occupational therapists, six physical therapists, and two social workers) with previous dance experience participated in this study. Four main themes emerged from the analysis representing the personal and organizational factors influencing on the implementation of dance interventions: (1) Clinician's dance experience and training, (2) Interest and personal beliefs towards using dance as a potential intervention, (3) Support from the organization of the institution, and (4) Available resources. Although each site was different, the main factors acting as barriers and facilitators were similar for all three sites.

CONCLUSION

The identification of the barriers and facilitators to implementing dance in rehabilitation is the first step to support the translation of knowledge about dance. A tailored approach designed for clinicians and managers should address the main barriers to knowledge use about dance, as a potential rehabilitation modality for individuals with disabilities.

IMPLICATIONS FOR REHABILITATION

Personal and organizational factors can act simultaneously as barriers and facilitators to the implementation of a dance intervention. Lack of time for professional development and lack of support from the organization are the main barriers to the uptake of knowledge about dance in rehabilitation. A knowledge translation strategy addressing the barriers to knowledge use is helpful for clinicians and managers facilitating the implementation of dance in rehabilitation settings.

BAILAMOS: Development, Pilot Testing, and Future Directions of a Latin Dance Program for Older Latinos

Older Latinos have low rates of physical activity (PA) and poor health outcomes. Focus groups and a single group, pre-post 3-month pilot of a culturally appropriate Latin dance program (BAILAMOS) were conducted among older, inactive Latinos with a self-identified mobility limitation. Nine themes emerged from focus groups, including cultural influences of dance and barriers to dancing. In the pilot intervention, 9 of 13 older Latinos completed the program and attended 85% of the sessions. Self-reported PA significantly increased (p < .05; d = 1.39), but daily accelerometer-assessed PA decreased for moderate-intensity PA (p = .18; d = 0.29). Participants reported significantly greater enjoyment of PA (p < .05; d = 0.61) and improved physical quality of life (p = .23; d = 0.31). Improvements in mobility (p = .15; d = 0.56) and aspects of cognition were demonstrated. The BAILAMOS program appears to be feasible, culturally appropriate, and has the potential to improve psychosocial determinants of PA, self-reported PA, and aspects of health.

B.A.I.L.A. - a Latin dance randomized controlled trial for older Spanish-speaking Latinos: rationale, design, and methods

BACKGROUND

Physical activity (PA) has documented health benefits, but older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance holds a promise as a culturally appropriate form of PA that challenges individuals physically and cognitively. This paper describes a randomized controlled trial that will test the efficacy of BAILAMOS, a 4-month Latin dance program followed by a 4-month maintenance program, for improving lifestyle PA and health outcomes.

METHODS

Older adults (n=332), aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels, and at risk for disability will be randomized to one of two programs, a dance program or health education control group. BAILAMOS is a 4-month program that meets two times per week for one 1h per session. Dance sessions focus on instruction, including four styles of dance, and couples dancing. Bi-monthly Fiestas de Baile (dance parties) are also included, in which participants dance and practice what they have learned. Monthly 1-hour discussion sessions utilize a Social Cognitive framework and focus on knowledge, social support, and self-efficacy to increase lifestyle PA. The health education control group will meet one time per week for two 2h per session.

OUTCOMES

Primary outcomes including PA changes and secondary outcomes including self-efficacy, physical function, cognitive function, and disability will be assessed at baseline, 4, and 8 months. It is hypothesized that PA, self-efficacy, physical function, cognitive function, and functional limitations and disability scores will be significantly better in the BAILAMOS group at 4 and 8 months compared to the control group.

Does dance-based therapy increase gait speed in older adults with chronic lower extremity pain: a feasibility study

A decreased gait speed in older adults can lead to dependency when the individuals are no longer able to participate in activities or do things for themselves. Thirty-seven senior apartment residents (31 females; Mean age=80.6 years; SD=8.9) with lower extremity pain/stiffness participated in a feasibility and preliminary efficacy study of 12 weeks (24 sessions). Healthy-Steps dance therapy compared to a wait-list control group. Small improvements in gait speed ([ES]=0.33) were noted for participants completing 19-24 dance sessions. Improvements in gait speed measured by a 10 Meter Walk Test (0.0517 m/s) exceeded 0.05 m/s, a value deemed to be meaningful in community dwelling older adults. These feasibility study findings support the need for additional research using dance-based therapy for older adults with lower extremity pain.

