Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions

Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework

Background

Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.

Objective

To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.

Methods

Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).

Results

High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.

Conclusions

Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.

Findings from a pragmatic cluster randomised controlled feasibility trial of a music and dance programme for community dwelling older adults

INTRODUCTION

Functional decline, chronic illness, reduced quality of life and increased healthcare utilisation are common in older adults. Evidence suggests music and dance can support healthy ageing in older adults. This study explored the feasibility, potential for effect and cost effectiveness of the Music and Movement for Health (MMH) programme among community-dwelling older adults using a pragmatic cluster-randomised, controlled feasibility trial design.

METHODS

Community-dwelling adults aged 65 years or older were recruited to seven clusters in the Mid-West region of Ireland. Clusters were block randomised to either the MMH intervention or control. Primary feasibility outcomes included recruitment, retention, adherence, fidelity, and safety. Secondary outcomes measured physical activity, physical and cognitive performance, and psychosocial well-being, along with healthcare utilisation were assessed at baseline and after 12 weeks.

RESULTS

The study successfully met feasibility targets, with recruitment (n = 100), retention (91 %), adherence (71 %), data completeness (92 %) and intervention fidelity (21 out of 24) all meeting predetermined criteria. Both groups exhibited an increase in self-reported physical activity and improved physical function. Participants in the intervention group scored consistently better in psychosocial measures compared to the control group at follow-up. The health economic analysis confirmed the feasibility of the methodology employed and points to the potential cost-effectiveness of the MMH relative to the control or no organised programme.

DISCUSSION AND IMPLICATIONS

The MMH intervention and study design were found to be feasible and acceptable with important findings to inform future evaluation of the clinical and cost-effectiveness of a definitive randomised controlled trial.

The effect of dance workshops participation on reaction time in persons with moderate intellectual disabilities - pilot study

Background: Persons with intellectual disabilities who are physically active have faster reaction time compared to the physically inactive persons with intellectual disabilities (Yildirim et al. 2010). Aim: To recognize how participation in a series of hip-hop dance workshops can improve reaction time in persons with intellectual disabilities. Methods: 13 persons with moderate intellectual disabilities aged 14-22 (M = 17,30; SD = 2,52). A quasi-experiment was prepared using a single-group plan (nine dance workshops). Study design applied: pre-test - post-test. Measurement Tool - Optogait - acoustic response test. Results: Reaction time measured prior to dance workshops was M = 1,58; SD = 0,48 and after workshops was M = 1,34; SD = 0,69. The analysis using Wilcoxon signed-ranks test showed that this difference is statistically significant, Z = 2,06; p < .05. Conclusions: Hip-hop dance classes improve response times in persons with moderate intellectual disabilities.

Toward Development of a Novel Proprioceptive Trail-Making Test: Comparing Healthy Dancers and Non-Dancers

There is a pressing need for ecologically valid versions of traditional neuropsychological tests indexing executive function (EF), such as the Trail-Making Task (TMT), that incorporate movement and bodily awareness in healthy participants with varying abilities. We designed a proprioceptive version of the TMT (pTMT) that involved coordinated gross motor movement and proprioceptive awareness to investigate whether this measure of visual attention, task switching, and working memory positively correlated with a computerized version of the TMT (the dTMT). We aimed to establish the initial validity of our proprioceptive TMT (pTMT) by comparing performances on the dTMT and pTMT among a cohort of 36 healthy participants (18 dancers, 18 non-dancers; M age = 22, SD = 5.27; 64% female) anticipating that dancers would express higher intrinsic bodily awareness than non-dancers. Results revealed a mild to moderate but statistically significant positive correlation between dTMT and pTMT completion times [part A: r (36) = .33, p = .04; part B: r (36) = .37, p = .03] and numbers of errors [part B: r (36) = .41, p = .01] across both participant groups. These data suggest partial measurement convergence between these two TMT versions. Relative to non-dancers, dancers exhibited a higher level of performance (likely due to their better proprioceptive ability) through their faster completion times on dTMT-B [t (34) = 3.81, p = .006, d = 1.27] and pTMT-B [t (34) = 2.97, p = .005, d = .99], and their fewer errors on dTMT-B [t (34) = 2.93, p = .006, d = 1.0]. By identifying cognitive differences between these different groups of healthy individuals, our data contribute to both a theoretical understanding and the initial development of gross motor movement-based cognitive assessments, providing a path toward the further refinement of an ecologically valid full-body TMT.

Effect of a juggling-based physical activity on postural stability, reaction time, and attention focus in older adults: a randomized crossover study

BACKGROUND

In the aging society, more attention is paid to the promotion of forms of physical activity that can improve postural stability and cognitive functioning. In this context, the importance of combined exercises, requiring simultaneous physical and cognitive involvement, is emphasized. Juggling seems to be a form of activity that is both cognitively and physically demanding. The purpose of this study was to determine the effect of additional juggling exercise on postural stability and cognitive abilities in healthy, physically active older adults.

METHODS

Twenty-six healthy and physically active older adults (70.08±4.40 years old) were included in a randomized crossover study. The addition of juggling three times a week during four weeks was the main intervention (one period), while the control phase included four weeks with no addition of juggling (second period). Measurements of postural stability and cognitive abilities were performed before and after each period. For the purpose of postural stability assessment, a velocity of center of pressure with root mean square, area 95 percentile, medio-lateral and anterior-posterior range of motion were measured. Center of pressure signals were obtained using an AccuGait™ System force plate in three conditions: free standing, dual-task and limits of stability. The Vienna Test System was used for the assessment of selected cognitive abilities. A battery of reaction time tests and Cognitrone test were used for this purpose.

RESULTS

A significant interaction effect of intervention and time was observed in the postural stability dual-task condition in the root mean square of the center of pressure velocity in the advantage of the juggling period (medio-lateral: F=14.83, p<.01, ƞp2=.37; anterior-posterior: F=26.30, p<.01, ƞp2=.51). Additionally, moderate effect sizes were observed in the velocity of the center of pressure and variability of simple reaction time measurements, but without statistical significance.

CONCLUSIONS

The results of this study indicate that the implementation of juggling activity in everyday life may have positive effects on cognitive abilities and postural stability in healthy, physically active older adults, but the true effect may be low to moderate.

TRIAL REGISTRATION

The study was registered retrospectively (30.10.2023) at ClinicalTrials.gov (NCT06108713).

The Impact of Aerobic Dance Intervention on Postural Balance in Children: A Randomized Controlled Trial

This study aimed to investigate the impact of an 8-week aerobic dance intervention on postural balance in children. Forty-one children, aged 9 to 11, were randomly assigned to either an aerobic dance group (ADG) or a control group (CG) from a primary school. Postural balance was assessed using center of pressure (CoP) excursions before and after the 8-week intervention period. Evaluations were conducted on both firm and foam surfaces in bipedal and unipedal stances under open-eyes (OE) and closed-eyes (CE) conditions, as well as on both medial-lateral (ML) and anterior-posterior (AP) surfaces in a bipedal stance under OE conditions. The ADG exhibited significantly decreased CoPVm values during firm bipedal CE, unipedal OE, foam bipedal OE and CE, and foam unipedal OE (p < 0.005). This study suggests that aerobic dance intervention improved postural balance in children, showcasing adaptability and improved stability under various conditions.

The effects of dance interventions on physical function and quality of life among middle-aged and older adults: A systematic review

BACKGROUND

Fundamental physical functions such as postural control and balance are vital in preserving everyday life, affecting an individual's quality of life. Dance is a physical activity that offers health advantages across various life stages. Nevertheless, the effects of dance interventions on physical function, postural control, and quality of life among older adults have remained underexplored. The review aimed to examine the strength of evidence for dance interventions on physical function and quality of life among middle-aged and older adults.

