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

Authors:

Abstract

Dance therapy is a physical activity that can lead to balance improvement in older adults. The aim of the study was to evaluate the effects of dance therapy on balance and risk of falls in older women. Twenty-four older women (mean age 66.4 years old) attended dance sessions for three months. Pretest/posttests were completed using the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test M-CTSIB. Results showed the Limits of Stability Test was significantly higher (17.5%) after dance classes. Regular use of dance therapy shows promise in improving balance by increasing the limits of stability.
The effect of dance therapy on the balance of women over 60
years of age: The influence of dance therapy for the elderly
Katarzyna Filar-Mierzwa
a
,Małgorzata Długosz
b
, Anna Marchewka
c
, Zbigniew Dąbrowski
c
and Anna Poznańska
d
a
Department of Occupational Therapy, University School of Physical Education in Kracow, Kracow, Poland;
b
University School of Physical Education in Kracow, Kracow, Poland;
c
Department of Clinical Rehabilitation,
University School of Physical Education in Kracow, Kracow, Poland;
d
Sport Institute, University School of Physical
Education in Kracow, Kracow, Poland
ABSTRACT
Dance therapy is a physical activity that can lead to balance improvement in
older adults. The aim of the study was to evaluate the effects of dance therapy
on balance and risk of falls in older women. Twenty-four older women (mean
age 66.4 years old) attended dance sessions for three months. Pretest/posttests
were completed using the Postural Stability Test, the Limits of Stability Test, and
the Fall Risk Test M-CTSIB. Results showed the Limits of Stability Test was
significantly higher (17.5%) after dance classes. Regular use of dance therapy
shows promise in improving balance by increasing the limits of stability.
KEYWORDS
Balance; dance therapy;
older women
Introduction
The process of aging is associated with an increase of neuromuscular deficits (Henderson, Irving, &
Nair, 2009; Latham et al., 2003). This may lead to falls and disorders of balance and gait (Moreland
et al., 2003; Rubenstein, 2006). Exercise is recommended as a way to slow down functional decline
and to improve balance and mobility in older adults (Granacher et al., 2010; Sturnieks, St George, &
Lord, 2008; Tiedemann, Sherrington, Close, & Lord, 2011). Dance movement therapy is a form of
physical activity that may improve balance in older adults. According to the American Dance
Therapy Association, dance therapy is the therapeutic use of movement as a process leading to
emotional and physical integration of a person (Kozłowska, 2002). It means that dance therapy is
multifaceted and affects both the physical and mental spheres. The aim of the study was to evaluate
the effects of dance therapy on balance and risk of falls in older women. We hypothesized that dance
therapy may improve balance in older women.
Falls in older adults
Age-related declines affect all major body systems, including the cardiovascular, respiratory, diges-
tive, nervous, and musculoskeletal systems (Demczyszak, Wrzosek, & Ziółkowska, 2007;
Wieczorowska-Tobis, Kostka, & Borowicz, 2011). Furthermore, aging may functionally affect the
motor and postural systems, which are both linked to postural stability (Błaszczyk & Czerwosz,
2005). It has been shown that loss of static balance; reduced excitability of the peripheral portion of
the vestibular system; and weaker compensatory, psychomotor, and sensory reactions, which are
associated with aging, increase risk for imbalance and falls (Hall & Miller, 2001; Nashner, 1993;
Shumway-Cook & Woollacott, 2001).
CONTACT Katarzyna Filar-Mierzwa, PhD katarzyna.filar@awf.krakow.pl Department of Occupational Therapy, University
School of Physical Education in Kracow, Al. Jana Pawła II 78, Kracow 31-571, Poland.
© 2016 Taylor & Francis
JOURNAL OF WOMEN & AGING
http://dx.doi.org/10.1080/08952841.2016.1194689
Approximately 28%35% of people aged 65 years and over fall down each year, and this
proportion increases to 32%42% for those over 70 years of age (World Health Organization,
2007). The causes of falls can be divided into internal (intrinsic) and external (environmental).
Internal factors are directly linked to age-related involution, chronic diseases, pharmacotherapy, or
recent acute illnesses (Kwiatkowska et al., 2011). Environmental factors include all the elements that
are present in the environment of older adults and may have an effect on their balance: They can be
slippery and uneven surfaces; steep stairs; wrapped, thick, and fluffy carpets; movable walkways;
thresholds; uncomfortable shoes; inadequate bathroom lighting, beds, chairs, and shelves; cables;
damaged street surfaces; or high curbs (Kwiatkowska et al., 2011).
The incidence of falls increases with age and can result in injuries leading to total immobility of
older adults or even their untimely death (Czerwiński, Borowy, & Jasiak, 2006; Szpringer,
Wybraniec-Lewicka, Czerwiak, Michalska, & Krawczyńska, 2008; Wieczorowska-Tobis et al.,
2011). Older people living in nursing homes are at increased risk of falling as compared to
community dwellers. It has been reported that approximately 30%50% of people living in long-
term care institutions fall each year, and 40% of them experience recurrent falls (World Health
Organization, 2007). Ignasiak, Kaczorowska, Katan, and Domaradzki (2009) compared the mobility
of 30 older women from a nursing home and 30 age- and sex-matched community dwellers using
the specialized Fullerton Functional Fitness Test for older adults. The aim of the test, consisting of
six motor attempts, was to assess all the physiological parameters providing independence and safety
during the activities of daily livingnamely, aerobic fitness, flexibility, strength, agility, and dynamic
balance. Women from a nursing home were shown to present worse physical fitness and balance
than the controls, which turned out to be associated with different living conditions and lifestyle.