Chronic inflammation and neutrophil activation as possible causes of joint diseases in ballet dancers

Herein, we investigated the effects of a ballet class on the kinetic profiles of creatine kinase (CK) and lactate dehydrogenase (LDH) activities, cytokines, complement component 3 (C3), and the concentrations of immunoglobulin (Ig), IgA and IgM, in ballerinas. We also verified neutrophil death and ROS release. Blood samples were taken from 13 dancers before, immediately after, and 18 hours after a ballet class. The ballet class increased the plasma activities of CK-total (2.0-fold) immediately after class, while the activities of CK-cardiac muscle (1.0-fold) and LDH (3.0-fold) were observed to increase 18 hours after the class. Levels of the TNF-α, IL-1β, IgG, and IgA were not affected under the study conditions. The exercise was found to induce neutrophil apoptosis (6.0-fold) 18 hours after the ballet class. Additionally, immediately after the ballet class, the neutrophils from the ballerinas were found to be less responsive to PMA stimulus. Conclusion. Ballet class was found to result in inflammation in dancers. The inflammation caused by the ballet class remained for 18 hours after the exercise. These findings are important in preventing the development of chronic lesions that are commonly observed in dancers, such as those with arthritis and synovitis.

Scottish Country Dance: Benefits to Functional Ability in Older Women

The effects of long-term participation in Scottish country dance on body composition, functional ability, and balance in healthy older females were examined. Participants were grouped into dancers and physically active nondancers (ages 60–70 and 70–80 for both groups). Physical activity, body composition (body-mass index, skinfold thickness, waist-to-hip ratio), functional ability (6-min walk distance, 6-m walk time, 8-ft up-and-go time, lower body flexibility, shoulder flexibility), and static balance were measured. Younger dancers and physically active nondancers had similar 6-min walk distance, 6-m walk time, and 8-ft up-and-go time results; however, while older dancers performed similarly to younger dancers, older physically active nondancers performed poorer than their younger counterparts (p< .05). Body composition and static balance were the same for all groups. Regular physical activity can maintain body composition and postural stability with advancing age; however, Scottish country dance can delay the effects of aging on locomotion-related functional abilities.

An isokinetic training program for reducing falls in a community-dwelling older adult: a case report

BACKGROUND

With the population older than 65 years, projected to double by the year 2030, falls in older adults are a substantial health concern. Muscle strength deficits are one of the multifactorial components linked to increased fall risk, and decreasing these deficits has been one of the goals of interventions designed to decrease fall risk. These interventions have traditionally focused on improving peak torque; however, recent research suggests that exercise protocols that focus on the rate of torque development (RTD) may be more effective in decreasing fall risk.

PURPOSE

This case report examines clinical outcomes following implementation of an isokinetic strengthening protocol coupled with a balance program designed to reduce fall risk in a community-dwelling older adult.

METHODS

The individual was a 70-year-old woman with a history of 3 falls over the past 8 months and no related medical etiology who had self-limited her activities because of fear of another fall. She was classified as having substantial risk for future falls because of fall history, increased fear of falling, and below age norms on the Berg Balance Scale (BBS), and the Timed Up and Go (TUG). The treatment program consisted of 12 weeks of high-intensity isokinetic knee extensor training, high challenge dynamic gait and balance activities, and core strengthening. The isokinetic protocol consisted of 4 sets of 10 concentric-only repetitions at speeds of 240°/sec and 300°/sec for a total of 8 work sets. Dynamic gait activities incorporating directional and obstacle drills, and rocker and balance boards were used for balance training activities. Progressive theraband exercises were used for core strengthening. As her home program, the participant was encouraged to return to line dancing twice per week. During the 12-week protocol, the participant completed two 90-minute therapy sessions and two 90-minute dance classes per week.

RESULTS

After the 12 weeks of treatment, knee extensor peak torque at 150 ms improved on the right from 67.8 N to 107.1 N (57.9% increase), and on the left from 65.1 N to 97.6 N (49.9% increase). The BBS score improved from 45 to 52; and the TUG improved from 14.0 to 8.6 seconds. Both final scores exceeded fall risk cutoffs (BBS = 48; TUG = 13.5 seconds) and the change score exceeded minimal detectable change (BBS = 7; TUG 5.4 seconds).

CONCLUSIONS

The treatment program produced improvements in knee extensor peak torque and RTD, but more importantly, the final scores on the clinical outcome measures placed the participant above established fall-risk cutoff scores. Although future research with increased numbers of participants and a control group should be conducted to confirm this study's results, these findings support the use of isokinetic training to reduce fall risk in older adults.