METHODS

A systematic review was conducted across four databases (PubMed, Cochrane Library, Web of Science, and Medline), focusing on studies involving more than four weeks of dance interventions. MeSH terms [dance or dance intervention or dance rehabilitation or dance movement] and [motor function or functional capacity or postural control or functional mobility or mobility or postural balance or balance or flexibility or gait] and [well-being or quality of life or life satisfaction] were utilized in the search. This review was registered in the PROSPERO database (CRD42023422857). Included studies were assessed using the Cochrane Risk of Bias.

RESULTS

The search revealed 885 studies, and 16 met the inclusion criteria. The effects of various dance genres on physical functions and quality of life were compared. Most studies showed that dance intervention improved physical function, balance, postural control and quality of life. Dance intervention showed a high level of adherence compared to physiotherapy, self-care, conventional therapy, and aerobic and resistance exercise.

CONCLUSION

In terms of improving physical function and quality of life, structured dance is a safe and relatively effective alternative to exercise. Note the effect of movement selection and intensity in the dance interventions. Dance with music may increase participants' interest, encouraging more physical activity among middle-aged and older adults.

Impact of creative dance on subjective well-being amongst older adults: an arts-informed photo-elicitation study

As the popularity of dance as a health-enhancing activity for adults over the age of 65 has grown, experimental research that aims to identify the physical, psychological, and social impacts of dancing is now prevalent in academic journals. Consistently, the participant's voice is left out of this research.

Photo-elicitation interviews were used within an arts-informed methodology. Ten female dancers aged 66-77 years who attend the same weekly, creative dance class participated.

Thematic analysis of interview transcripts revealed an overarching theme of psychosocial resilience and five sub-themes: connecting with others, challenging perceptions of aging, emotional vulnerability, the importance of creativity, and opportunity to exercise autonomy.

The results offer novel insight into the impact of creative dancing on subjective wellbeing   and suggest that creative dancing can foster psychosocial resilience. The relationship between creative dance and psychosocial resilience should be explored further in other creative dance groups and older male dancers.

"It doesn't feel like exercise": a realist process evaluation of factors that support long-term attendance at dance classes designed for healthy ageing

Introduction

Dance can positively impact older people's health and wellbeing across cultures and socioeconomic groups, countering age-related physical, sensorimotor and cognitive decline.

Background/objectives

The RIPE (Really Is Possible for Everyone) Dance program aims to improve older people's physical, mental, cognitive and social wellbeing by integrating engaging dance sequences with evidence-based fall prevention exercises. We sought to identify what mechanisms support observed long-term participation in this program, including by people living with challenging health conditions.

Methods

Following a realist evaluation approach, we co-developed and tested program theories iteratively with participant interviewees (n = 20), dance teachers (n = 2) and via observation of a dance class. Initial data were dual-coded and emergent findings were interrogated by the research team. Findings were organised to express Program activities + Context + Mechanism = Process outcomes configurations.

Results

We identified four program theories comprising 14 mechanisms which explained long-term attendance: 1. RIPE Dance benefits my body and mind (trust in the program, belief in health benefits), 2. RIPE Dance helps me feel good about myself (self-efficacy, pride in achievement, psychological safety, defying expectations, feeling valued), 3. RIPE Dance creates camaraderie (social connection, mutual support, rapport with the teacher), and 4. RIPE Dance is uplifting (raised spirits, fun, synchrony, musical reactivity).

Conclusion

The RIPE Dance program provides effective and enjoyable 'exercise in disguise' for older people with diverse mobility profiles.

Significance/implications

This research confirms that participation in dance can contribute significantly to healthy, happy ageing. Findings detail program activities that were most strongly associated with process outcomes, offering guidance for further program development, implementation and scaling up.

Volting, a Novel Dancing Wheelchair with Augmented Mobility: Pushing Lateral Inclinations

Wheelchair users are often perceived as someone ill and who will be limited in performing daily activities. This paradigm can be changed if instead to focus on limits, we start to think about the new possibilities that could be explored from their current mobility and technology. We present a novel dancing wheelchair with augmented mobility named Volting. Our novel wheelchair was designed to tilt the seat laterally up to 14°. This inclination is performed proportionally to the inclination of the user by a mechanism based on passive suspensions. Our system was analyzed as a double inverted pendulum and a mathematical model was developed using Euler-Lagrange equations. This analysis was used to calculate the ideal stiffness. Thus, we performed experiments with three distinct stiffness values and varying the weight of participants to analyze the behavior of our mechanism. Our results show that lateral inclinations in our wheelchair can be unstable, low sensitivity or linear tendency. The latter behavior, which is the most appropriate, was obtained using the suspension whose stiffness was close to the ideal value, thus validating our mathematical approach. Moreover, this behavior was maintained even if the user weight varies up to 10kg above the estimated value, ensuring a good performance for varying morphologies. Finally, our device was tested by a professional wheelchair dancer who shows the new possibilities of Volting in terms of mobility.

Implications of Physical Exercise on Episodic Memory and Anxiety: The Role of the Serotonergic System

There is a growing interest in investigating the effects of physical exercise on cognitive performance, particularly episodic memory. Similarly, an increasing number of studies in recent decades have studied the effects of physical activity on mood and anxiety disorders. Moreover, the COVID-19 pandemic has raised awareness of the importance of regular physical activity for both mental and physical health. Nevertheless, the exact mechanisms underlying these effects are not fully understood. Interestingly, recent findings suggest that the serotonergic system may play a key role in mediating the effects of physical exercise on episodic memory and anxiety. In this review, we discuss the impact of physical exercise on both episodic memory and anxiety in human and animal models. In addition, we explore the accumulating evidence that supports a role for the serotonergic system in the effects of physical exercise on episodic memory and anxiety.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Evaluation of a Virtual Dance Class for Cancer Patients and Their Partners during the Corona Pandemic-A Real-World Observational Study

BACKGROUND

During the corona pandemic, all courses on physical activity for cancer patients were canceled. The aim of our study was to evaluate the feasibility of switching dancing classes for patients and their partners to online classes.

METHODS

Patients and partners from courses at four different locations who consented to the online course offer were asked to fill in a pseudonymous questionnaire on access to the training, technical challenges, acceptance and well-being (1-item visual analog scale from 1 to 10) before and after the training.

RESULTS

Sixty-five participants returned the questionnaire (39 patients and 23 partners). Fifty-eight (89.2%) had danced before, and forty-eight (73.8%) had visited at least one course of ballroom dancing for cancer patients before. The first access to the online platform was difficult for 39 participants (60%). Most participants (57; 87.7%) enjoyed the online classes, but 53 (81.5%) rated them as less fun than the real classes as direct contact was missing. Well-being increased significantly after the lesson and remained improved for several days.

CONCLUSION

Transforming a dancing class is feasible for participants with digital experience and goes along with technical difficulties. It is a substitute for real classes if mandatory and improves well-being.

A virtual dance sport class for cancer patients: the trainer perspective

PURPOSE

Due to the corona, pandemic classes with physical activity for cancer patients were postponed. For an ongoing program with ballroom dancing classes for patients and their partners, the training was switched to a digital format.

METHODS

We evaluated the training by structured written interviews of the trainers including an open report part concerning the development and realization of the project, the teaching and training concept and their experiences as trainers.