Dance therapy
It has been found that dance therapy improves functioning of the body, coordination, balance,
flexibility, and speed of movements (Czerwiński et al., 2006; Pasek, Pasek, Witiuk-Misztalska and
Sieroń,2011;Żak, 2000). The use of other treatments such as a circuit aerobic step exercise program
(Anek & Bunyaratavej, 2015), aqua aerobic therapy (Kim & OSullivan, 2013), Nordic walking
training (Virag et al., 2015), as well as strength training in older adults (Holviala et al., 2014) also
improve balance and functional abilities.
It has been shown that physical exercise, including dance, may exert a beneficial effect on balance
and mobility; thus it can reduce the risk of fall in older adults (Alpert et al., 2009; Federici, Bellagamba,
& Rocchi, 2005; Hamburg & Clair, 2003; Keogh, Kilding, Pidgeon, Ashley, & Gillis, 2009).
Dance therapy is something that older adults enjoy, which in turn is essential in terms of their
motivation. Resnick and Spellbring (2000) showed that the main reasons older adults quit their
exercise programs are boredom and fear; conversely, having fun was the main reason behind the
adherence of older adults to their physical activity programs. The unique potential of dance stems
from the fact that the routine may vary from class to class, and it is often perceived as a fun, rather
than as a standard exercising (e.g., walking on a treadmill) (Alpert et al., 2009).
Granacher et al. (2012) confirmed that dance therapy plays an important role in improving
balance of older adults. They studied the effects of dance classes on static and dynamic postural
control. The study included two groups: 14 individuals who attended 60-minute salsa classes twice a
week for 8 consecutive weeks and 14 controls who did not practice any sports. The participants were
examined using a balance platform. The study showed that participation in salsa classes improved
both static and dynamic balance. Although the salsa classes were demonstrated to be a good way to
improve balance, they turned out to be insufficient for gait improvement and postural muscle
strengthening.
Hackney, Hall, Echt, and Wolf (2013) analyzed a group of visually impaired individuals over 75 years
of age to assess the impact of modified, adjusted forms of tango on their balance and quality of life.
More than half of the participants were women. Balancing skills of the participants were assessed with
2K. FILAR-MIERZWA ET AL.
the Dynamic Gait Index (DGI) and standing up from a chair (how many times a person is able to get up
from a chair in 30 seconds) tests. DGI was developed as a clinical tool to assess gait, balance, and fall
risk. The subjects were examined three times: Prior to the dance therapy, immediately thereafter, and
after one month. The intervention resulted in a significant improvement of balancing skills, which
points to the usefulness of dance therapy in this indication, also in older adults.
Methodology
Participants
The study included 24 women aged between 61 and 74 years (mean 66.4 years). Prior to enrollment,
each woman completed a survey regarding their incidence of balancing disorders and falls during the
two years preceding the study. None of the participants had a history of falls, but three reported
episodes of vertigo and balancing disorders. One of the inclusion criteria of the study was sedentary
lifestyle, i.e., lack of any physical activity aside from that associated with the activities of daily living.
Other inclusion criteria were: Female sex, over 60 years of age, and the lack of physical and/or
psychological contraindications to dance therapy, as certified by a primary care physician. The list of
the exclusion criteria included paralysis and paresis interacting with independent mobility, severe
vertigo, dementia, diabetes mellitus, and cardiovascular disorders.
The subjects were familiarized with all the study procedures and then their written informed
consent was sought. The protocol of the study was approved by the Local Ethics Committee at the
Regional Medical Chamber in Kracow, Poland.
Protocol for dance therapy sessions
The women participated in the dance therapy program for three months, with three 45-minute
sessions weekly. Each dance therapy session included three parts. The first part was a 10-minute
warm-up, including training of an appropriate dancing posture (exercises for a normal body
posture), slow dancing technique evenly improving all muscle groups equally, and dancing-gymnas-
tic exercises (Janowska & Seredyńska, 2006). The second part, a 30-minute proper training, included
basic steps and figures of a folk dance (Kuźmińska, 2002), ballroom dance (Official Board of
Ballroom Dancing, 1968), integration dance, and dances of foreign nations (PSPiA Klanza, 1995),
as well as practicing simple choreographies, including previously learned steps, figures, and dancing
improvisation. The third part, a 5-minute cooling down, included coordination, balance, breathing,
and relaxation exercises (Janowska & Seredyńska, 2006).
The dance therapy, according to the aforementioned protocol, represented a form of moderate
physical activity, corresponding to 50%70% of maximum heart rate in a given person. For example,
the target heart rate for a 70-year-old person is 75105 beats per minute, and this value should not
be exceeded at any point of the session. Therefore, heart rates of participating women were
monitored with a cardiac monitor (Polar Sport Tester, Polar Electro Oy, Finland) throughout each
training session.
Standardization of tests
First, the subjects were examined for their postural stability. The aim of this static test was to
evaluate the participants ability to maintain balance by means of the angular deflection of her center
of gravity. Selection of an appropriate static measurement scale was based on body height of the
participant (Biodex Medical Systems, 2009; McIlroy & Maki, 1997; Nashner, 1993).
The Limits of Stability (LOS) test was the second test performed by the study participants. The
LOS for balance in a standing position was determined at the maximum angle at which the
subject could deviate from the vertical position without losing her balance. This test verified the
JOURNAL OF WOMEN & AGING 3
subjects ability to maintain her center of gravity whenever it was outside the plane of support.
When the LOS is exceeded, a person falls or needs to implement corrective strategies to prevent
the fall (place-step, bending the knees) (Biodex Medical Systems, 2009;Clark,Rose,&Fujimoto,
1997).
The last test was the Fall Risk Test Modified Clinical Test of Sensory Integration and Balance
(FRT MCTSIB). Researchers selected this test to assess the risk of falls. According to literature, it
accurately identifies persons with moderate to severe balancing disorders. Furthermore, the test can
be used to identify the disorders linked to various systems involved in postural control, i.e., visual
control, and vestibular and somatosensory systems. The test is comprised of four parts. In Part 1, the
ability to maintain a standing position on a solid surface motionless with eyes open (visual control,
vestibular and somatosensory systems) is tested. In Part 2, the same parameter is examined but with
eyes closed. The aim of Part 3 is to determine ones ability to maintain an upright position on a
dynamic surface with open eyes (evaluation of interaction between visual control and somatosensory
systems). The same parameter is a subject of examination in Part 4 but with eyes closed (assessment
of interaction between somatosensory and vestibular systems). The test is well known in clinical
practice, and its results correlate strongly with the risk of falling (Biodex Medical Systems, 2009;
NeuroCom Int., 2008).
Procedures
Prior to and after dance therapy, subjects were tested on the BioSway balance platform (Biodex),
according to standardization in line with the manufacturers instructions (Biodex Medical Systems,
2009). The device consisted of a suitably configured platform and a display. It also provided a foam
surface to create unstable ground conditions. Researchers used the platform because it is convenient
and provides reliable, reproducible, and objective data on the levels of neuromuscular control and
balance on both stable and unstable surfaces. Each subject was examined three times. Prior to each
proper test, a test examination was carried out in order to ensure that each participant understood
the procedure correctly.
Results
The results were analyzed with a specialized software package, Statistica (StatSoft). First, the
outliers were identified and excluded from further analysis. Statistical characteristics of the results
were presented as arithmetic means, standard deviations, medians, lower and upper quartiles,
maximum and minimum values, and coefficients of variation (%). The results are shown in
Table 1.
Normal distribution of the analyzed variables was verified with the Shapiro-Wilk test, a powerful
test that is particularly applicable for examination of small samples. As the values of all three tests
(Postural Stability Test [PST], LOS test, FRT) were distributed normally, a paired t-test was used for
comparison of pre- and postdance therapy values. The results are presented in Table 1.
A statistically significant difference (p< 0.05) was found between the pre- and postdance
therapy results for the LOS test. The mean postdance therapy result of the test was 17.5% higher
than the respective predance therapy value (29.1 ± 11.44 vs. 34.2 ± 11.91; p= 0.0059) (Table 1).
The researchers did not find a significant difference between the pre- and postdance therapy
results for the PST (p= 0.5412). Similarly, no statistically significant differences were observed
between the pre- and postdance therapy values for all the parts of the FRT MCTSIB (eyes open firm
surface: p= 0.3822; eyes open foam surface: p= 0.5754; eyes closed firm surface: p= 0.1561; or eyes
closed foam surface: p= 0.9236) (Table 1).
4K. FILAR-MIERZWA ET AL.
Discussion
The aim of the study was to analyze the effects of dance therapy on balancing skills in women older
than 60 years. The study showed that a 3-month program of dance therapy resulted in a significant
improvement of balancing skills in older women, as demonstrated by an increase in the values of the
LOS test.
Available studies have suggested that dance therapy may improve balance and reduce the risk of
falls in older women. Most previous studies analyzing the effects of dance classes on balance in older
adults documented a significant improvement of this parameter (Eyigor, Karapolat, Durmaz,
Ibisoglu, & Cakir, 2009; Shigematsu et al., 2002; Sofianidis, Hatzitaki, Douka, & Grouios, 2009).
Alpert et al. (2009) analyzed the effects of a modified form of jazz dance on balancing skills,
cognitive function, and mood in healthy older adult women. The level of balancing skills was
determined with a standardized clinical test, The Sensory Organization Test (SOT). The test was
used to study three sensory activities related to sustainability: Visual aids, proprioception, and
kinesthetic control. Balancing skills of the study participants improved gradually during the dance
classes and were eventually significantly better than at the baseline. Jazz dance improves flexibility of
the locomotor system and exerts a favorable effect on both the balancing and cognitive skills.
Therefore, jazz dance classes constitute an original and attractive option to improve balancing skills
of older women and to prevent falls. In another study, Borges et al. (2012) analyzed the effects of a
dance therapy, including some figures and steps of ballroom dancing, on balancing skills and
autonomy in older adults with a sedentary life. The study included 75 people, among them 39
individuals who attended dance classes for 8 months, three times a week, and 36 controls who did
not undertake any physical activity throughout the analyzed period. Balancing skills of the study
participants were determined on the basis of their posture and with a stabilometer. When compared
to the controls, individuals subjected to dance therapy showed significant improvement in their
balancing skills and functioning.
One explanation for the improvement of balancing skills in our participants is the fact that
dancing involves all three components required to maintain balance, i.e., visual control and the
somatosensory and vestibular systems. The somatosensory system was previously shown to be an
essential component of dance training and to exert beneficial effects on both the motor and sensory
orientation (Simmons, 2005).
Our findings partially supported the hypothesis that dance therapy may improve balancing skills
in older women. However, it should be remembered that the improvement was confirmed with only
one out of the three conducted testsnamely, with the LOS test.
Aging is associated with a decrease in stability limits (Holbein-Jenny, McDermott, Shaw, &
Demchak, 2007). This reflects the influence of multiple factors, among them reduced ankle
Table 1. Pre- and postdance therapy results of the conducted tests and statistical significance of the intervention-related changes.
Test NAverage Median Min. Max.
Lower
quartile
Top
quartile SD
Coefficient of
variation
Paired
t-test
Postural Stability Test Before 23 1.11 1.20 0.30 2.20 0.70 1.30 0.43 38.53 t=0.62
After 24 1.15 1.20 0.40 1.80 0.80 1.55 0.43 37.11 p= 0.5412
Limits of Stability Test Before 24 29.1 29.0 10.0 54.0 20.5 36.5 11.44 39.28 t=3.04
After 24 34.2 32.0 15.0 58.0 28.0 42.0 11.91 34.86 p= .0059*
Fall Risk Test CTSIB eyes
open foam surface
Before 24 1.36 1.37 0.82 2.07 1.16 1.58 0.28 21.05 t=0.57
After 23 1.32 1.33 0.86 2.05 1.06 1.60 0.32 24.27 p= 0.5754
Fall Risk Test CTSIB eyes
open firm surface
Before 24 0.67 0.64 0.32 1.00 0.58 0.76 0.17 25.88 t= 0.89
After 24 0.64 0.62 0.33 1.20 0.46 0.76 0.22 34.00 p= 0.3822
Fall Risk Test CTSIB eyes
closed foam surface
Before 23 2.63 2.52 1.95 3.54 2.26 3.02 0.46 17.50 t=0.09
After 23 2.45 2.47 1.57 3.52 1.91 2.94 0.59 24.29 p= 0.9236
Fall Risk Test CTSIB eyes
closed firm surface
Before 24 0.73 0.69 0.40 1.28 0.52 0.89 0.23 31.89 t= 1.47
After 24 0.69 0.70 0.28 1.11 0.56 0.83 0.21 30.99 p= 0.1561
Note. *Significantly different from the respective predance therapy value (p< 0.05).
JOURNAL OF WOMEN & AGING 5
muscle strength (Melzer, Benjuya, Kaplanski, & Alexander, 2009) and poor cutaneous mechan-
oreceptor function in the soles of the feet, both resulting in greater instability of older subjects
during the activities of daily living and increased risk of falling (Girardi, Konrad, Amin, &
Hughes, 2001).
Dance therapy puts great emphasis on controlled weight shifting and ankle movement sway,
alternation between a narrow stance and a wide stance to continually change the base of support,
rotational trunk-driven movements, and dorsiflexion and plantar flexion during dance. These
features may impact important sensorimotor elements that contribute to enhanced limits of stability.
Therefore, the increase in the limits of stability may likely be attributed to the improvements in
flexion/extension ankle torques, range of ankle motion, movement recovery strategies, or sensory
integration. All these features are inherent to dance (Fuzhong, 2014).
Due to dance therapy-induced increases in the limits of stability, older women can more
efficiently perform the activities of daily living, which provides them with a stronger sense of
independence and safety. This in turn may result in quality of life improvement.
Participation in dance classes protects older subjects against deterioration of their physical fitness,
a key determinant of both normal body balance and reduced risk of falling. Women in this study
commented that they liked dance therapy and would continue this form of physical activity. Attitude
may protect older women against balancing disorders and falls in the future.
Balancing skills can be assessed with various types of clinical tests, scales, and exams on dedicated
balance or posturographic platforms. In this study, we used the BioSway, a special balance platform.
Importantly, previous studies showed that examination with a balance platform provides highly
reproducible results and is a reliable method to assess static and dynamic balance in people of
various ages (Ocetkiewicz, Skalska, & Grodzicki, 2006).
Aside from the measurement methods, this study also has other strengths. The measurements
with the balance platform were taken immediately after completing the dance therapy program in
order to exclude potential confounding effects of other physical activity on the results. Moreover,
only the data for women who regularly attended the dance therapy classes were included in the
analysis.
Limitations
However, our study is not free from some potential limitations, such as lack of a control group,
small sample size, and that only one out of the three parameters was significant. Future studies
should include women from various age categories, also above 80 years of age, whose balancing
skills usually deteriorate markedly. As dance therapy is multifaceted, the psychological and social
effects of this modality should be further evaluated as a motivational factor for continued
physical activity.
Conclusions
Regular dance therapy seems to be a promising method for improving balancing skills due to
increase in the stability limits. Therefore, this form of physical activity, supervised by qualified
professionals, should be recommended for older women, especially those who have sedentary life-
styles. However, due to potential limitations of this study, verification of this hypothesis requires
further research, including a control group and a larger number of subjects.
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8K. FILAR-MIERZWA ET AL.
... 2 Aerobik step egzersizleri, havuz egzersizleri, Nordik yürüme eğitimi ve diğer kuvvetlendirme eğitimleri gibi terapiler yaşlı bireylerde denge ve fonksiyonel becerileri geliştirmektedir. 3 Son yıllarda dans temelli egzersiz terapisinin (DTET) de yaşlı bireylerde denge becerilerini artırabilecek bir fiziksel aktivite şekli olduğuna dair kanıtlar artış göstermekte olup düşme riskini azaltabileceği düşünülmektedir. 3,4,5 Yaşlı bireylerin fiziksel aktivite ve egzersiz ile ilişkili müdahaleleri çoğunlukla tamamlayamadıkları ve bu durumun nedenleri olarak yaşlıların egzersize düzenli katılmamaları, yeterli bağlılık göstermemeleri ve egzersizi bırakma oranlarının yüksek oluşu olarak gösterilmektedir. ...
... 3 Son yıllarda dans temelli egzersiz terapisinin (DTET) de yaşlı bireylerde denge becerilerini artırabilecek bir fiziksel aktivite şekli olduğuna dair kanıtlar artış göstermekte olup düşme riskini azaltabileceği düşünülmektedir. 3,4,5 Yaşlı bireylerin fiziksel aktivite ve egzersiz ile ilişkili müdahaleleri çoğunlukla tamamlayamadıkları ve bu durumun nedenleri olarak yaşlıların egzersize düzenli katılmamaları, yeterli bağlılık göstermemeleri ve egzersizi bırakma oranlarının yüksek oluşu olarak gösterilmektedir. 5 Bu nedenle, bir müdahalenin bireyselleştirilebilmesi ve yaşlı popülasyonuna göre uyarlanabilmesi için katılımcıların etkinliğe katılımının artırılmasını sağlayacak şekilde ek araştırmalar yapılması gerekmektedir. ...
... 4,7 DTET'nin vücut fonksiyonlarını, koordinasyonu, esnekliği, mobiliteyi ve hareket hızını geliştirdiği gösterilmiştir. 3 11,12 Bireylerin alt ekstremite kas kuvveti, yaşlı bireylerde fonksiyonel alt ekstremite kuvvetini değerlendiren 30 saniye Otur-Kalk Testi ile, 13 üst ekstremite fonksiyonel kas kuvveti Jamar El Dinamometresi ile değerlendirildi. 14 Bireylerin üst gövde esneklikleri Sırt Kaşıma Testi ile değerlendirildi. ...
... Dance, as defined by the American Dance Therapy Association (ADTA), is the psychotherapeutic use of movement to promote emotional, social cognitive, and physical integration of individuals for the purpose of improving health well-being. Dance is an emerging alternative intervention that has shown increased compliance and effectiveness for improving physical function in healthy older adults 22,[25][26][27] and adults with stroke. 28,29 Dance movements may be especially advantageous for the aging population and those with stroke as they facilitate training strategies, such as continuous CoM displacements within the individual's stability limits. ...
... Specifically, studies have reported numerous dance forms, including Korean, ballroom, Argentine, tango, Turkish folkloristic, Greek, Caribbean, and aerobic, and categorized the forms to slow, medium, or fast-paced dance based on the movement patterns. 26,28,29,49,50 These different dance paces alter the biomechanical or kinematic demands of movement control and could result in distinct movement adaptations. Hence, given that there is still limited knowledge on how the quality of movement and postural stability changes with varying paces of dance, this study's biomechanical analysis could be particularly useful in identifying dance movement patterns in aging and stroke populations to help develop population-specific or customized assessment and intervention regimens. ...
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Background: Recent studies demonstrate improvements in both postural stability and mobility among aging populations and those with stroke who are exposed to dance-based exergaming (DBExG). However, age-related deficits and aging with cortical pathology may lead to distinct movement adaptation patterns during DBExG, which could impact therapeutic outcomes. Aim: The aim of this study was to examine the movement kinematics (postural stability and mobility) of healthy older adults, older adults with stroke, and young adults for different paces of dance during DBExG. Method: The study included 33 particpants (11 participant from each group of healthy older adults, older adults with chronic stroke, and healthy young adults) who performed the DBExG using slow- (SP), medium- (MP), and fast-paced (FP) songs with movements in the anteroposterior (AP) and mediolateral (ML) directions. Center of mass (CoM) sway area, excursion (Ex), and peaks as well as hip, knee, and ankle joint excursions were computed. Results: Results of the study revealed that CoM sway areas and Exs were greater for healthy young adults than for older adults with stroke for the SP dance (p < 0.05) and that there were significantly more AP CoM peaks for young adults than for healthy older adults and those with stroke for the FP dance (p < 0.05). Young adults also exhibited greater hip and ankle Exs than older adults with stroke (p < 0.05) for all song paces. Similarly, knee and ankle Exs were greater for healthy older adults than for older adults with stroke for all song paces (p < 0.05). Conclusion: The quantitative evaluation and comparison of the movement patterns presented for the three groups could provide a foundation for both assessing and designing therapeutic DBExG protocols for these populations.
... Considering that the balance function of people with cognitive impairment is worse than that of healthy older adults, older people with MCI tend to have higher fall rates (Fuentes-Abolafio et al., 2021). Previous studies have found that dance involves visual control and the somatosensory and vestibular system to maintain balance (Filar-Mierzwa et al., 2020); thus, it can effectively improve the balance ability of older adults and reduce the incidence of falls (Shanahan et al., 2016;Filar-Mierzwa et al., 2017;Liu et al., 2021). However, a comprehensive analysis of the BBS score in our study showed that the balance ability of the dance group was not better than that in the control group. ...
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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.
... Wyniki badań pokazały, że terapia poprawia stabilność ocenianą testem Limit of Stability Test. Autorzy wskazują, że taka forma aktywności fizycznej powinna być zalecana dla starszych kobiet, szczególnie tych prowadzących siedzący tryb życia [11]. ...
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Autorzy przeprowadzili badania słuchaczek Uniwer- sytetu Trzeciego Wieku, u których zastosowano ćwi- czenia koordynacji wzrokowo-ruchowej z wykorzysta- niem wzrokowego sprzężenia zwrotnego na platformie stabilograficznej. Celem pracy była ocena udziału kon- troli wzrokowej i kontroli wzrokowo-ruchowej podczas utrzymywania równowagi w pozycji stojącej po zasto- sowanych ćwiczeniach stymulacji układu równowagi w pętli wzrokowego sprzężenia zwrotnego. Wyznaczo- nymi wskaźnikami oceniano udział wzroku w kontro- li postawy ciała oraz koordynację wzrokowo-rucho- wą. Wskaźnik kontroli wzrokowej po ćwiczeniach uległ zmniejszeniu. Natomiast wskaźnik kontroli wzrokowo- -ruchowej istotnie zwiększył się. Ćwiczenia koordy- nacji wzrokowo-ruchowej wykorzystujące wzrokowe sprzężenie zwrotne (biofeedback) poprawiają kontro- lę wzrokowo-ruchową kobiet po 60. r.ż., jednocześnie zmniejszają udział wzroku w kontroli postawy podczas utrzymywania równowagi w pozycji stojącej.
... 9 A meta-analysis also showed that among ordinary sports, dance was one of the most effective exercises to alleviate depressive symptoms among depressed patients. 10 Moreover, apart from mental disorders, sports dance therapy can also be beneficial for other special populations, such as those with obesity 11 or hypertension, 12 elderly people with balance problems, 13 and in Parkinson's disease, 14 to name just a few. However, these studies generally focused on the investigation of some special populations. ...
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Purpose: This study aims to investigate the role of frequent sports dance in preventing mental disorders, including anxiety and depression, among college students using real-world data, and to further analyze potential risk factors associated with anxiety and depression. Methods: We investigated 921 college students from eight universities in China. A survey was completed by 901 students and they were included in the analysis. The anxiety score was evaluated by the Generalized Anxiety Disorder 7-item (GAD-7) scale and the depression score was evaluated by the Patient Health Questionnaire-9 (PHQ-9). Subgroup comparisons were performed among frequent sports dance students and non-frequent sports dance students. Results: Of all the students, 9.98% had moderate-to-severe anxiety and 14.65% students suffered from moderate-to-severe depression. Compared with non-frequent sports dance students, frequent sports dance students had significantly lower depression scores (P=0.04). According to the multiple logistic regression models, when potential confounding factors were all adjusted, frequent sports dance was also significantly associated with less depression (OR=0.55, 95% CI: 0.36-0.84, P<0.01). We also found that higher college grade levels (P<0.01), non-physical education students (P=0.02), higher body mass index (P=0.02), lower exercise frequency per week (P<0.01), addiction to drinking (P=0.02), and previous diagnosis of anxiety or depression in hospital (P<0.01) were significantly associated with more anxiety; higher college grade levels (P<0.01), addiction to drinking (P<0.01), preference for eating fried food (P=0.02), soda as the main source of drinking water (P=0.01), and previous diagnosis of anxiety or depression (P=0.03) were significantly associated with more depression, while higher exercise frequency per week (P<0.01), only-child status (P<0.01), and preference for eating vegetables (P=0.02) were significantly associated with less depression. Conclusion: Anxiety and depression are common among college students. Frequent sports dance may serve as a protective factor for preventing depression and it can be recommended for college students.
... Dentre os tipos de atividade física populares entre idosos, a dança de salão constitui uma modalidade, caracterizada por proporcionar junção de movimentos biomecânicos simultâneos e expressão de sentimentos sendo, capaz de fornecer aos idosos uma série de benefícios, além de permitir interação social e consequente inserção na sociedade. Com relação aos efeitos fisiológicos, a dança de salão é capaz de promover melhora da coordenação, percepção corporal e espacial, melhora da agilidade e equilíbrio, fortalecimento da musculatura, e consequentemente diminuição da incidência de quedas (FILAR-MIERZWA et al., 2017;MONTEIRO et al., 2007). ...