Experiência subjetiva de idosas durante exercício em ambiente virtual

Os objetivos desse estudo quali-quantitativo foram verificar as experiências subjetivas relacionadas ao exercício em idosas antes e depois da realização de atividade física em ambientes real e virtual, bem como a preferência pelo ambiente. A amostra foi composta por 20 idosas (71,1±6,5 anos) que executaram sessões de dança nos dois ambientes e responderam ao instrumento Subjective Exercise Experiences Scale (SEES) antes e depois da prática. Na situação virtual foi utilizado o jogo Just Dance I do console Wii® da Nintendo. Na situação real, cada participante reproduziu os mesmos movimentos demonstrados pela pesquisadora. Para a análise dos dados da SEES foram utilizados os testes Wilcoxon e Mann-Whitney (p<0,05). Houve redução significativa na pontuação da subescala distress psicológico da SEES após ambas as situações experimentais e aumento no bem-estar positivo apenas em ambiente virtual. A maioria das idosas escolheu o ambiente real como o preferido.

Dancing as a psychosocial intervention in care homes: a systematic review of the literature

BACKGROUND

There is a need to find meaningful and engaging interventions to improve mood and behaviour for residents of care homes. The demand on care staff might diminish opportunities for them to encourage these activities. Staff anecdotal information attests that dancing as an activity improves mood in residents and staff. Hence, the importance of investigating what dancing brings to the care home social environment.

AIMS

To provide a systematic review of the evidence from studies related to dancing interventions for older people with dementia living in care homes.

METHOD

Electronic databases were searched. Previous reviews were also included, and recognised experts were consulted up to January 2012. Inclusion criteria considered study methodology and evidence that the impact of the dance intervention had been measured.

RESULTS

Ten studies were identified that satisfied the inclusion criteria: seven qualitative and three quantitative. Studies used different approaches such as therapeutic dance, dance movement therapy, dance therapy, social dancing and psychomotor dance-based exercise. There was evidence that problematic behaviours decreased; social interaction and enjoyment in both residents and care staff improved. A few adverse effects were also acknowledged.

CONCLUSION

The evidence on the efficacy of dancing in care homes is limited in part owing to the methodological challenges facing such research. This review aims to raise awareness of the possibility of implementing dance work as an engaging activity in care homes. We shall also consider options for future dance work research as a means to encourage relationships and sensory stimulation for both residents and staff.

Physical performance in recently aged adults after 6 weeks traditional Thai dance: a randomized controlled trial

Background

Exercise has been shown to be effective in cardiovascular endurance in the elderly. We studied the effect of Thai dancing on physical performance of Thai elderly.

Methods

This was an open-labeled, randomized intervention study. The Thai dancing group exercised for 40 minutes three times a week for 6 weeks. Physical performance ability was the primary outcome, including a 6-minute walk test (6MWT), five-times sit-to-stand (FTSST), and a sit-and-reach test measured before and after 6 weeks of intervention.

Results

There were 42 subjects enrolled in the study, and 38 female subjects completed (20 in Thai dance group, 18 controls), with an average age of 65.8 ± 5.1 years. The Thai dance group had significantly better physical performance in all measurements at the end of the study. The 6MWT was longer (416.7 ± 58.7 versus 345.7 ± 55.1 m; P = 0.011), FTSST was quicker (10.2 ± 1.5 versus 14.4 ± 3.3 seconds; P < 0.001), and flexibility was higher (14.9 ± 3.5 versus 11.1 ± 5.7 cm; P = 0.002) in the Thai dance group than the control group.

Conclusion

Thai dance can improve physical performance in recently aged (elderly) female adults.

The embodied and relational nature of the mind: implications for clinical interventions in aging individuals and populations

Considerable research over the past decade has garnered support for the notion that the mind is both embodied and relational. Jointly, these terms imply that the brain, physical attributes of the self, and features of our interpersonal relationships and of the environments in which we live jointly regulate energy and information flow; they codetermine how we think, feel, and behave both individually and collectively. In addition to direct experience, evidence supports the view that stimuli embedded within past memories trigger multimodal simulations throughout the body and brain to literally recreate lived experience. In this paper, we review empirical support for the concept of an embodied and relational mind and then reflect on the implications of this perspective for clinical interventions in aging individuals and populations. Data suggest that environmental influences literally “get under the skin” with aging; that musculoskeletal and visceral sensations become more prominent in activities of the mind due to aging biological systems and chronic disease. We argue that conceiving the mind as embodied and relational will grow scientific inquiry in aging, transform how we think about the self-system and well-being, and lead us to rethink health promotion interventions aimed at aging individuals and populations.