RESULTS

5 trainers reported data from 6 different classes including 65 participants. All in all, digital dance training is feasible and a substantial part of the participants of former face-to-face training took part. Yet, digital training imposes some restrictions to the movements taught and the interactions with and between the participants. Trainers have to invest time in a new conception of the training and additional time in guiding participants with lower experience in technical issues.

CONCLUSION

Participants in virtual training rooms need more support and social interactions in digital training are less and different from ballroom lessons and trainers which puts more strain on trainers to motivate cancer patients.

The feasibility of a stepping exergame prototype for older adults with major neurocognitive disorder residing in a long-term care facility: a mixed methods pilot study

PURPOSE

To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD).

MATERIALS AND METHODS

Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA.

RESULTS

Seven older adults with MNCD in the exergame and 11 in the active control group completed the study [mean age = 83.2 ± 6.5 years; 94.4% female; SPPB score = 7.3 ± 2.4]. Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (η2=.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise.

CONCLUSIONS

The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings.

TRIAL REGISTRATION

The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315)Implications for rehabilitationThe VITAAL exergame prototype is accepted by individuals with MNCD residing in a long-term care facility who are able to participate.Supervision of exergaming by health professionals is essential for successful implementation.The VITAAL exergame prototype might maintain cognitive levels in major neurocognitive disorder longer than walking combined with standardised squatting and stepping exercises.

Musical and psychomotor interventions for cognitive, sensorimotor, and cerebral decline in patients with Mild Cognitive Impairment (COPE): a study protocol for a multicentric randomized controlled study

BACKGROUND

Regular cognitive training can boost or maintain cognitive and brain functions known to decline with age. Most studies administered such cognitive training on a computer and in a lab setting. However, everyday life activities, like musical practice or physical exercise that are complex and variable, might be more successful at inducing transfer effects to different cognitive domains and maintaining motivation. "Body-mind exercises", like Tai Chi or psychomotor exercise, may also positively affect cognitive functioning in the elderly. We will compare the influence of active music practice and psychomotor training over 6 months in Mild Cognitive Impairment patients from university hospital memory clinics on cognitive and sensorimotor performance and brain plasticity. The acronym of the study is COPE (Countervail cOgnitive imPairmEnt), illustrating the aim of the study: learning to better "cope" with cognitive decline.

METHODS

We aim to conduct a randomized controlled multicenter intervention study on 32 Mild Cognitive Impairment (MCI) patients (60-80 years), divided over 2 experimental groups: 1) Music practice; 2) Psychomotor treatment. Controls will consist of a passive test-retest group of 16 age, gender and education level matched healthy volunteers. The training regimens take place twice a week for 45 min over 6 months in small groups, provided by professionals, and patients should exercise daily at home. Data collection takes place at baseline (before the interventions), 3, and 6 months after training onset, on cognitive and sensorimotor capacities, subjective well-being, daily living activities, and via functional and structural neuroimaging. Considering the current constraints of the COVID-19 pandemic, recruitment and data collection takes place in 3 waves.

DISCUSSION

We will investigate whether musical practice contrasted to psychomotor exercise in small groups can improve cognitive, sensorimotor and brain functioning in MCI patients, and therefore provoke specific benefits for their daily life functioning and well-being.

TRIAL REGISTRATION

The full protocol was approved by the Commission cantonale d'éthique de la recherche sur l'être humain de Genève (CCER, no. 2020-00510) on 04.05.2020, and an amendment by the CCER and the Commission cantonale d'éthique de la recherche sur l'être humain de Vaud (CER-VD) on 03.08.2021. The protocol was registered at clinicaltrials.gov (20.09.2020, no. NCT04546451).

Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer's Disease and MCI: A Review

Alzheimer's disease (AD) is a multifactorial, progressive, neurodegenerative disease typically characterized by memory loss, personality changes, and a decline in overall cognitive function. Usually manifesting in individuals over the age of 60, this is the most prevalent type of dementia and remains the fifth leading cause of death among Americans aged 65 and older. While the development of effective treatment and prevention for AD is a major healthcare goal, unfortunately, therapeutic approaches to date have yet to find a treatment plan that produces long-term cognitive improvement. Drugs that may be able to slow down the progression rate of AD are being introduced to the market; however, there has been no previous solution for preventing or reversing the disease-associated cognitive decline. Recent studies have identified several factors that contribute to the progression and severity of the disease: diet, lifestyle, stress, sleep, nutrient deficiencies, mental health, socialization, and toxins. Thus, increasing evidence supports dietary and other lifestyle changes as potentially effective ways to prevent, slow, or reverse AD progression. Studies also have demonstrated that a personalized, multi-therapeutic approach is needed to improve metabolic abnormalities and AD-associated cognitive decline. These studies suggest the effects of abnormalities, such as insulin resistance, chronic inflammation, hypovitaminosis D, hormonal deficiencies, and hyperhomocysteinemia, in the AD process. Therefore a personalized, multi-therapeutic program based on an individual's genetics and biochemistry may be preferable over a single-drug/mono-therapeutic approach. This article reviews these multi-therapeutic strategies that identify and attenuate all the risk factors specific to each affected individual. This article systematically reviews studies that have incorporated multiple strategies that target numerous factors simultaneously to reverse or treat cognitive decline. We included high-quality clinical trials and observational studies that focused on the cognitive effects of programs comprising lifestyle, physical, and mental activity, as well as nutritional aspects. Articles from PubMed Central, Scopus, and Google Scholar databases were collected, and abstracts were reviewed for relevance to the subject matter. Epidemiological, pathological, toxicological, genetic, and biochemical studies have all concluded that AD represents a complex network insufficiency. The research studies explored in this manuscript confirm the need for a multifactorial approach to target the various risk factors of AD. A single-drug approach may delay the progression of memory loss but, to date, has not prevented or reversed it. Diet, physical activity, sleep, stress, and environment all contribute to the progression of the disease, and, therefore, a multi-factorial optimization of network support and function offers a rational therapeutic strategy. Thus, a multi-therapeutic program that simultaneously targets multiple factors underlying the AD network may be more effective than a mono-therapeutic approach.

The effect of rhythmic movement on physical and cognitive functions among cognitively healthy older adults: A systematic review and meta-analysis

OBJECTIVE

To explore the effects of rhythmic movement interventions on the physical and cognitive functions among cognitively healthy older adults.

METHODS

We searched PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, CBM, Wanfang Data, and VIP databases from inception to March 30, 2022. The inclusion criteria were: ① randomized controlled trials (RCTs); ② older adults (aged ≥ 60 years) without cognitive impairments or neurological or neurodegenerative diseases; ③ intervention: rhythmic movement (rhythmic exercise or physical activities performed to music); ④ outcomes: physical or cognitive function. Overall, 44 RCTs across 20 countries (n = 2752 participants) were included.

RESULTS

An association was found between rhythmic movement and improved physical function (mobility, cardiopulmonary endurance, muscle strength, flexibility, and balance), global cognitive function, and quality of life (QOL). The physical function outcomes suggested additional significant benefits when using control groups with no exercise than when using control groups with exercise. No significant improvement was found in executive function.

CONCLUSION

Regular rhythmic movement likely improves physical function, global cognitive function, and QOL in healthy older adults. The effect of rhythmic movement on the physical function in older adults is similar to that of routine exercise. Further studies on cognitive function of healthy older adults using larger samples of populations with more balanced sex ratios with long-term follow-up are particularly encouraged.

Tai Chi exercise improves working memory capacity and emotion regulation ability

Purpose

The study aimed to research the promoting effects of Tai Chi exercise on working memory capacity and emotional regulation ability among college students.

Methods

Fifty-five participants were recruited and randomly divided into the Tai Chi group and control group. The Tai Chi group had a 12-week Tai Chi training to implement intervention, while the control group performed non-cognitive traditional sports with the same exercise intensity as the Tai Chi group. The visual 2-back test of action pictures and the Geneva emotional picture system test were performed before and after the trial, which aimed to examine whether the action memory of Tai Chi training can improve individuals' working memory capacity and emotion regulation ability.

Results

After 12 weeks, a significant difference was observed in Accuracy Rate (AR) (F = 54.89, p ≤ 0.001) and Response Time (RT) (F = 99.45, p ≤ 0.001) of individuals' Visual Memory Capacity between the Tai Chi group and the control group. Significant effects in Time (F = 98.62, p ≤ 0.001), Group (F = 21.43, p ≤ 0.001), and Interaction (Groups × time; F = 50.81, p ≤ 0.001) on Accuracy Rate (AR) of the Visual Memory Capacity were observed. The same effect was observed again on the Response Time (RT) of the Visual Memory Capacity, Time (F = 67.21, p ≤ 0.001), Group (F = 45.68, p ≤ 0.001), Interaction (groups × time; F = 79.52, p ≤ 0.001). Post-hoc analysis showed that at the end of 12 weeks, the participants in the Tai Chi group had significantly higher Visual Memory Capacity than those in the control group (p < 0.05).After 12 weeks, valence difference (F = 11.49, p ≤ 0.001), arousal difference (F = 10.17, p ≤ 0.01), and dominance difference (F = 13.30, p ≤ 0.001) in the emotion response were significantly different between the control group and the Tai Chi group. The effect of valence differences in Time (F = 7.28, p < 0.01), Group (F = 4.16, p < 0.05), and Time*Group (F = 10.16, p < 0.01), respectively, was significant in the Tai Chi group after 12-week intervention. Post hoc analysis showed valence swings in the Tai Chi group were significantly lower than that in the control group (p < 0.05); The effect of arousal difference in Time (F = 5.18, p < 0.05), Group (F = 7.26, p < 0.01), Time*Group (F = 4.23, p < 0.05), respectively, was significant in the Tai Chi group after 12-week intervention. Post hoc analysis showed arousal fluctuations in the Tai Chi group was significantly lower than that in the control group too (p < 0.01); As the same, the effect of dominance differences in Time (F = 7.92, p < 0.01), Group (F = 5.82 p < 0.05) and Time*Group (F = 10.26, p < 0.01), respectively was significant in the Tai Chi group. Dominance swings in the Tai Chi group were significantly lower than that in the control group (p < 0.001).

Conclusion

The data support our speculation that action memory training in Tai Chi exercise may improve individuals' working memory capacity, and then improve their emotion regulation ability, which has provided insightful information for customized exercise programs for emotion regulation in adolescents. Thus, we suggest those adolescents who are experiencing volatile moods and poor emotion regulation attend regular Tai Chi classes, which could contribute to their emotional health.

Randomized Controlled Trial of Social Ballroom Dancing and Treadmill Walking: Preliminary Findings on Executive Function and Neuroplasticity From Dementia-at-Risk Older Adults

This randomized controlled trial (NCT03475316) examined the relative efficacy of 6 months of social ballroom dancing and treadmill walking on a composite executive function score, generated from digit symbol substitution test, flanker interference, and walking while talking tasks. Brain activation during functional magnetic resonance imaging (fMRI) versions of these executive function tasks were secondary outcomes. Twenty-five dementia-at-risk older adults (memory impairment screen score of ≥3 to ≤6 and/or an Alzheimer's disease-8 Dementia Screening Interview of ≥1) were randomized in June 2019 to March 2020-16 completed the intervention before study termination due to the COVID-19 (eight in each group). Composite executive function scores improved post-intervention in both groups, but there was no evidence for between-group differences. Social dancing, however, generated greater improvements on digit symbol substitution test than treadmill walking. No intervention-related differences were observed in brain activation-although less hippocampal atrophy (tertiary) was observed following social dancing than treadmill walking. These preliminary findings are promising but need to be confirmed in future large-scale and sufficiently powered randomized controlled trials.

The effect of physical activity breaks, including motor-cognitive coordination exercises, on employees’ cognitive functions in the workplace

BACKGROUND: The findings of the effectiveness of physical activity on adults’ cognitive abilities have not yet been transferred into corresponding fields of application. OBJECTIVE: The present study evaluates a motor-cognitive coordination programme in a company to improve employees’ cognitive performance in the short and medium term. METHODS: A total of 67 employees — 32 men and 35 women aged between 19 and 61 years — participated in this study, and 55 completed the study. The sample was randomly divided into an experimental group, which received a motor-cognitive coordination training, and a control group, which received a relaxation and mobility training. Both groups met for 15-minute sessions three times a week for eight weeks. Before and after the intervention, working memory, attention, information-processing capacity, divergent thinking, and mood were measured. In addition, acute effects regarding attention and mood were tested. RESULTS: The results showed that the motor-cognitive coordination break improves working memory and divergent thinking after eight weeks of intervention, whereas neither the mood nor the information processing speed improved more for the experimental group compared to the control group. The results on the acute increase in attention performance failed to reach significance. CONCLUSION: The new approach of this study was not only the derivation and development of targeted exercises, but also their testing and evaluation in the field of application. Motor-cognitive coordination exercise in the workplace might play an important role in both occupational health management and personnel development, especially for companies that are under highly competitive and innovative pressure.

Effect of the Juggling-Based Motor Learning Physical Activity on Well-Being in Elderly: A Pre-Post Study with a Special Training Protocol

Background: The importance of physical activity for the elderly is undeniable. Specific forms of exercise that are able to engage practitioners, both cognitively and physically, may provide more positive consequences for health and quality of life. Juggling is one of these activities that has both of these characteristics. Methods: Twenty elderly people (70.55 ± 4.91) were included in a juggling-based motor learning protocol for twelve training units during one month of exercising. An evaluation of the proposed exercises (five-point Likert scale) and a subjective assessment of well-being (WHO-5) were conducted during the protocol. Results: All participants learned to perform a three-ball flash cascade. Exercises were rated as very attractive (4.85 ± 0.31) by the practitioners, and a statistically significant improvement in well-being in participants was shown (p < 0.01; d = 0.76). Additionally, in the participating group, the number of people at risk of depression decreased significantly after the intervention with juggling classes (p < 0.01; g = 0.5). Conclusions: The proposed protocol could be an interesting physical activity for the elderly. It can be assumed that this activity, especially when performed in a group form, can improve the well-being of participants in a short period of time.

Fitness Dance Counteracts Female Ph.D. Candidates' Stress by Affecting Emotion Regulation

Background: The impact of stress on the nation's physical and mental health is considerable. Exercise is considered to have beneficial effects on mental health and the capacity for coping with stress. The purpose of this study is to verify the effects of fitness dance intervention on female Ph.D. candidates' stress, and compare it with the intervention effects of MBSR. Method: A repeated measurement experimental design was used to evaluate the effects of fitness dance and MBSR on Chinese female Ph.D. candidates' stress. Results: Twelve weeks of fitness dance and MBSR can reduce participants' stress from severe to moderate. Eight weeks of fitness dance can reduce the tension from perceived stress (p = 0.019) and loss of control from perceived stress (p = 0.043). Twelve weeks of fitness dance can reduce the tension from perceived stress (p < 0.000), loss of control from perceived stress (p = 0.002) and perceived stress (p = 0.001). Fitness dance and MBSR affect emotion regulation, thereby affecting stress. Fitness dance reduced participants' stress by improving their cognitive reappraisal ability. MBSR reduced participants' stress by improving their cognitive reappraisal ability and expression suppression ability. Conclusions: Fitness dance, as a method of exercise intervention, is suitable for reducing Chinese female Ph.D. candidates' stress.