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Resumo: A prática contínua da dança de salão pode atenuar aspectos deletérios do envelhecimento e melhorar a qualidade de vida, funcionalidade e o convívio social. Neste sentindo, objetivo deste estudo foi avaliar os benefícios da dança de salão em idosos. Foram incluídos 40 idosos, com idade acima de 60 anos, de ambos os sexos. Os participantes foram alocados intencionalmente, em dois grupos GC (n= 20), constituído por idosos sedentários e GE (n=20) constituído por idosos praticantes da dança de salão. A qualidade de vida foi investigada por meio do questionário SF-36 e a funcionalidade através do questionário OARS ambos, previamente validados. Para análise de dados foi utilizado o software Instat. O teste t foi realizado para comparar os grupos. Houve melhora significativa em cinco dos oito domínios investigados através do SF-36 referente a qualidade de vida no GE quando comparados com o GC. Também verificou-se melhor desempenho funcional em relação as atividades de vida diária no GE. Conclui-se que a dança de salão é capaz de produzir benefícios relacionadas a funcionalidade e qualidade de vida na população investigada. Palavras-chave: Envelhecimento. Exercício físico. Atividade Física. Funcionalidade. Incapacidade e Saúde. Abstract: The continuous practice of ballroom dancing can attenuate harmful aspects of aging and improve the quality of life, functionality and social life. In this sense, the objective of this study was to evaluate the benefits of ballroom dancing in the elderly. Forty elderly people, over 60 years old, of both sexes were included. Participants were allocated intentionally, in two groups, CG (n = 20), consisting of sedentary elderly people and GE (n = 20) consisting of elderly people who practice ballroom dancing. Quality of life was investigated using the SF-36 questionnaire and functionality through the OARS questionnaire, both previously validated. For data analysis, the Instat software was used. The t test was performed to compare the groups. There was a significant improvement in five of the eight domains investigated through SF-36 regarding quality of life in the SG when compared to the CG.
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This systematic review aimed to verify the quality of analyses using PRISMA guidelines and evaluate the effectiveness of dance/movement therapy (DMT) interventions in individuals with intellectual disabilities. As search engines, Medline, PubMed, and Web of Science were used to select the studies under specific requirements. We also used the American Journal of Dance Therapy as an additional search. Five studies were selected after the final screening. Regarding the levels of evidence (LOE), two studies had an LOE of 3 and three studies had an LOE of 4. The risk of bias (ROB) through quality assessment of controlled intervention studies showed a high ROB in all selected studies. Although the results showed the low LOE and high ROB, the selected studies reported that DMT interventions improved motor skills, body knowledge, emotional well-being, skin temperature in fingers, and muscle relaxation in individuals with moderate to severe IQ from young adults to middle-aged adults.
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Introducción: Las caídas se consideran un problema de salud pública en los adultos mayores y su abordamiento debería ser multidimensional. La danza surge como una opción de intervención que permite integrar diferentes esquemas en la potenciación del movimiento. Objetivo: Determinar los efectos de la danza a nivel de equilibrio, función motora y actividades de la vida diaria en adultos mayores con riesgo de caer. Métodos: Revisión exploratoria en torno a cuáles son los efectos de la danza en adultos mayores con riesgo de caer para mejor el equilibrio, la marcha, la función motora y las actividades de la vida diaria. Las búsquedas se llevaron a cabo en PubMed, LILACS, Registro Central Cochrane de Ensayos Clínicos Controlados, PEDro, OTSeeker, artículos en texto completo en las diferentes bibliotecas virtuales (ProQuest, Ovid, Ebsco, Science Direct) y búsqueda manual. Resultados: Se encontraron 19 estudios que reportan sesiones de 45 a 60 minutos durante 12 semanas. La danza puede considerarse una intervención segura que disminuye significativamente la intervención de control para equilibrio y marcha en adultos mayores. Conclusiones: Los resultados de este trabajo sustentan que se puede emplear la danza como una opción interventiva en adultos mayores que presentan riesgo de caer.
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Ketidakmampuan mengelola emosi dalam kehidupan membuat seseorang tidak dapat menghadapi permasalahan yang penuh tekanan. Teknik regulasi emosi sangat penting dalam kehidupan. Salah satu cara untuk mengolah emosi dengan belajar tari klasik gaya Surakarta.Tujuan penelitian untuk mengetahui gambaran regulasi emosi penari tradisional tari klasik gaya Surakarta di UKM SENTRA UIN Raden Mas Said. Data penelitian adalah data kualitatif dengan pendekatan fenomenologi. Informan dalam penelitian ini diambil secara purprosive sampling sebanyak tiga penari putri dengan rentang usia 20-22 tahun. Sumber data berupa hasil dari wawancara semi terstruktur, observasi, dan dokumentasi. Analisis data menggunakan analisis deskripsi berupa pemaparan uraian dan diolah dengan menggunakan software atlas.ti. Hasil regulasi emosi di UKM SENTRA penari memiliki regulasi emosi yang baik berupa ketenangan diri, sabar, dapat beradaptasi dengan lingkungan baru, memiliki rasa empati yang baik, dan peka terhadap lingkungan. Informan menjadi lebih dapat memahami diri, percaya diri, memiliki kontrol diri yang baik, serta lebih bersemangat dalam menjalani hidup setelah tergabung dalam UKM SENTRA.
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Background: This systematic review provides an overview about those papers with a specific physical exercise intervention aimed to improve physical, cognitive and/or emotional outcomes in healthy older people aged 60 or over. Studies with no intervention whose sample were active healthy older adults were also included. Methodology: An exhaustive literature search was done through two databases, including studies from January 2000 to December 2020. The present systematic review was registered in an international database of prospectively systematic reviews in health and social care named PROSPERO with the registry number CRD42020223081. Results: Of the 2148 identified records, 69 met the inclusion criteria and were selected. Results from the review showed a wide variety of older adults and lengths of the interventions, from five weeks (the shortest one) to five years. Aerobic exercise, either isolated or combined with strength performance, was also the most common type of exercise recognized in this systematic review. Conclusions: Findings also suggest that the number of studies with all, physical, cognitive and emotional outcomes have been increasing during recent years in healthy older adults.
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The percentage of people 60 year-olds has been constantly increasing in recent decades, as a result of improvement of living conditions. This situation has generated a lot of research on the problems of the aging. Majority of the studies concerns the quality of life, health condition, lifestyle, nutrition and social or living standards. The authors have indicates that promotion of healthy lifestyle among the elderly helps improve their quality of life. The aim of this study was to assess fitness of a group of senior women representing various living environments. Material and method: the tests were conducted on a group of city dwelling women aged over 60 years, living in old age homes or receiving sanatorium treatment. Fitness was assessed by means of Fullerton test. This test allows evaluating the basic, everyday motor ability and fulfils one important condition - it ensures safety of the tested person while performing the task.
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Background Limits of stability, defined as the ability to maintain the center of gravity within the boundary of the base of support, is critically important for older adults in performing their activities of daily living. However, few exercise programs specifically tailored to enhance limits of stability exist. The primary purpose of this study was to determine whether a therapeutically designed intervention, Tai Ji Quan: Moving for Better Balance (TJQMBB), could improve limits of stability in older adults. A secondary purpose was to examine concomitant change in limits of stability and physical performance as a result of the intervention. Methods A single-group design was used in which 145 community-dwelling older adults (average age: 75 years) were enrolled in TJQMBB classes, participating twice weekly for 48 weeks. Primary outcome measures were three indicators of limits of stability (LOS) (endpoint excursion, movement velocity, and directional control), with secondary measures of physical performance being Timed Up and Go and 50-foot speed walk (in seconds), which were assessed at baseline, 24 weeks, and 48 weeks. Changes in the repeated measures of outcome variables were analyzed via latent curve analysis. Results At 48 weeks, a significant rate of change (improvement) over time was observed in the three limits of stability indicators (endpoint execution: 8.30% LOS, P<0.001; movement velocity: 0.86 degrees/second, P<0.001; directional control: 6.79% of 100, P<0.001); all reached a threshold of real change as judged by the minimal detectable change values. Improvements in the three limits of stability measures were concomitantly correlated with improved (reduced times) performance scores in the Timed Up and Go (−0.30, −0.45, and −0.55, respectively) and 50-foot walk (−0.33, −0.49, and −0.41, respectively). Conclusion In this single-group study, community-dwelling older adults trained through TJQMBB significantly improved their limits of stability, providing preliminary support for the use of TJQMBB as a therapeutic modality for enhancing functional activities in older adults.
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[Purpose] The purpose of the present study was to examine the effects of an aqua aerobic therapy exercise for older adults on biomechanical and physiological factors affecting gait. [Subjects] A total of 15 subjects participated in this study and they were randomly divided into the experimental and the control group. [Methods] Physiological variables, leg strength, power and flexibility, and biomechanical variables, both kinematic and kinetic, were measured before and after the aqua aerobic therapy exercise. Each subject was instructed to walk along an elevated walkway and during the trials a trapdoor opened at random to create a 10 cm falling perturbation. Full body motion and kinetics was gathered during the gait. [Results] There were significant reductions in body weight, and body fat mass, and stride time after the perturbation. Significant increases in leg strength corresponded to the maximum joint moment of the landing leg showing that the subjects' ability for recovery of balance after the perturbation improved. [Conclusion] As the results showed significant improvements in gait pattern and recovery time after perturbed gait, we conclude that aqua aerobic therapy is an effective exercise method for training older adults to reduce their risk of falling.
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Background: Fall risk increases with age and visual impairment, yet the oldest-old adults (>85 years) are rarely studied. Partnered dance improves mobility, balance, and quality of life in older individuals with movement impairment. Objective: The aim of the study was to determine the feasibility and participant satisfaction of an adapted tango program amongst these oldest-old adults with visual impairment. Exploratory analyses were conducted to determine efficacy of the program in improving balance and gait. Methods: In a repeated-measures, one-group experimental design, 13 older adults (7 women; age: M = 86.9 years, SD = 5.9 years, range = 77-95 years) with visual impairment (best eye acuity: M = 0.63, SD = 0.6 logMAR) participated in an adapted tango program of twenty 1.5-hour lessons, within 11 weeks. Feasibility included evaluation of facility access, safety, volunteer assistant retention, and participant retention and satisfaction. Participants were evaluated for balance, lower body strength, and quality of life in two baseline observations, immediately after the program and 1 month later. Results: Twelve participants completed the program. The facility was adequate, no injuries were sustained, and participants and volunteers were retained throughout. Participants reported enjoyment and improvements in physical well-being. Exploratory measures of dynamic postural control (p < .001), lower body strength (p = .056), and general vision-related quality of life (p = .032) scores showed improvements following training. Discussion: These older individuals with visual impairment benefitted from 30 hours of tango instruction adapted for their capabilities.
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