Can social dancing prevent falls in older adults? a protocol of the Dance, Aging, Cognition, Economics (DAnCE) fall prevention randomised controlled trial

BACKGROUND

Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the 'holistic' approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people.

METHODS/DESIGN

A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed.

DISCUSSION

This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing diversity in exercise programs targeting seniors recognises the heterogeneity of multicultural populations and may further increase the number of taking part in exercise.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12612000889853The trial is now in progress with 12 villages already have been randomised.

Tango programme for individuals with age-related macular degeneration

Recent research shows that tango dance is an absorbing and effective strategy to reduce levels of depression, while also increasing well-being. This study investigates the feasibility, acceptability, and adherence to a tango programme for individuals with age-related macular degeneration (ARMD). Depression is closely intertwined with the ARMD diagnosis, since the loss of central vision has a profoundly negative impact on the person’s quality of life. Seventeen participants were randomised to tango dance (1.5 h, 2 times/week for 4 weeks) or wait-list control condition. Demographic questions and Visual Function Questionnaire were taken at pre-test. Self-rated symptoms of depression, self-esteem, and satisfaction-with-life were assessed at pre-test and post-test. Tango group participants showed significant reductions in depression and significantly increased satisfaction-with-life and self-esteem at post-test relative to the controls, and reported physical improvement, including increased balance. Tango dance was demonstrated to be a feasible and positive activity for this population.

Capacidade funcional submáxima e força muscular respiratória entre idosas praticantes de hidroginástica e dança: um estudo comparativo

O exercício físico é uma estratégia eficaz para prevenir e retardar as perdas funcionais do envelhecimento, mas há poucos estudos indicando qual a melhor modalidade para incrementar o status funcional do idoso. OBJETIVO: Comparar a força muscular respiratória (FMR) e a capacidade funcional submáxima de idosas praticantes de hidroginástica e dança. MATERIAL e MÉTODOS: Estudo transversal com idosas do sexo feminino (n=46), praticantes de hidroginástica (Grupo Hidroginástica - GH; n=23) e dança (Grupo Dança - GD; n=23). Para medida da prática de atividade física, foi utilizado o International Physical Activit Questionnarie (IPAQ-versão curta); a FMR foi avaliada por meio da pressão inspiratória máxima (PImax) e da pressão expiratória máxima (PEmax), e a medida da capacidade funcional submáxima, realizada pelo Teste da Caminhada dos Seis Minutos (TC6m). RESULTADOS: O GD apresentou maior PImax (84 ± 12,49 cmH2O) quando comparado ao GH (63,35 ± 10,47 cmH2O) (p< 0,0001), e a PEmax não variou significativamente entre os grupos (p= 0,08). Quanto à distância percorrida no TC6m, o GD (616,53 ± 60,81 m) obteve melhor desempenho que o GH (446,65 ± 48,67 m) (p< 0,0001). Quanto ao nível de atividade física, o GD apresentou 19 idosas (82,61%) muito ativas e quatro (17,39%) ativas, e o GH apresentou oito idosas (30,76%) muito ativas e 15 (69,23%) ativas. CONCLUSÃO: As idosas praticantes de dança evidenciaram maior força muscular inspiratória e capacidade funcional submáxima, possivelmente devido ao maior nível de atividade física e também pelo fato de a dança ser uma modalidade essencialmente aeróbia.

Prevalence and correlates of participation in fall prevention exercise/physical activity by older adults

OBJECTIVE

To examine older people's participation in fall prevention exercise/physical activities.

METHODS

Participants comprised 5,681 randomly selected older people (≥ 65 years) who took part in the 2009 New South Wales (Australia) Fall Prevention telephone survey (61% response-rate). The instrument consisted of 11 prompted activities including two separate questions on participation in strength and balance training. Tai chi, dance, team sports, golf, bowls and specific balance training were classified as balance-challenging activities. Correlates of low participation were examined using multivariable logistic regression.

RESULTS

One in eight older people (12.0%, 95% CI: 11.0-13.0) participated in strength training, 6.0% (95% CI: 5.2-6.7) participated in balance training and 21.8% (95% CI: 20.5-23.0) participated in balance-challenging activities. Adherence to public health recommendations (≥ 2 days/week) for strength or balance-challenging activities was reported by 21.0% (95% CI: 9.8-22.2) with 5.3% adhering to both forms. Engagements in strength or in balance-challenging activities were lower among those who had low education (<high-school), lived in disadvantaged neighbourhoods, were obese, had fair/poor self-rated health, had problems with walking or used a walking aid or had fallen in the past year.