Rhythmic Physical Activity and Global Cognition in Older Adults with and without Mild Cognitive Impairment: A Systematic Review

Growing evidence suggests that rhythmic physical activity (PA) improves cognitive function in both persons with normal brain aging and with cognitive impairment. This study aims to conduct a systematic review of randomized controlled trials assessing the effects of rhythmic PA over global cognition in older adults with and without mild cognitive impairment. Different keywords related to the topic and Boolean operators were used in the Web of Science, PubMed, and Scopus databases. A total of 11 articles that met the inclusion criteria were analyzed; all of them assessed global cognition using either the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) or the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Five studies showed beneficial effects over global cognition. All studies had at least one experimental group with rhythmic training, and the interventions evidenced a great diversity of rhythmic stimuli, as well as a varied frequency, duration and type of activities. The heterogeneity of the protocols could be the reason for the mixed findings. Future studies with more precise exercise prescriptions are needed to establish whether rhythmic PA has beneficial effects on global cognition.

A Comparison of the Effects of Short-Term Physical and Combined Multi-Modal Training on Cognitive Functions

Physical training has beneficial effects not only on physical fitness, but also on cognitive functions. The most effective way to improve cognitive functions via physical training as well as the degree to which training effects transfer to untrained cognitive functions is still unclear, however. Here, we investigated the effects of adaptive and multi-modal short-term training interventions on cognitive training gains and transfer effects. Over a period of 12 weeks, 102 employees of a car manufacturing company (age range 20 to 61 years) received trainer-guided exercises, consisting of either two adaptive training interventions, physical (strength) training and multi-modal (motor-cognitive) training, or non-adaptive strength training (active control group). For the multi-modal intervention, the "Agility Board" was employed, a novel, multi-modal training device. Pre- and post-training, psychometric tests were conducted to measure cognitive abilities, such as perceptual speed, attention, short-term memory, working memory, inhibition, and mental rotation. In addition, motor-cognitive performance was assessed. Compared with the active control group, both training groups showed enhanced performance at posttest. While multi-modal training yielded performance improvements only in trained tasks, physical training was associated with improvements in untrained working memory updating and immediate recall tasks, suggesting transfer effects to short-term and working memory functioning. In summary, the results demonstrate the importance of adaptive difficulty settings for short-term physical training interventions, at least for the enhancement of working memory.

The Effect of Juggling as Dual-Task Activity on Human Neuroplasticity: A Systematic Review

This systematic review formulated a research question based on the PICO method in accordance with the Guidelines for Systematic Reviews and Meta-Analyses (PRISMA), "What is the effect of juggling as dual-task activity on neuroplasticity in the human brain?" In total, 1982 studies were analysed, 11 of which met the inclusion criteria and were included in the review. These studies included 400 participants who had no prior juggling experience or were expert jugglers. The research methodology in seven studies was based on a long-term intervention with juggling. Three studies were based on brain imaging during the act of juggling, and one study was based on comparing differences between experienced jugglers and non-jugglers without the intervention. In all of these selected studies, positive structural changes in the human brain were found, including changes mainly in the gray matter (GM) volume in the visual motion complex area (hMT/V5) and the white matter (WM) volume in fractional anisotropy (FA). Based on this evidence, it can be concluded that the bimanual juggling task, as a dual-task activity, may effectively integrate brain areas to improve neuroplasticity. The small number of well-designed studies and the high risk of bias call for further research using a juggling intervention to identify conclusive evidence.

Effects of Two Short-Term Aerobic Exercises on Cognitive Function in Healthy Older Adults during COVID-19 Confinement in Japan: A Pilot Randomized Controlled Trial

Aerobic exercise improves executive function-which tends to decline with age-and dual-task training with aerobic exercise improves the global cognitive function. However, home-based older adults could not follow these programs due to social isolation during the coronavirus disease 2019 pandemic. Therefore, we conducted a single-blind randomized controlled trial with 88 healthy older adults without dementia or sarcopenia who were randomly assigned into the Nordic walking (aerobic exercise), dance (dual-task training with aerobic exercise), or control group. The participants in both exercise intervention groups trained for 30 min, three times per week, for 4 weeks. All groups consumed amino acid-containing foods three times per week. We found that both exercise intervention groups showed improvements in executive function, while the dance group showed additional improvement in global cognitive function. The dance group showed a higher maximum gait speed, greater improvement in imitation ability, and improved executive function and cognitive function than the Nordic walking group. The intervention programs did not significantly affect the muscle mass or muscle output than the control group; however, both programs improved the participant neurological functions such as the heel lift, with dance training being the most effective intervention. In conclusion, dance training effectively improves cognitive function.

Dancing With Parkinson's Disease: The SI-ROBOTICS Study Protocol

Introduction: Parkinson's disease (PD) is one of the most frequent causes of disability among older people, characterized by motor disorders, rigidity, and balance problems. Recently, dance has started to be considered an effective exercise for people with PD. In particular, Irish dancing, along with tango and different forms of modern dance, may be a valid strategy to motivate people with PD to perform physical activity. The present protocol aims to implement and evaluate a rehabilitation program based on a new system called “SI-ROBOTICS,” composed of multiple technological components, such as a social robotic platform embedded with an artificial vision setting, a dance-based game, environmental and wearable sensors, and an advanced AI reasoner module.

Methods and Analysis: For this study, 20 patients with PD will be recruited. Sixteen therapy sessions of 50 min will be conducted (two training sessions per week, for 8 weeks), involving two patients at a time. Evaluation will be primarily focused on the acceptability of the SI-ROBOTICS system. Moreover, the analysis of the impact on the patients' functional status, gait, balance, fear of falling, cardio-respiratory performance, motor symptoms related to PD, and quality of life, will be considered as secondary outcomes. The trial will start in November 2021 and is expected to end by April 2022.

Discussions: The study aims to propose and evaluate a new approach in PD rehabilitation, focused on the use of Irish dancing, together with a new technological system focused on helping the patient perform the dance steps and on collecting kinematic and performance parameters used both by the physiotherapist (for the evaluation and planning of the subsequent sessions) and by the system (to outline the levels of difficulty of the exercise).

Ethics and Dissemination: The study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on the number NCT05005208. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.

Everybody Can Dance-Except Aging Professional Dancers! A Discussion of the Construction of the Aging Dancing Body in Four Dance Texts

The subject of the article is a critical investigation of research concerning age and dance. Our objective is to investigate whether and how researchers express their ideas about dance and age in a selection of research papers. We are particularly interested in whether researchers are reproducing an instrumental understanding of age in the context of dance and whether discourses of dance define bodies as older or younger in ways that differ from the definitions used in other social contexts. What kind of assumptions about the abilities of dancers form the baseline expectations of researchers? We wonder if harming the body is an implicit part of dance practice that operates as a tacit premise in the understanding of age and dance. Through a document analysis of several research texts on dance and age, we try to identify what kinds of meanings, expectations, and bodies such documents convey and produce. One of our findings from the analysis of the literature is that young dancers from western European countries and the U.S. are concerned with age throughout their entire career, while in dance practices in Japan, being an older dancer is regarded as a as a value that gives flavor and energy to both to aging and dance in a shared interaffective and mutual space.

Benefits of Tango Therapy in Alleviating the Motor and Non-Motor Symptoms of Parkinson's Disease Patients-A Narrative Review

The present study examines the efficacy of tango therapy on motor and non-motor symptomatology in Parkinson's disease, as detailed in articles published over the previous four decades (1980-2022). All data was collected using PubMed, Google Scholar, Web of Science, and Science Direct. The present descriptive study outlines the advantages of tango in the rehabilitation of Parkinson's disease's motor and non-motor symptoms. Numerous studies have been conducted to determine the usefulness of tango for people with PD. Information from various research is critical for determining if tango is a useful supplementary therapy for the variety of symptoms related to Parkinson's disease. The purpose of this review was to describe the present state of research on this subject. Thus, the objective of this review is to promote awareness of tango therapy's therapeutic benefits for Parkinson's disease.

The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis

Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training (e.g., exergames, square stepping) produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training.

Systematic Review Registration:www.crd.york.ac.uk/prospero/, identifier: CRD42020175632.

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.

Improvisational Movement to Improve Quality of Life in Older Adults With Early-Stage Dementia: A Pilot Study

Alzheimer's disease has profound effects on quality of life, affecting not only cognition, but mobility and opportunities for social engagement. Dance is a form of movement that may be uniquely suited to help maintain quality of life for older adults, including those with dementia, because it inherently incorporates movement, social engagement, and cognitive stimulation. Here, we describe the methods and results of the pilot study for the IMOVE trial (NCT03333837, www.clinicaltrials.gov), a clinical trial designed to use improvisational dance classes to test the effects of movement and social engagement in people with mild cognitive impairment (MCI) or early-stage dementia. The pilot study was an 8-week investigation into the feasibility and potential effects of an improvisational dance intervention on people with MCI or early-stage dementia (PWD/MCI) and their caregivers (CG). The pilot aimed to assess changes in quality of life, balance, mood, and functional brain networks in PWD/MCI and their CG. Participants were recruited as dyads (pairs) that included one PWD/MCI and one CG. Ten total dyads were enrolled in the pilot study with five dyads assigned to the usual care control group and five dyads participating in the dance intervention. The intervention arm met twice weekly for 60 min for 8 weeks. Attendance and quality of life assessed with the Quality of Life in Alzheimer's disease (QoL-AD) questionnaire were the primary outcomes. Secondary outcomes included balance, mood and brain network connectivity assessed through graph theory analysis of functional magnetic resonance imaging (fMRI). Class attendance was 96% and qualitative feedback reflected participants felt socially connected to the group. Increases in quality of life and balance were observed, but not mood. Brain imaging analysis showed increases in multiple brain network characteristics, including global efficiency and modularity. Further investigation into the positive effects of this dance intervention on both imaging and non-imaging metrics will be carried out on the full clinical trial data. Results from the trial are expected in the summer of 2022.

Can Dance and Music Make the Transition to a Sustainable Society More Feasible?

Transition to sustainability is a process that requires change on all levels of society from the physical to the psychological. This review takes an interdisciplinary view of the landscapes of research that contribute to the development of pro-social behaviors that align with sustainability goals, or what we call 'inner sustainability'. Engaging in musical and dance activities can make people feel trust and connectedness, promote prosocial behavior within a group, and also reduce prejudices between groups. Sustained engagement in these art forms brings change in a matter of seconds (such as hormonal changes and associated stress relief), months (such as improved emotional wellbeing and learning outcomes), and decades (such as structural changes to the brains of musicians and dancers and superior skills in expressing and understanding emotion). In this review, we bridge the often-separate domains of the arts and sciences by presenting evidence that suggests music and dance promote self-awareness, learning, care for others and wellbeing at individual and group levels. In doing so, we argue that artistic practices have a key role to play in leading the transformations necessary for a sustainable society. We require a movement of action that provides dance and music within a constructive framework for stimulating social sustainability.

The Effect of an 8-Week Aerobic Dance Program on Executive Function in Children

In the current study, we examined the effect of an aerobic dance program as part of physical education (PE) classes on aspects of primary school children's executive functions (EFs) (inhibition, working memory, and cognitive flexibility). Participants were 41 children (21 boys and 20 girls; M age =10.30, SD = 0.50 years, M height = 134.09, SD= 3.9 cm; M weight = 35.61, SD = 7.85 kg) who were divided into an experimental group (EG) and a no-PE control group (CG). The EG followed an aerobic dance intervention as part of their PE program (45 minute sessions two days per week over eight weeks). Participants in both groups performed EF tests before and after the intervention period to evaluate their mental flexibility, inhibition, and working memory. A two-way mixed model repeated measures ANOVA revealed a significant effect of the aerobic dance program on participants' cognitive flexibility (i.e., on Trails Making Tests _B-A times and committed errors) (p <0.001), and on Stroop measures of inhibition (corrected number of words and corrected errors) (p <0.001 and p <0.01, respectively), with post-hoc analyses showing an improved performance by the EG in working memory (digit recall score) from pre-test to post-test and in comparsion to the CG (p < 0.001). Thus, this 8-week aerobic dance program promoted EF development among primary school children.

Usability Study of a Multicomponent Exergame Training for Older Adults with Mobility Limitations

The global population aged 60 years and over rises due to increasing life expectancy. More older adults suffer from “geriatric giants”. Mobility limitations, including immobility and instability, are usually accompanied by physical and cognitive decline, and can be further associated with gait changes. Improvements in physical and cognitive functions can be achieved with virtual reality exergame environments. This study investigated the usability of the newly developed VITAAL exergame in mobility-impaired older adults aged 60 years and older. Usability was evaluated with a mixed-methods approach including a usability protocol, the System Usability Scale, and a guideline-based interview. Thirteen participants (9 female, 80.5 ± 4.9 years, range: 71–89) tested the exergame and completed the measurement. The System Usability Scale was rated in a marginal acceptability range (58.3 ± 16.5, range: 30–85). The usability protocol and the guideline-based interview revealed general positive usability. The VITAAL exergame prototype received positive feedback and can be considered usable by older adults with mobility limitations. However, minor improvements to the system in terms of design, instructions, and technical aspects should be taken into account. The results warrant testing of the feasibility of the adapted multicomponent VITAAL exergame, and its effects on physical and cognitive functions, in comparison with conventional training, should be studied.

Ecological and Construct Validity of a New Technical Level Cuban Dance Field Test

The study aimed to explore the sensitivity and specificity of a new methodological approach related to the musical rhythm for discriminating a competitive Cuban dancer’s (CDCs) level. Thirty CDCs (Age 23.87 ± 1.76 years, body mass 60.33 ± 9.45 kg, stature 1.68 ± 0.07 m) were divided into three groups: beginner (BEG, n = 10), intermediate (INT, n = 10), and advanced (ADV, n = 10) according to their training experience/level. Each dancer was assessed while dancing at three different musical rhythms: fast (118 BPM), medium (96 BPM), and slow (82 BPM). The assessed variables were average heart rate (HR_M), peak (HR_P), and dancing time (DC_T). The ADV group succeeded at all three musical combinations (317, 302, 309 s for 82, 96, 118 BPM). The INT group correctly performed only the first two combinations (304, 304 s for 82, 96 BPM), while a significant time difference was shown at the fast musical rhythm (198 ± 6.64 s) compared to the medium (p < 0.001) and slow rhythms (p < 0.001) respectively. As the speed of the musical rhythms increased, the BEG group was not able to follow the rhythm: their results were 300 ± 1.25 s for the slow musical rhythm, 94.90 ± 12.80 s for the medium musical rhythm and 34.10 ± 5.17 s for the fast musical rhythm (p < 0.001). The HR_M and HR_P grew along with the increase in musical rhythm for all groups (p < 0.001). The ROC analysis showed a high sensitivity and specificity in discriminating the groups for each rhythm’s condition. The BEG and INT groups showed an AUC = 0.864 (95% CI = 0.864–0.954); INT and ADV showed an AUC = 0.864 (95% CI = 0.864–0.952); BEG and ADV showed an AUC = 0.998 (95% CI = 0.993–1.000). The results of this study provided evidence to support the construct and ecological validity of the time of the musical rhythms related to competitive CDCs. Furthermore, the differences in the performances according to various musical rhythms, fast (118 BPM), medium (96 BPM), and slow (82 BPM), succeeded in discriminating a dancer’s level. Coaches and strength and conditioning professionals should include the Cuban Dance Field Test (CDFT) in their test battery when dealing with talent detection, selection, and development.

The VITAAL Stepping Exergame Prototype for Older Adults With Major Neurocognitive Disorder: A Usability Study

Purpose: This study investigates the usability of a stepping exergame in older adults with major neurocognitive disorder (MNCD) residing in a long-term care facility.

Materials and Methods: A mixed methods study was conducted. Participants played exergames for 30 min on one try-out session. During the exergames, the think aloud method was used, and field notes were taken by the facilitator. Following the exergames, participants completed the System Usability Scale (SUS) and a semi-structured in-depth interview about usability including their personal experiences. Audio files were transcribed and a thematic content analysis of the think aloud data, field notes and interviews were performed using NVivo 12.

Results: Twenty-two participants with MNCD were included [mean age = 84.3 ± 5.5 (70–95) years; 81.8% women; Short Physical Performance Battery score = 7.5 ± 3.2 (1–12), Montreal Cognitive Assessment score = 11.9 ± 4.4 (2–19)]. System usability was rated “ok to good” with a mean SUS score of 57.8 (SD = 12.3) with scores ranging from 37.5 to 90.0. Five main themes emerged from the thematic content analysis: (1) perceived user friendliness and acceptability of the exergames; (2) interactional experience; (3) motivational factors; (4) training modalities; and (5) risks. There were no adverse events nor dropouts.

Conclusion: Participants evaluated the usability of the exergames positively. The results indicate that the stepping exergame is usable in older adults with MNCD.

Dance Intervention Impact on Brain Plasticity: A Randomized 6-Month fMRI Study in Non-expert Older Adults

Background: Dance is a complex activity combining physical exercise with cognitive, social, and artistic stimulation.

Objectives: We aimed to assess the effects of dance intervention (DI) on intra and inter-network resting-state functional connectivity (rs-FC) and its association to cognitive changes in a group of non-demented elderly participants.

Methods: Participants were randomly assigned into two groups: DI and life as usual (LAU). Six-month-long DI consisted of supervised 60 min lessons three times per week. Resting-state fMRI data were processed using independent component analysis to evaluate the intra and inter-network connectivity of large-scale brain networks. Interaction between group (DI, LAU) and visit (baseline, follow-up) was assessed using ANOVA, and DI-induced changes in rs-FC were correlated with cognitive outcomes.

Results: Data were analyzed in 68 participants (DI; n = 36 and LAU; n = 32). A significant behavioral effect was found in the attention domain, with Z scores increasing in the DI group and decreasing in the LAU group (p = 0.017). The DI as compared to LAU led to a significant rs-FC increase of the default mode network (DMN) and specific inter-network pairings, including insulo-opercular and right frontoparietal/frontoparietal control networks (p = 0.019 and p = 0.023), visual and language/DMN networks (p = 0.012 and p = 0.015), and cerebellar and visual/language networks (p = 0.015 and p = 0.003). The crosstalk of the insulo-opercular and right frontoparietal networks were associated with attention/executive domain Z-scores (R = 0.401, p = 0.015, and R = 0.412, p = 0.012).

Conclusion: The DI led to intervention-specific complex brain plasticity changes that were of cognitive relevance.

Effects of Dance Interventions on Cognition, Psycho-Behavioral Symptoms, Motor Functions, and Quality of Life in Older Adult Patients With Mild Cognitive Impairment: A Meta-Analysis and Systematic Review

Background: Dance interventions are considered beneficial for older patients with mild cognitive impairment in many aspects. We conducted a comprehensive systematic review and meta-analysis to assess the effects of dance on different aspects (cognitive function, emotions, physical function, and quality of life) of this population. Methods: A systematic search of PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, Embase, American Psychological Association PsycInfo, ProQuest, Scopus, Cumulative Index to Nursing and Allied Health Literature, the Chinese BioMedical Literature Database, the VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang Data database was performed. Two reviewers independently assessed the study quality. Results: Fourteen studies were retrieved from the databases for analysis. The pooled results showed that dance interventions significantly improved global cognition (standardized mean difference [SMD] = 0.73, 95% confidence interval [CI]: 0.47 to 0.99, P < 0.00001), rote memory (mean difference [MD] = -2.12, 95% CI: -4.02 to -0.21, P = 0.03), immediate recall (SMD = 0.54, 95% CI: 0.30 to 0.78, P < 0.0001), delayed recall (SMD = 0.56, 95% CI: 0.26 to 0.86, P = 0.0002) and attention (SMD = 0.38, 95% CI: 0.13 to 0.64, P = 0.003). No significant improvement was found in executive function, language, depression, anxiety, dementia-related behavioral symptoms, motor function, and quality of life. Conclusion: Dance interventions benefit most aspects of cognitive functions. The evidence for the effects of dance on psycho-behavioral symptoms, motor function and quality of life remains unclear. More trials with rigorous study designs are necessary to provide this evidence.

Exploring the effects of visual and literary arts interventions on psychosocial well-being of diverse older adults: a mixed methods pilot study

BACKGROUND

Engagement in the arts may have health benefits for older adults. Most research has focused on music and dance; less is known about the benefits of other arts interventions. The purpose of this study was to examine the effects of visual (ceramics and collage) and literary arts (storytelling and writing) on well-being.

METHODS

We used mixed methods to examine the effects of a 12-week visual or literary arts intervention on well-being. Adults age 55 and over from four housing sites were assigned to start an intervention immediately (intervention) or wait 12 weeks (controls). The study included pre/post-test measures of well-being and focus groups about perceived benefits.

RESULTS

Compared to controls, participants in the ceramics intervention had significant improvements in interest in life and mastery, while no changes were observed after the storytelling intervention. Seven psychosocial benefits were identified .

CONCLUSIONS

Participation in visual and literary arts for older adults was associated with well-being media.

Dancing Against falls iN Community-dwElling older adults (DANCE): a study protocol of a stratified, block-randomised trial

Background

Unintentional falls among older adults are of primary importance due to their impact on quality of life. Falling accounts for 95% of hip fractures, leading to an approximately six times increased risk of death within the first 3 months. Furthermore, physical and cognitive parameters are risk factors for falls. The purpose of this study is to examine the effect of a 6-month salsa dance training intervention, compared with regular fitness circuit training and a control group.

Methods

This study will include 180 older adults: 90 healthy patients and 90 patients with osteoporosis. Participants will be allocated randomly in either of the groups, stratified according to age. Training groups will receive 2 weekly 1-hour training sessions, continuously through 6 months. Participants will be tested at baseline and 6 and 18 months post baseline. Primary outcome will be number of falls and secondary outcomes include bone mineral density, body composition, pain evaluation, weekly physical activity, single-task and dual-task gait patterns, balance, Fullerton Functional Fitness Test and assessment of the mini-BESTest.

Discussion

This study will investigate the effects of a specially designed dance training programme (Dancing Against falls iN Community-dwElling older adults (DANCE)) to reduce the risk of falling among older adults. The study will investigate the effect against an active and passive comparator, resulting in the possibility to state, if DANCE training should be an alternative to traditional training.

Trial registration number

NCT03683849.

Impact of cognitive reserve on dance intervention-induced changes in brain plasticity

Dance is a complex sensorimotor activity with positive effects on physical fitness, cognition, and brain plasticity in the aging population. We explored whether individual levels of cognitive reserve (CR) proxied by education moderate dance intervention (DI)-induced plasticity assessed by resting-state functional connectivity (rs-FC) changes of the sensorimotor network (SMN), and between the dorsal attention network (DAN) and anterior default mode network (aDMN). Our cohort consisted of 99 subjects, randomly assigned to either a DI group who underwent a 6-month intervention (n = 49, M_age = 69.02 ± 5.40) or a control group (n = 50, M_age = 69.37 ± 6.10). Moderation analyses revealed that CR moderated DI-induced increase of the SMN rs-FC with significant changes observed in participants with ≥ 15 years of education (b = 0.05, t(62) = 3.17, p = 0.002). Only DI alone was a significant predictor of the DAN-aDMN crosstalk change (b = 0.06, t(64) = 2.16, p = 0.035). The rs-FC increase in the SMN was correlated with an improved physical fitness measure, and changes in the DAN-aDMN connectivity were linked to better performance on figural fluency. Consistent with the passive CR hypothesis, we observed that CR correlated only with baseline behavioral scores, not their change.

Filipino Multicomponent Intervention to Maintain Cognitive Performance in High-Risk Population (FINOMAIN): Study Protocol for a Cluster Randomized Controlled Trial

Background: More than half of the people with dementia live in lower-middle income countries (LMIC), yet we lack research and evidence-based knowledge to guide health promotion and prevention strategies for cognitive decline. In the Philippines, the prevalence of mild cognitive impairment (MCI) and cardiovascular risk factors among older persons are high, making this population at high risk for developing dementia. This protocol describes a cluster randomized controlled trial that aims to investigate the efficacy of a multicomponent intervention to maintain cognitive performance among high-risk population. Methods: This is a cluster-randomized, two-arm, single-blind trial of a multicomponent intervention that combines dance called INDAK (Improving Neurocognition through Dance and Kinesthetics), nutrition counseling, and vascular risk management. The intervention arm will receive 12 months (1-h, twice per week) of INDAK and every 3 months of nutrition counseling and intensive vascular risk management and monitoring. The control group will receive the usual vascular care advice and referral. A total of 605 (20-25 clusters per arm) community-dwelling Filipino older adults aged ≥ 60 years old with MCI will participate in the study and will be assessed at baseline, 6th- and 12th-month follow-up. The primary outcome is cognitive performance assessed by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog), Mnemonic Similarity Tasks (MST), and executive function composite (EFC). Secondary outcomes are functional connectivity assessed through brain imaging, and measures of behavioral, functional level, and quality of life. Discussion: The study aims to provide scientific evidence on a public health intervention that is contextualized in a community setting to reduce dementia risk among older adults with MCI. This model can be an ecological, low-cost, and effective program, thereby conducive to widespread implementation in the Philippines as well as in other low-resource settings with similar public health challenges. The pilot phase was underway with eight villages (clusters), but temporarily interrupted by the pandemic. The full study is anticipated to start after community restrictions are eased.

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.

Body adaptation to Dance: A Gerontological Perspective

A number of studies have investigated the effectiveness of dance in older adults in the context of healthy aging. Analysing results across studies is important to understand whether dance in older adults is an effective adjunctive intervention for the healthy aging. To summarize the current research results about the effectiveness of dance in older adults in the context of healthy aging, and to identify key areas for future research. The search was conducted in Web of Science, PubMed and Google Scholar databases, using the following search string and Boolean logic (‘AND’, ‘OR’) locating studies published between database inception and September 2018: Dance OR contemporary dance OR ballroom dance OR Latin dance OR standard dance OR hip-hop dance OR tango AND Cardiovascular OR circulation AND Emotion OR well-being OR blood pressure OR disease OR thrombosis OR vascular OR glucose OR blood OR cardiac OR mental OR heart rate. Two reviewers independently extracted studies data. Eight suitable publications were included. The results showed that dance promote improvements in cognitive parameters when compared to other types of exercise or no-exercise. Significant effects were found on some physiological parameters, even after a short intervention period. Dance proved to be able to assist older adults in the context of healthy aging. The improvements in the cognitive, physiological and motor control parameters are very relevant for this population, due to the impact in a better quality of life.

The Effects of the BAILAMOSTM Dance Program on Physical Activity Levels and Cognition of Older Latino Adults: A Pilot Study

Objective: To investigate the effects of the BAILAMOS^TM dance program on physical activity (PA), cardiorespiratory, and cognitive health. Methods: A parallel, two-armed pilot study was conducted with 57 older Latinos randomized to the BAILAMOS^TM dance program (n = 28) or health education (HE) (n = 29). We conducted two- and three-way repeated-measures ANOVAs. Results: BAILAMOS^TM participants increased participation in leisure moderate-to-vigorous PA (LMVPA) (F[1,53] = 3.17, p = .048, η²_G = .01) and performance in global cognition relative to HE participants (F[1,52] = 4.19, p = .045, η²_G = .01). Attendance moderated increases in moderate PA, MVPA, LMVPA, and total PA (p < .05). Participants of both groups with ≥75% attendance increased participation in PA. Among participants with <75% attendance, BAILAMOS^TM participants increased PA relative to HE. Discussion: BAILAMOS^TM positively impacted self-reported PA and global cognition in older Latinos. Even smaller doses of dance appear to impact self-reported PA levels.

Effect of Dance on Balance, Mobility, and Activities of Daily Living in Adults With Cerebral Palsy: A Pilot Study

The age-related decline in motor function with respect to balance and mobility may hamper the activities of daily living, quality of life, and social participation. Despite the importance of managing secondary conditions leading to premature aging, the literature regarding appropriate physical activity for adults with cerebral palsy (CP) is still scarce. Dance forms have emerged as an effective physical activity that improves balance and mobility in individuals with neurological conditions and boosts social engagement. However, its effect on adults with CP has yet to be examined. This pilot study aimed to examine the long-term effect of dance on improving balance and mobility in adults with CP. This single-cohort study included 10 adults with CP. They attended two 90-min-long creative dance sessions per week for 12 weeks. The outcomes measured effects on balance, mobility, balance confidence, and level of functional independence. These measurements were obtained at pre-intervention, post-intervention, and the 3-month follow-up. Outcome data of pre- to post-intervention and pre-intervention to 3-month follow-up were analyzed and compared. Statistically significant differences were found in the pre- and post-intervention displacement of the center of pressure (CoP) in the eyes-opened (EO) condition, timed up and go test (TUG), and Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and Korean-Activity of Balance Confidence (K-ABC) scores. Significant improvements were also observed for the CoP-EO, BBS, TUG, DGI, and K-ABC between the pre-intervention and 3-month follow-up assessments. However, there were no significant differences in the CoP in the eyes-closed condition and Korean modified Barthel Index score. Participants expressed enjoyment without any pain or fatigue. Our findings suggest that dance may have a positive impact in improving balance and mobility and may consequently contribute to healthy aging in adults with CP.