CONCLUSION

Participation in best practice exercise to prevent falls is low. Population-based approaches and targeted strategies for high-risk group are needed.

Argentine tango dance compared to mindfulness meditation and a waiting-list control: a randomised trial for treating depression

OBJECTIVES

To determine whether tango dancing is as effective as mindfulness meditation in reducing symptoms of psychological stress, anxiety and depression, and in promoting well-being.

DESIGN

This study employed analysis of covariance (ANCOVA) and multiple regression analysis.

PARTICIPANTS

Ninety-seven people with self-declared depression were randomised into tango dance or mindfulness meditation classes, or to control/waiting-list.

SETTING

classes were conducted in a venue suitable for both activities in the metropolitan area of Sydney, Australia.

INTERVENTIONS

Participants completed six-week programmes (1½h/week of tango or meditation). The outcome measures were assessed at pre-test and post-test.

MAIN OUTCOME MEASURES

Depression, Anxiety and Stress Scale; The Self Esteem Scale; Satisfaction with Life Scale, and Mindful Attention Awareness Scale.

RESULTS

Sixty-six participants completed the program and were included in the statistical analysis. Depression levels were significantly reduced in the tango (effect size d=0.50, p=.010), and meditation groups (effect size d=0.54, p=.025), relative to waiting-list controls. Stress levels were significantly reduced only in the tango group (effect size d=0.45, p=.022). Attending tango classes was a significant predictor for the increased levels of mindfulness R(2)=.10, adjusted R(2)=.07, F (2,59)=3.42, p=.039.

CONCLUSION

Mindfulness-meditation and tango dance could be effective complementary adjuncts for the treatment of depression and/or inclusion in stress management programmes. Subsequent trials are called to explore the therapeutic mechanisms involved.

How diverse was the leisure time physical activity of older Australians over the past decade?

OBJECTIVES

Public health recommendations for older adults highlight the need to engage in a combination of aerobic, muscle strength, flexibility and balance activities. This study characterised leisure time physical activity in older Australians (≥ 65 years), examining the diversity in reported activities

DESIGN

Cross-sectional monitoring.

METHODS

The Exercise Recreation and Sport Surveys (2001-2009) were combined and analysed for 22,050 elderly.

RESULTS

Walking was reported by 45.6%, of those 53% engaged exclusively in walking. Prevalent sports (i.e., >1%) were bowls (9.4%), aerobics/callisthenics exercise (9.1%), golf (7.7%), swimming (6.4%), gym work (5.2%), cycling (3.2%), tennis (2.9%), dancing (2.1%), fishing (2.0%), tai chi (1.4%), weight lifting (1.2%) and yoga (1.1%). Significant gender differences were apparent. Over time, significant increases were reported in walking, aerobic/callisthenics and gym workout in both genders. In the previous year, 32.0% of older adults participated in "nil" activity, 40.6% engaged in one activity, 19.5% and 8.0% participated in two or three or more activities, respectively. Common combinations were walking with another aerobic activity. Only 2.6% reported a combination of aerobic, balance and strength activities. Multiple-activity participation increased over the years, but declined with increasing age, education and for the most disadvantaged, compared to single-activity participation. Partially or exclusively organised participation, combined, was reported by 42.5% of older adults. Women were more likely to combine mode of participation. Geographic region was associated with multiple-activity participation and organised-only participation.

CONCLUSIONS

Most elderly people engage in one activity, if at all. An increase in participation in balance enhancing activities and weight training is warranted to maximize health benefits.

Exploring the effects of dance-based therapy on balance and mobility in older adults

Balance and mobility are a common concern among older adults. This pilot randomized controlled study examines the effect of dance-based therapy to increase balance and mobility in 27 participants with mean age 85 years (±7.5) from a single aging-in-place facility in the Midwest. Multidirectional reach, velocity, step length differential, and a Functional Ambulation Profile were measured before and after 18 sessions of low-impact dance-based therapy. Although a Wilcoxon rank sum test showed no significance, effect size analyses suggest that dance-based therapy was mildly or moderately effective in several components of balance and mobility. Additional research is needed with a full-scale trial.

Exercise prescription after fragility fracture in older adults: a scoping review

The purpose of this study is to identify and chart research literature on safety, efficacy, or effectiveness of exercise prescription following fracture in older adults. We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥45 years with any fracture. "Exercise prescription" included post-fracture therapeutic exercise, physical activity, or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies, and observational studies. Trained reviewers independently evaluated citations for inclusion. A total of 9,415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 "other" designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters, and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture.