Content uploaded by Maria Kosma
Author content
All content in this area was uploaded by Maria Kosma on Jul 04, 2020
Content may be subject to copyright.
Full Terms & Conditions of access and use can be found at
https://www.tandfonline.com/action/journalInformation?journalCode=crid20
Research in Dance Education
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/crid20
The effectiveness of performative aerial practice
on mental health and the love of movement
Maria Kosma , Nick Erickson , Chase J. Savoie & Mark Gibson
To cite this article: Maria Kosma , Nick Erickson , Chase J. Savoie & Mark Gibson (2020): The
effectiveness of performative aerial practice on mental health and the love of movement, Research
in Dance Education, DOI: 10.1080/14647893.2020.1784868
To link to this article: https://doi.org/10.1080/14647893.2020.1784868
Published online: 03 Jul 2020.
Submit your article to this journal
View related articles
View Crossmark data
ARTICLE
The eectiveness of performative aerial practice on mental
health and the love of movement
Maria Kosma
a
, Nick Erickson
b
, Chase J. Savoie
c
and Mark Gibson
d
a
School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA;
b
School of Theater, Louisiana State
University, Baton Rouge, LA, USA;
c
Department of Biochemistry and Molecular Biology, Louisiana State
University, Baton Rouge, LA, USA;
d
Performance Specialist and Consultant, Louisiana State University, Baton
Rouge, LA, USA
ABSTRACT
The purpose of this phronetic, quasi-experimental study was to
examine if skill-based and performative aerial practice (treatment
group-class, n = 8) was more benecial on mental health and the
love of movement than only skill-based aerial practice (control
group-class, n = 9). The total study population included 17 under-
graduate, beginner students in aerial practice (M
age
= 20.59). Based
on Cohen’s d and two-way repeated measures ANOVA, depression
and stress decreased over time with an upper-level small (d =.27;
η
2
= 7.6%) and medium (d =.55; η
2
= 19%) within-subjects eect,
respectively. Five qualitative themes emerged, including positive
psychosocial and physical changes, healthy lifestyle choices, con-
tinuance with aerial practice – especially for the treatment group,
and challenges with aerial silks, especially for the control group.
Beyond skill development, including performativity qualities in aer-
ial practice (dancing, expressing emotion, story sharing) may be key
to the love of movement and long-term exercise participation.
ARTICLE HISTORY
Received 21 August 2019
Accepted 16 June 2020
KEYWORDS
Aerial silks; skill and
performativity; mental
health; love of movement;
phronesis
Introduction
Based on the 2017 National (US) Survey on Drug Use and Health, depression levels have
significantly increased among young adults (18–25 years old) between 2010 and 2017, who
continue to experience the highest rates of depression compared with all other age groups.
In 2010, 7.7% of young adults reported being depressed compared with 13.5% of young
adults reporting depressive symptoms in 2017 (National Institute of Mental Health 2019,
https://www.nimh.nih.gov/health/statistics/major-depression.shtml). Based on the same
survey, there were more females (8.7%) experiencing a major depressive episode than
males (5.3%). Depression has several negative effects, including decreased functioning
and quality of life and increased risk of cardiovascular disease, diabetes, and obesity
morbidity (Penninx Brenda et al. 2013). Similarly, based on a report by Harvard Medical
School and the 2015 survey of the American College Health Association-National College
Health Assessment, college-level students report high levels of stress, which may be
CONTACT Maria Kosma mkosma@lsu.edu School of Kinesiology, Louisiana State University, Baton Rouge, LA
70803, USA
RESEARCH IN DANCE EDUCATION
https://doi.org/10.1080/14647893.2020.1784868
© 2020 Informa UK Limited, trading as Taylor & Francis Group
associated with self-injury and suicidal attempts (Liu et al. 2019). Like depression, there was
a modest effect between anxiety disorders and obesity (Rajan and Menon 2017).
The main reasons many young college students experience high stress and depression
levels include societal pressures to succeed academically and professionally (Liu et al.
2019). Although participation in physical activity has shown to significantly decrease
stress and depression levels (Mikkelsen et al. 2017), many college students, and especially
freshmen, are not physically active, with the greatest declines in physical activity levels
occurring after high school graduation (Lackman, Smith, and McNeill 2015). Young
females exhibit greater temporal declines in physical activity levels than young males
(Corder et al. 2016). Therefore, it is imperative to identify attractive physical activity
programs among young adults.
A promising approach in understanding physical activity behavior is based on phron-
esis (practical wisdom or reasoning), which was coined by Aristotle in his Nicomachean
Ethics (Aristotle 350 B.C.E) in an attempt to exemplify that human action, such as being
active or not, is influenced by one’s history, cultural upbringing, and societal experiences
(Buchanan 2000, 2004, 2006, 2016; Flyvbjerg 2001, 2004; Kosma and Buchanan 2018a;
Kosma, Buchanan, and Hondzinski 2015, 2017). People make phronetic (wise) decisions
regarding how to lead the good life based on their valued goals, which are normative in
nature. The worth of leading healthy lifestyles is not a mere individualistic desire but
a value that is appreciated by many community members within a society (Buchanan
2016). People may wonder if and why they should be active and follow a healthy diet. As
a young adult, why should I spend time exercising and preparing home-made meals? Is it
worthy to dedicate my precious time to an active lifestyle considering my busy school
schedule and employment responsibilities to cover education-related expenses? Familial
and cultural experiences during childhood can influence the value of movement and
other healthy lifestyles (Kosma and Buchanan 2018a). For example, children who are
encouraged to play and be active tend to sustain this behavior later in life (Bélanger et al.
2015).
Phronetic action, such as valuing movement, is viewed as an end in itself like the joy of
dancing and theatrical play (Kosma and Buchanan 2018a; Kosma and Erickson 2020;
Sheets-Johnstone 1966). Playful activity translates into healthy psychological, social, and
biological development of children (Sheets-Johnstone 2003) and can lead to health and
well-being during adulthood. Lively, enjoyable, and non-competitive child-like move-
ment patterns like running, play-chasing, jumping, and fighting without hitting link to
health and well-being and can be performed among siblings and their parents (Sheets-
Johnstone 2003). Based on three recent phronetic studies, playful, non-competitive, and
culturally meaningful activities like basketball and dancing were enjoyable and valued
among African American males and females, respectively (Kosma and Buchanan 2018b,
2019; Kosma, Buchanan, and Hondzinski 2017).
It is speculated that artistic and expressive movement like dancing can be valuable and
enjoyable (Angier 2010; Kosma and Buchanan 2018a) as recently shown in a phronetic
qualitative study, where aerial practice either as a form of dance or physical theater was
viewed as fun and motivating among young college students (Kosma and Erickson 2020).
Based on a meta-analysis, artistic expression like movement dance therapy and dancing
seems to link to positive mental health, including reduced depression and stress levels
(Koch et al. 2014). Given also that exercise alone links to positive psychological and
2M. KOSMA ET AL.
physical benefits among college students (Gerber et al. 2014; Lin et al. 2015; Loy,
O’Connor, and Dishman 2013), it is unknown if performative art movement has stronger
benefits on mental health and the love of movement than mere exercise participation.
Therefore, the purpose of this phronetic, quasi-experimental study was to examine if
a skill-based and performative form of aerial practice was more beneficial on mental
health and the love of movement than only a skill-based aerial practice program.
Materials and methods
Design and procedures
This was a phronetic, mixed-methods, quasi-experimental study among 17 undergradu-
ate students, who enrolled in two semester-long (January 2019 – April 2019) under-
graduate aerial practice classes for beginners at Louisiana State University (LSU), Baton
Rouge, LA, USA. Classes met three times per week, one hour each time (three hours/
week for the treatment group and three hours per week for the control group – about 48
class sessions/group) and were taught by the same instructor, who was a trained under-
graduate teaching and research assistant and advanced aerialist. Instruction was also
facilitated by a trained MFA graduate and advanced aerialist. The emphasis in the
treatment group/class (n = 8) was on both skill development (e.g. technique) and
performativity, including choreography, storytelling, and artistic expression; whereas,
in the control group/class (n = 9) the emphasis was only on skill development. For
example, both groups learned basic aerial skills like climbing, inverting, and performing
different movements while wrapped on silks; however, the treatment group was expected
to place the movements in a certain sequence – advice was provided – and perform them
to music. They were encouraged to either perform their sequence as aerial dance or
physical theater by expressing themselves and/or sharing a story. The control group
performed a pre-determined sequence of three skills without music and they were
expected to pay attention only to technical aspects like pointing their toes and holding
a pose. In both classes, the instructors were supportive and engaging, providing con-
structive feedback and allowing the students to explore different movement variations on
their own and learn from each other. Study participants were interviewed by the first
author in her office and the length of the interviews varied from 5 minutes to 27 minutes.
The study met the ethical research requirements of LSU by being reviewed and approved
by the LSU Institutional Review Board (IRB) and, prior to the interviews and survey
distribution, participants signed the study’s consent form. As described in the consent
form and in compliance with LSU IRB requirements, the interview process was informal
and comfortable, and participants had the right to withdraw from this research project at
any time without penalty. Participants’ responses to the interview were confidential and
private. In the consent form, a list of national and local mental health resources,
including LA Department of Health and Our Lady of the Lake Hospital, was provided
in case participants had any questions regarding mental health support services.
Interview questions at pretest and posttest addressed aerial practice goals and experi-
ences and health aspects. The interview process was dialogical in nature to build trust and
engage in in-depth discussions regarding participants’ movement experiences and health.
The content of the interview guide is shown in Table 1. Participants were also asked
RESEARCH IN DANCE EDUCATION 3
about their life plans and challenges, age, gender, ethnicity, and education. All interviews
were conducted in-person and audio-taped. The first author drafted the initial interview
guide and discussed it with the study co-authors for clarity and consistency with the
study objectives. The final questions were then pilot-tested with two participants, whose
results were included in the study.
Prior to the questions regarding demographic information, the 20-item Center for
Epidemiologic Studies Depression scale (CES-D) (Radloff 1977) and the 10-item Cohen’s
Perceived Stress Scale (PSS) (Cohen, Kamarck, and Mermelstein 1983) were verbally
administered also in an interview format. Participants marked responses in the four-
point (0–3) CES-D Likert scale indicating how they felt over the past week, whether
depressed, happy, sad, fearful, without an appetite, etc. Scores on the CES-D scale range
between 0 and 60, with higher scores indicating more depressive symptoms; four items
were reverse scored for the analysis. The CES-D Scale has acceptable reliability (e.g.
α = .85-.90) and validity, including discriminant and criterion validity in a variety of
populations, such as African American, Caucasian, people of different education levels,
adolescents, and young adults (Radloff 1977). Similarly, PSS is a five-point Likert scale
regarding thoughts and feelings over the past month, such as feeling depressed, stressed,
angry, or in control about life situations. Scores on the PSS range from 0 to 40, with
higher scores indicating higher stress levels; four positive items were reverse scored for
the analysis. The scale’s internal consistency and factorial validity have been supported
among several populations, including adults and college students (Lee 2012).
Data analysis
Audiotapes of the interviews were transcribed verbatim and double-checked for
transcription accuracy. Participants’ actual names were replaced by pseudonyms
for the purposes of reporting the study results. The interviewer, who was the first
study author, entered the transcripts, post hoc reflections, and debriefing notes in
NVivo 10 to develop themes and sub-themes based on phronetic, hermeneutic
research for analyzing qualitative data (Flyvbjerg 2004; Kafle 2011): a) after reading
the transcripts and notes multiple times, the first author systematically coded the
Table 1. Interview guide.
Pretest Questions
(1) What is your major at (university name)?
(1) What year of study are you in?
(1) Have you practiced aerial silks in the past? How did the audition make you feel?
(1) Does it make a difference to practice on your own vs. with others?
(1) What are your life priorities now?
(1) Do you have any health problems?
(1) Do you have financial assistance for your studies?
(1) What are your future goals related to aerial practice and/or other exercises?
Posttest Questions
(1) What were some positive experiences with your aerial class?
(1) What were some negative experiences with your aerial class?
(1) What did you think about the social setting?
(1) Did your regular exercises change due to aerial and how?
(1) Are you planning to continue with aerial silks in the future? Why or why not?
(1) Did aerial help you with your health and how?
(1) Did aerial help you achieve or re-think some of your life goals and how?
4M. KOSMA ET AL.
data and developed themes and sub-themes by examining each individual story and
the whole data set in a recursive process; b) the other study authors independently
reviewed the coded data to finalize the themes and sub-themes via consensus
discussion; c) representative extracts were then selected based on the coded data,
the entire data set, study purpose, and the literature. Two-Way Repeated Measures
ANOVA were conducted using SPSS (V. 25) to examine potential differences in
depression and stress levels based on group (treatment vs. control), time (pretest vs.
posttest), and their potential interaction. Given the small sample size, Cohen’s
d effect size (Cohen 1988) for Two-Way Repeated Measures ANOVA was also
calculated.
Results
Participant characteristics
The study population included 17 undergraduate students (M
age
= 20.59 ± 1.37 years old;
females = 12; males = 5; European Americans = 14; other [Asian or of mixed-race] = 3),
who were beginners in aerial practice. Eight people encompassed the treatment-group
class (women = 6, men = 2) and nine individuals participated in the control-group class
(women = 6, men = 3). Initially, there were 10 students per class; however, two
individuals were excluded from the treatment group due to injury or participation in
a separate class section with a different instructor. Also, one participant in the control
group was excluded from the study because of his involvement with performative aerial
silks at the end of each control-group class meeting.
Reported health issues in the control group included asthma, endometriosis,
Hashimoto’s Disease and depression, and polycystic kidney disease. The treatment
group reported ADHD, panic attacks, sleeping problems, and heavy smoking.
Most students were tuition free because they received university scholarship and/
or parental financial support. Some of them were also employed. Students majored
in diverse programs, including international trade and finance, mass communica-
tions, coastal environmental science, theater studies, engineering, pre-pharmacy,
kinesiology, psychology, graphic design, criminology, and wildlife habitat manage-
ment. Most students’ life plans were to finish their undergraduate degree, pursue
graduate studies, and/or secure gainful employment.
Dierences in depression and stress by time and group
Given the small sample size, Cohen’s d effect size – rather than statistical significance – is
highlighted. The guidelines to determine the magnitude of Cohen’s d are as follows:
small = .2; medium = .5; and large = .8 (Cohen 1988). Based on the two-way repeated
measures ANOVA and Cohen’s d effect size, there were no significant interaction –
group by time – effects (d for stress = .09; d for depression = .05). Although there was an
upper-level small between-subjects effect for stress favoring the control group (d = .30,
M
difference
= 1.58, η
2
= 7%), both groups had low pretest scores on depression (M = 11.06)
and stress (M = 14.47) and their levels decreased across time with an upper-level small
(d = .27; M
change
= −1.35, η
2
= 7.6%) and medium (d = .55; M
change
= −2.12, η
2
= 19%)
RESEARCH IN DANCE EDUCATION 5
within-subjects effect, respectively. Even though the sample size was small, the medium
within-subjects effect for stress approached statistical significance: F (1, 15) = 3.55,
p = .08, reinforcing the positive, temporal effects of both aerial practice classes on mental
health.
Emerging themes
Based on the phronetic, qualitative analysis, five themes emerged for both groups. The
first theme was positive psychosocial changes: positive feelings (e.g. self-rewarding, moti-
vating, distressed) and supportive setting. Positive physical changes encompassed theme
2: enhanced strength and fitness, improved endometriosis symptoms. The third theme
was positive lifestyle changes, including enhanced exercise, improved sleep and diet, and
quit smoking. The fourth theme was continuing or not with aerial. Even though at pretest
most participants expressed interest in continuing with aerial silks, only three out of nine
control-group participants planned to continue with aerial practice at the posttest due to
enjoyment. However, all treatment-group participants at the posttest planned to con-
tinue with aerial silks because of their enjoyable experiences, including performativity
(artistic expression). Both groups expressed similar challenges with participating in aerial
silks (Theme 5), including injuries, bruises, pain, and feelings of frustration because of
slow progress. More people in the control group expressed negative experiences than the
treatment group.
Theme 1: positive psychosocial changes
Both the treatment and control groups experienced positive psychosocial changes,
including positive feelings – self-rewarding and stress release – from participating in
aerial silks within a supportive setting.
Positive feelings
Expressed positive feelings from participating in aerial silks included a sense of achieve-
ment and accomplishment; a fun, motivating, and satisfying activity; and a distressed
experience by escaping the daily routine. Jobi, Delaine, and Eliza in the control group
emphasized the importance of aerial silks to their mental health, especially following their
progress. Similarly, Brandan, Cathy, and Kara in the treatment group said that aerial silks
evoked feelings of accomplishment and relaxation.
. . . I think it impacts your mental health a lot. And it puts you in a better mindset mentally
‘cause you’re working on bettering yourself, and that feels good (Delaine, control).
. . . I wasn’t, you know, the best in the class but I could still see myself progressing. So that
was like a really good mental thing (Jobi, control).
. . . the first and the second quiz, um, felt very much like an achievement, being able to work
to produce a routine from what were given, and being able to kind of add to it what we
wanted to. Um, it was a great feeling put in the time to really get the set down to something
that was presentable and then being able to successfully perform it in front of the entire class
(Brandan, treatment).
6M. KOSMA ET AL.
Mentally I feel like this has been one of my best semesters. I look forward to silks every day.
Um, and then I’m also taking a dance class. So, I think all the movement is just really like doing
what it needs to do for my mental health. Last semester was really hard . . . especially mentally,
but physically too; I was always tired, and I actually like realized that I was going through
a binge eating disorder and so I wasn’t eating right last semester and I wasn’t sleeping right. But
I also wasn’t like doing anything physical, so I think that had a lot to do with it (Eliza, control).
It (aerial silks) just helped alleviate some of it (stresses of college). It’s an hour where you can just
relax. But then still be doing something productive and physically enriching (Kara, treatment).
Supportive setting
Several participants in both groups stated that the class atmosphere from the students,
instructors, and teaching assistants (TA) was supportive, in that the main goal was to
enhance learning via positive and constructive feedback.
The people are great. The people are also really positive and it’s really refreshing to have that
because – especially when you’re in college and you’re go, go, go all the time and um, it’s
really competitive and you’re just looking at somebody else as your competition all the
time . . . you have to do your best, but then look how everybody’s encouraging you to do your
best and it’s really helpful when it comes from other students and not just like teachers, you
know. So, it’s a really interesting vibe. It’s all positive. So that helped me (Kara, treatment).
. . . we’ve all been so supportive of each other, like hyping each other up and stuff, it’s been so
positive for me. Makes me want to come to class every single day (Linzy, treatment).
. . . the people in my class, they’re all really supportive ‘cause I guess you always think people
are judging you, but when you get something down . . . – like I couldn’t get my egg knot for,
it felt like a hundred years. But when I finally did, everybody was like really excited for me
and that was a really nice feeling (Jobi, control).
I really liked the support that we would get from the instructors . . . I liked the little groups
that we were in, as well, getting to know one another. It kind of like made a tiny little support
structure . . . which is kind of cool, just like encouraging each other and helping each other
learn (Nadan, control).
Theme 2: positive physical changes
Enhanced strength and fitness
Both groups mentioned that aerial practice increased their strength, and especially their
upper-body strength; additionally, the treatment group emphasized changes in their
flexibility and their physique – being in shape. Beyond feeling stronger, Eliza in the
control group ‘did not feel as tired throughout the day.’ Don in the control group feels ‘a
lot stronger’ and although in the beginning he had trouble ‘holding my own weight, it’s
much easier now.’ Similarly, Jeff (control group) enhanced his upper-body strength and
feels that he lost weight due to aerial silks:
I definitely feel like I’ve gotten stronger . . . in the past I was able to do like maybe like 1 or
2 pull ups. And like it was tough. But now I’m getting to be able to do like 10 in a row and
like I definitely feel a big difference in like physical strength, just from continually lifting
my body weight and doing that in class . . . I definitely feel like it’s made a difference. And
I’ve also lost some weight. I’ve lost about 5 pounds since the beginning of the semester . . .
RESEARCH IN DANCE EDUCATION 7
I have a feeling it’s because of aerial because I’m not doing anything else really different in
my life.
Treatment-group participants felt stronger, in shape, and more flexible due to aerial silks.
Brandan noticed that he is ‘more flexible from stretching out a little bit more.’ Romain
also feels now ‘stronger and far more flexible than previously.’ Cathy said: ‘aerial silks has
helped define my body a little bit more and made it more solid.’
Improved endometriosis symptoms
Bail in the treatment group mentioned that aerial silks has improved her endometriosis
symptoms, in that her pain is better managed now than before and her body feels better:
I think that aerial has actually somewhat improved my health condition (endometriosis)
overall . . . my body feels a lot better and pain management has become a lot, I guess . . .
I don’t know how to explain it . . . it’s kind of treating the symptoms, I guess, more for my
condition . . . even though I still experience pain, it’s a different – I don’t feel so, I guess, weak
and broken down any more’ cause my body’s just healthier in general, and the stretching
helps a lot too. So, I love, I love it. It’s really fun.
Theme 3: positive lifestyle changes
Enhanced exercise
Many participants in both groups indicated that they either enhanced or changed their
workout by emphasizing upper-body strength, endurance, and flexibility. The desire to
change exercise regimens was the combination of one’s physical experiences with aerial
practice and the realization that enhanced strength and flexibility are key elements to
success in aerial silks.
I actually started going to the gym more regularly after I started silks. I feel like it gave me
kind of motivation to do ab workouts and upper body and even lower body workouts
because I want to be able to do that at silks. I want to be able to do more inverts in silks (Bail,
control).
I definitely do a lot more upper body kind of workouts . . . I favor doing cardio and leg
workouts because my legs are stronger than my upper body, but I definitely tailor my
workouts to have more arm and definitely back stuff. I never did back stuff before . . . And
I thought that I had good core muscles, but then you start getting into some more of like the
straight leg inverts and stuff, and you’re like, “Man, my core is not where I thought it was. So,
I definitely do a lot of more core-specific exercises” (Jobi, control).
I’d be like in the library in the study room and like in between my study breaks I’d be like on
the ground doing little inversion exercises. So, I’m just like incorporating it in my schedule . .
. because I want to get new skills and I want to improve (Delaine, control).
I’m more prone to exercise now than I was before I started aerial silks, just because of this
little push of getting stronger and it kind of encourages you to get stronger. So, there’s more
motivation for you to exercise in general. I’ve been more focusing on upper body because of
aerial silks and how much upper body strength you need. Less on leg workouts just recently
(Elaina, treatment).
Aerial has made me go to the gym more. So that’s good because I want to do really good at
silks and I realize that I need to be like very strong . . . I never really concentrated my upper
8M. KOSMA ET AL.
body when I would work out. I’d always do lower body. And so, I had to do upper body, and
then I saw results (more upper body strength) . . . and then it made me start running again.
I hate cardio, but I started doing a mile every time I’d go work out to warm up, and that’s
helped with endurance . . . but then I started like really working out, like doing calisthenics as
far as like pull-ups and um push-ups and um, a lot of body weight things that gymnasts use.
I haven’t done those things in a long time because I used to do gymnastics . . . It’s not added
body weight, it’s just my body weight. It’s just the movement . . . You could go to the park
and do these calisthenics (Kara, treatment).
Brandan and Romain in the treatment group emphasized more stretching in their
workouts: ‘I am stretching much more now . . . I’ve made it my goal to like eventually
do the splits now’ (Brandan). Romain also said that he is ‘doing a considerable amount
more of stretching and yoga . . . without the extra stretching I feel like a lot of the moves,
I just quite simply wouldn’t be able to do.’
Healthier diet
A few participants in both groups shared that aerial silks motivated them to change their
diet and eat healthier than they used to eat. Elaina in the treatment group said: ‘aerial
encourages me to eat better because I know that I need energy for doing aerial silks or for
exercise.’ Similarly, Jobi in the control group said:
I do try to eat healthier because I know I’m gonna be asked to do a lot of physical workouts,
and I know if I don’t eat enough or if I eat just like, I don’t know, snacks and junk food
before I go to the class, I’m not gonna be able to perform as well as I could if I had like . . .
a bowl of brown rice and some vegetables . . . Because I know it’s easy to just get some pizza
rolls and eat those, quick snack before class. But can’t really do that.
Quit smoking
Romain in the treatment group indicated that he is passionate enough about aerial silks
that he quit smoking to perform better:
. . . starting about at age 17 ‘till now, relatively the past like 2 months, uh, I’ve liked smoked
cigarettes, like a pack a day, pretty much. Um, and I didn’t really have any motivation to
quit. The whole “scared of dying” thing didn’t really bother me. But I could notice that it was
playing a role in what I was able to do duration-wise with aerial silks. And since like in the
beginning I was, you know, testing the waters, but I found out I really liked it and it wasn’t
worth me hindering myself with smoking. So, I have been like a month and a half now non-
smoking. And that was a pretty big feat . . . you’re not gonna quit unless you want to quit.
And I never really had a reason to. This is the reason to, for me . . . it’s definitely played a role
in that, at least me discovering a passion, something I’m passionate about.
Improved sleep pattern
Linzy in the treatment group attributes her better sleep pattern and reduced panic attacks
to the workout she is getting from aerial silks:
I used to get panic attacks. I have had one this entire semester. I think, like aerial has been
very positive for me. I think it’s been helping me sleep at night, with getting more
workouts, getting more like, more of a routine, I would say . . . Having that, having the
ability to go to the classroom and stuff, and like it really wears me out, and so I think
RESEARCH IN DANCE EDUCATION 9
having something that does that for me has been very beneficial. I’ve got a more routine
sleep pattern, I feel.
Theme 4: continuing or not with aerial
At pretest, most participants in both groups expressed interest in continuing with aerial
silks. Two people in the control group said that they were not sure if in the future they
would pursue aerial silks or not. At the posttest, all treatment group participants
expressed interest in continuing with aerial silks because of enjoyment, including the
joy of performativity. However, five out of nine control-group participants said at the
posttest that they did not plan to continue with aerial practice or they were not sure
about it.
Enjoyment
Three participants in the control group enjoyed aerial silks and they planned to continue
with it. Beyond the enjoyment of the process and physical and mental benefits of aerial
practice, three participants in the treatment group planned to continue with aerial silks
due to performativity and creativity.
I want to continue next semester . . . I’m not sure if I’m staying just next semester or both
semesters. It depends how much class I finish. I really like it and I like how it makes me get
up and do something . . . it’s like making me exercise. Now that I’ve done it, I feel like I really
just never want to stop (Shelly, control).
I want to continue. I only have one more semester, but I really want to take it and maybe the
next semester. I just want to get better. Like it’s kind of addicting whenever you start to get
some of the things down and like I just want to do them all (Eliza, control).
I want to continue in the classes. It’s just something I love to do. I think that it’s good for my
mind and it’s good for my body, and I think that, you know, even if I didn’t take the class, I’d
tell myself like, “Oh, well, go to a gym or, you know something, a studio to go do aerial in my
free time (Delaine, control).
Yes, I’m definitely continuing to take the class next semester. I have friends that are also
going to take it, so I’ll be with them and we can grow together in that sport . . . because
I really enjoy it. And it’s good for me. I’ve been feeling it being good for my body just in
terms of strength, and health (Elaina, treatment).
I’m on a National Student Exchange Program here, so I’m only here for a year. So, I leave in
May, but I do want to continue it in Colorado. I just don’t know how that will happen as of
yet . . . I find a lot of enjoyment in it and it brings me back to like childhood days where I can
just go in and swing on some silk and just play around . . . it just makes me like incredibly
happy to do it (Cathy, treatment).
I definitely intend on putting that into my schedule for next semester . . . I enjoy it. It kind of
forces me to get in shape (Romain, treatment).
I would love to. I’m graduating this semester. So, I won’t be able to continue with this class
in particular, but . . . I can find like a gym here that does aerial and I can continue with
that . . . ‘cause I find a lot of enjoyment in it. There’s definitely that route to expression that
I maybe didn’t have before. I feel like it’s a great outlet both, I guess, physically and mentally.
10 M. KOSMA ET AL.
And I want to see myself get better, as well. I would love to continue that progression
(Brandan, treatment).
Yes, (I plan to take the other classes) until I graduate . . . to see also how far I can go with the
silks. Just to see what I’m capable of. Because I feel like learning the moves is one thing, and
then performing is another, being able to create your own moves and having a concept of the
silks on your body and being able to maneuver it in different ways to transition better, I feel
like that’s an entirely different thing too (Kara, treatment).
Do not plan to continue or it depends
Five participants in the control group said at the posttest that they did not plan to
continue with aerial silks, or they were not sure about it because they were either
graduating or they did not have the time and/or interest in continuing. A few students
also mentioned the high cost of aerial practice in different gyms.
I’d like to continue, definitely. I’m not graduating, no. I’m not sure if I’ll have the time to do
it next semester, but if I do, I’d love to do it again . . . it’s just something good in my life that
I look forward to and uh, I mean, I don’t really know (Bail, control).
I’ve only got one semester left and I was planning on it, but the time that the silks classes
happen are at the same time as another class that I need to take to graduate (Jobi, control).
I want to, but definitely next semester I can’t because of the requirements for my major. It
just conflicts with both aerial classes (Don, control).
After I graduate, I do not plan on it. I would like to if I was given an opportunity, but it’s not
something I plan on doing, just because the cost is tremendous . . . It’s mainly the cost. Also,
I’m just not that interested in doing the more advanced things (Nadan, control).
Theme 5: negative experiences with aerial
Some students in both groups mentioned that their only negative experiences with aerial
practice were injury, bruises, pain, and feelings of frustration from slow progress. There
were more participants in the control group who expressed negative feelings than the
three students in the treatment group.
Injury, bruises, pain
Kindall, Nadan, and Shelly in the control group referred to bruises and pain during
aerial practice. Nadan also mentioned that at times he ‘would not feel like doing it
(aerial)’ because he would go to class tired for reasons other than aerial silks. Shelly
indicated that there are movements that she ‘would never do again because of the
pain.’ Don (control group) mentioned that he is prone to injury in aerial and it hurts at
times:
I’ve learned that my body is very, I guess, injury-prone . . . I knew this when I played like
football and when I did weights and stuff . . . But then when I do the silks . . . it’s a new thing
that my body is not used to, so it, like my elbow, I have to wrap it every day or else it’ll hurt.
Sometimes my wrist will hurt . . . maybe my legs or something . . . There’s really nothing
negative about taking aerial silks other than the fact that I hurt myself sometimes, and that’s
my fault.
RESEARCH IN DANCE EDUCATION 11
Similarly, Marlyn in the treatment group got injured in aerial practice and she was not
able to participate in the class for one month. She was not sure if she would be able to do
her final performance, though she wants to perform like everybody else in the class:
It (injury) definitely made me feel upset cause I wanted to be up there performing like
everybody else. But instead I just had to sit back and take notes and watch them perform,
while I just couldn’t do anything.
Negative feelings due to slow progress
Although only one person, Kara, in the treatment group felt frustrated from ‘being stuck
on a skill,’ three participants in the control group expressed similar frustrations.
I didn’t work out for probably two weeks and I really suffered from that because my skills in
class were lacking. Like I just didn’t have the motivation to get out. Like I think I was stuck
on one move . . . and it kind of like just hindered me for a second, and then when I got it
I was like good again. So, I think that’s just me needing to be more resilient and practicing
self-defeat and stuff, and then overcoming it (Kara, treatment).
I guess it was sometimes a little frustrating, like if I couldn’t get something or if like someone
was more flexible than I was, and they were able to hit a pose and I wasn’t. So, it was a little
frustrating, but I knew it wasn’t anything wrong with me (Bail, control).
Well, I think for me, a negative experience would just be like . . . if I don’t get a skill right
away, then I can get like down on myself and I’m like “I know that I can do this. Like I know
that I’ve got it . . . I have like a mental block that I have to overcome to be able to get that
skill . . . (Delaine, control).
I guess, my only like negative experience is just like the self-doubt because I never really had
any upper body strength. It’s always kind of just been in my legs because I was a ballet
dancer . . . I did my first push-up that I’ve ever done – pull-up that I’ve ever done in my
entire life like a month ago and I was so excited . . . I know that if I was strong enough I could
do exactly what I needed to do (Eliza, control).
Discussion
The purpose of this phronetic, quasi-experimental study was to examine if the combina-
tion of a skill-based and performative form of aerial practice was more beneficial on
mental health and the love of movement than only a skill-based aerial practice class.
Based on the quantitative results, there was no interaction effect on depression and stress
levels. Depression and stress decreased over time for both groups with an upper-level
small within-subjects effect for depression and a medium within-subjects effect for stress.
Both groups exhibited low stress and depression levels at the pretest. These results
indicate that both aerial practice classes were equally effective in improving mental
health. These quantitative results coincided also with the qualitative results, in that
both groups exhibited positive psychological changes (self-rewarding, satisfying, and
distressing experiences), social experiences (supportive setting), and physical changes
(e.g. enhanced upper-body strength and flexibility). In other studies, it was shown that
exercise training programs like Zumba and extra-curricular, leisure exercise and sport
have positive psychological and physical effects, such as stress reduction and enhanced
12 M. KOSMA ET AL.
cardiovascular endurance, trunk strength, and dynamic balance (Bland et al. 2014;
Donath et al. 2014). Based on a meta-analysis, dance movement therapy and dance
seem to be effective in decreasing stress and depression (Koch et al. 2014). It was also
recently shown that biodanza, which is a combination of music and movement for
emotional expression, linked to decreased stress and depression levels among young
adults (López-Rodríguez et al. 2017).
Although most college students in a recent cross-sectional study did not endorse
learning new sport and fitness skills as a main reason for participating in college-based
exercise and fitness classes (Lackman, Smith, and McNeill 2015), both aerial practice
groups in this study enhanced their workouts, and especially their upper-body training
and flexibility – mainly for the treatment group – in order to improve in aerial silks.
Although being fit and in shape is a major exercise motivator among college students,
and especially females (Lackman, Smith, and McNeill 2015), aerial practice requires the
combination of skills, fitness, and artistic expression leading to the love of movement like
wanting to keep exercising for constant improvement, positive bodily sensations, and
artistic expression (e.g. storytelling and expressing emotion via aerial practice) (Kosma
and Erickson 2020, in press; Kosma et al. in press). This was also supported by another
unique finding regarding the linkage between aerial practice and positive lifestyle
changes, especially for the treatment group, including being more active, eating healthier,
sleeping better, and quitting smoking. This finding is encouraging, in that exercise levels
among young adults, and especially freshmen college students and females, tend to
decline (Lackman, Smith, and McNeill 2015). During the interviews, participants were
not asked about lifestyle changes; therefore, this result/theme emerged based on the
multiple positive experiences with aerial practice, and especially the performativity aspect
for the treatment group. It is noteworthy that most of the literature on young adults focus
on the effects of unhealthy lifestyles like inactivity, unhealthy diet, and inadequate sleep
on psychological problems and high obesity rates (Fatima, Doi, and Mamun 2016), and
not on how movement, and especially art movement, can have such positive lifestyle
effects on several domains – a unique finding in this current study.
There was a major group difference in preferences for long-term aerial practice
participation, in that all participants in the treatment group wanted to continue with
aerial silks and keep advancing, while most people in the control group did not want to
continue or they were not sure about it. Performative and creative aspects of aerial silks
were enjoyable for the treatment group, and several students expressed interest in
continuing (aspect of the love of movement) due to performativity qualities such as
expressing emotion, creating, and sharing a story with others. In three recent studies (two
qualitative and one quasi-experimental), performative qualities of aerial practice were
positively viewed as enjoyable and embodied experiences (body-mind unity), which are
essential in succeeding in this activity (Kosma and Erickson 2020, in press; Kosma et al.
in press). Other artistic expressions, such as writing poetry and reading literature, were
also perceived as motivating in pursuing life goals with positive mental health benefits
(Kosma and Buchanan 2019). Contrary to intrinsic reasons (e.g. enjoyment from emo-
tional expression) for participating in art movement, college students tend to participate
in college-based sports and fitness courses for graduation and credit purposes (Lackman,
Smith, and McNeill 2015). Taken together, the current study findings reinforce the
importance to emphasize dance and theater education programs within and outside
RESEARCH IN DANCE EDUCATION 13
college for the love of movement. Beyond skill development, performative qualities of art
movement link to positive mental health and lifestyle changes, including the love of aerial
practice and other related exercises for long-term movement participation.
Common challenges for both groups were bruises, pain, and the risk of injury. Fewer
participants in the treatment group perceived challenges with aerial practice than the
control group. Risk of injury is a common exercise barrier among young adults (Kosma
and Buchanan 2018b). Although similar challenges with aerial practice were expressed in
a recent qualitative, phronetic study (Kosma and Erickson 2020), a unique finding in the
current study reflects perceptions of negative feelings, expressed mainly among the
control-group participants, because of slow progress. Therefore, it is imperative for
dance and theater educators to allow time for self-improvement and growth.
This was a unique study in that a phronetic, quasi-experimental approach was used to
examine in-depth potential differential effects of two aerial practice classes on mental
health and the love of movement. Overall, both classes had positive psychosocial effects
and lifestyle changes. However, the treatment group expressed more enthusiasm in
continuing with aerial practice and experienced more positive lifestyle changes than
the control group. Additionally, fewer treatment-group students experienced challenges
with aerial practice than the control group. That said, it is still difficult to determine if the
performative aspect of aerial practice played a key role on the continuance of aerial silks
because a follow-up assessment was not administered, which constitutes a study limita-
tion. Another limitation was that although there were performative expectations for the
treatment group, the emphasis was on skill development for both groups because they
were beginner aerialists. The performativity aspect in the aerial practice class sequence
tends to be more prevalent among advanced aerialists, who have mastered different
movements in aerial silks. Additionally, this study included young, active adults and
the findings cannot generalize to other populations like people with movement difficul-
ties and/or disabilities and older adults.
Based on the study findings, dance and theater educators may need to balance skill
development and performativity elements in aerial practice. Although both aerial prac-
tice classes had positive effects on psychosocial health, there was a tendency for the
treatment group to feel motivated to continue with aerial silks in the future and
experience several positive lifestyle changes and not as many challenges as the control
group. Therefore, it may be imperative in dance and theater education programs to
incorporate both skill development and performativity qualities, including expression of
emotion, creativity, and sharing a story.
Conclusion
Based on this quasi-experimental and mixed-methods phronetic study, aerial practice can
lead to multiple psychosocial and physical benefits and positive lifestyle choices.
Including performativity features in aerial practice like dancing and sharing a story
may be key to the love of movement and long-term exercise participation. Future
researchers in art movement, such as dance, aerial dance, or physical theater can
incorporate both elements of artistic expression – skill development and performativity –
in their programs to examine their effectiveness in the love of movement and positive
mental health among other populations like children, older adults, and people with
14 M. KOSMA ET AL.
disabilities. Aerial practice does not have to be performed exclusively by young, non-
disabled populations; movement skills can be modified for diverse populations (see, e.g.,
adaptive aerial yoga: Wheel: life 2020, https://www.wheel-life.org/adaptive-aerial-yoga-
allows-wheelchair-users-to-fly/).
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was supported by the CHSE Peabody Dean’s Circle Grant.
Notes on contributors
Dr. Kosma is an Associate Professor in the School of Kinesiology, Louisiana State University,
Baton Rouge, LA, USA. She has an international educational experience, including an under-
graduate degree in Kinesiology from the University of Athens, Greece; an MS degree in
Kinesiology from the University of Jyväskylä, Finland and Catholic University Leuven, Belgium;
and a PhD in Exercise and Sport Science from Oregon State University, USA. Her main research
interests include physical activity health promotion related to culture, arts, social justice, and
human freedom. She uses a humanistic approach in public health, emphasizing personal and
community needs, physical culture, and diversity.
Mr. Erickson is an Associate Professor of Stage Movement, the Head of M.F.A. Acting, and the
Head of Physical Theatre in the School of Theater, Louisiana State University, Baton Rouge, LA,
USA. His physical theater program at LSU involves the teaching of all forms of dance, aerial arts,
actor movement including mask work, improvisation and ensemble work, and the generation of
new work. His program has partnerships with La Manufacture Dance School and with the
Cirq’Ô’Champs Festival in France
Ms. Chase Savoie is a pre-med student currently finishing her undergraduate degree at Louisiana
State University, Baton Rouge, LA, USA. She is majoring in biochemistry and dual minoring in
chemistry and physical theatre. She has trained in the Aerial Arts since 2016 and has been a TA/
Aerial Instructor since 2017.
Mr. Gibson is a Master of Fine Arts in Contemporary Performance from Naropa University and
has a B.A. in Physical Theatre from LSU. He has performed internationally multiple times at the
Edinburgh Fringe festival and most recently performed with the 2019 Cirque O’Champs in France.
His teaching philosophy incorporates embodied movement practices which bring awareness to the
body and its systems. He continues his work as a freelance artist teaching workshops to spread
corporeal awareness.
ORCID
Chase J. Savoie http://orcid.org/0000-0002-8331-1263
References
Angier, T. 2010. Techné in Aristotle’s Ethics: Crafting the Moral Life. New York, NY: Continuum
International.
RESEARCH IN DANCE EDUCATION 15
Aristotle. 350 B.C.E. Nicomachean Ethics. Translated by Martin Ostwald. Indianapolis, IN: Bobbs-
Merrill.
Bélanger, Mathieu, Catherine M. Sabiston, Tracie A. Barnett, Erin O’Loughlin, Stéphanie Ward,
Gisèle Contreras and Jennifer O’Loughlin. 2015. “Number of Years of Participation in Some,
But Not All, Types of Physical Activity During Adolescence Predicts Level of Physical Activity
in Adulthood: Results from a 13-Year Study.” International Journal of Behavioral Nutrition and
Physical Activity 12 (76): 1–8. doi:https://doi.org/10.1186/s12966-015-0237-x.
Bland, H. W., B. F. Melton, L. E. Bigham, and P. D. Welle. 2014. “Quantifying the Impact of
Physical Activity on Stress Tolerance in College Students.” College Student Journal 48 (4):
559–568.
Buchanan, D. R. 2000. An Ethic for Health Promotion: Rethinking the Sources of Human Well-
Being. New York, NY: Oxford University Press.
Buchanan, D. R. 2004. “Two Models for Defining the Relationship between Theory and Practice in
Nutrition Education: Is the Scientific Method Meeting Our Needs?” Journal of Nutrition
Education and Behavior 36 (3): 146–154. doi:10.1016/S1499-4046(06)60152-8.
Buchanan, D. R. 2006. “Perspective: A New Ethic for Health Promotion: Reflections on
A Philosophy of Health Education for the 21st Century.” Health Education & Behavior 33 (3):
290–304. doi:10.1177/1090198105276221.
Buchanan, D. R. 2016. “Promoting Dignity: The Ethical Dimension of Health.” International
Quarterly of Community Health Education 36 (2): 99–104. doi:10.1177/0272684X16630885.
Cohen, J. 1988. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ:
Erlbaum.
Cohen, S., T. Kamarck, and R. Mermelstein. 1983. “A Global Measure of Perceived Stress.” Journal
of Health and Social Behavior 24 (4): 385–439. doi:10.2307/2136404.
Corder, K., S. J. Sharp, A. J. Atkin, L. B. Andersen, G. Cardon, A. Page, R. Davey, et al.; on behalf of
the International Children’s Accelerometry Database (ICAD) Collaborators. 2016. “Age-Related
Patterns of Vigorous-Intensity Physical Activity in Youth: The International Children’s
Accelerometry Database.” Preventive Medicine Reports 4: 17–22. doi:10.1016/j.
pmedr.2016.05.006.
Donath, L., R. Roth, Y. Hohn, L. Zahner, and O. Faude. 2014. “The Effects of Zumba Training on
Cardiovascular and Neuromuscular Function in Female College Students.” European Journal of
Sport Science 14 (6): 569–577. doi:10.1080/17461391.2013.866168.
Fatima, Y., S. A. Doi, and A. Mamun. 2016. “Sleep Quality and Obesity in Young Subjects: A Meta-
Analysis.” Obesity Reviews 17 (11): 1154–1166. doi:10.1111/obr.12444|.
Flyvbjerg, B. 2001. Making Social Science Matter: Why Social Inquiry Fails and How It Can Succeed
Again. Cambridge, UK: Cambridge University Press.
Flyvbjerg, B. 2004. “Phronetic Planning Research: Theoretical and Methodological Reflections.”
Planning Theory & Practice 5 (3): 283–306. doi:10.1080/1464935042000250195.
Gerber, M., S. Brand, C. Herrmann, F. Colledge, E. Holsboer-Trachsler, and P. Uwe. 2014.
“Increased Objectively Assessed Vigorous-Intensity Exercise Is Associated with Reduced
Stress, Increased Mental Health and Good Objective and Subjective Sleep in Young Adults.”
Physiology & Behavior 135: 17–24. doi:10.1016/j.physbeh.2014.05.047.
Kafle, N. P. 2011. “Hermeneutic Phenomenological Research Method Simplified.” Bodhi: An
Interdisciplinary Journal 5 (1): 181–200. doi:10.3126/bodhi.v5i1.8053.
Koch, S., T. Kunz, S. Lykou, and R. Cruz. 2014. “Effects of Dance Movement Therapy and Dance
on Health-Related Psychological Outcomes: A Meta-Analysis.” The Arts in Psychotherapy 41
(1): 46–64. doi:10.1016/j.aip.2013.10.004.
Kosma, M., and D. R. Buchanan. 2018a. ““Connect,” Log It, Track It, Go! Techne—not
Technology—and Embodiment to Achieve Phronesis in Exercise Promotion.” Quest 70 (1):
100–113. doi:10.1080/00336297.2017.1355818.
Kosma, M., and D. R. Buchanan. 2018b. “Exercise Behavior, Facilitators and Barriers among
Socio-Economically Disadvantaged African American Young Adults.” International Journal of
Kinesiology and Sports Science 6 (2): 1–8. doi:10.7575/aiac.ijkss.v.6n.2p.1.
16 M. KOSMA ET AL.
Kosma, M., and D. R. Buchanan. 2019. “Aspects of Depression among Socio-Economically
Disadvantaged African American Young Adults.” International Quarterly of Community
Health Education 39 (4): 199–207. doi:10.1177/0272684X19829612.
Kosma, M., D. R. Buchanan, and J. M. Hondzinski. 2015. “The Role of Values in Promoting
Physical Activity.” Quest 67 (3): 241–254. doi:10.1080/00336297.2015.1050117.
Kosma, M., D. R. Buchanan, and J. M. Hondzinski. 2017. “Complexity of Exercise Behavior among
Older African American Women.” Journal of Aging and Physical Activity 25 (3): 333–344.
doi:10.1123/japa.2016-0032.
Kosma, M., and N. Erickson. 2020. “The Love of Aerial Practice: Art, Embodiment, Phronesis.”
International Journal of Kinesiology and Sports Science 8 (1): 14–25. doi:10.7575/aiac.ijkss.
v.8n.1p.14.
Kosma, M., and N. Erickson. in press; published online first on 8. 15.19. “The Embodiment of
Aerial Practice: Body, Mind, Emotion.” Journal of Dance Education. doi:10.1080/
15290824.2019.1622706.
Kosma, M., N. Erickson, C. J. Savoie, and M. Gibson. in press; published online first on 4. 10.20.
“Skill Development Vs. Performativity among Beginners in Aerial Practice: An Embodied and
Meaningful Learning Experience.” International Quarterly of Community Health Education.
doi:10.1177/0272684X20918053.
Lackman, J., M. L. Smith, and E. B. McNeill. 2015. “Freshman College Students’ Reasons for
Enrolling in and Anticipated Benefits from a Basic College Physical Education Activity Course.”
Frontiers in Public Health 3: 162. doi:10.3389/fpubh.2015.00162.
Lee, E.-H. 2012. “Review of the Psychometric Evidence of the Perceived Stress Scale.” Asian
Nursing Research 6: 121–127. doi:10.1016/j.anr.2012.08.004.
Lin, X., X. Zhang, J. Guo, C. K. Roberts, S. McKenzie, W. Wu, S. Liu, and Y. Song. 2015.
“Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of
Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.” Journal of the American Heart Association 4 (7): e002014.
doi:10.1161/JAHA.115.002014.
Liu, C. H., C. Stevens, S. H. M. Wong, M. Yasui, and J. A. Chen. 2019. “The Prevalence and
Predictors of Mental Health Diagnoses and Suicide among U.S. College Students: Implications
for Addressing Disparities in Service Use.” Depression and Anxiety 36 (1): 8–17. doi:10.1002/
da.22830.
López-Rodríguez, M. M., I. Baldrich-Rodríguez, A. Ruiz-Muelle, A. E. Cortés-Rodríguez,
T. Lopezosa-Estepa, and P. Roman. 2017. “Effects of Biodanza on Stress, Depression, and
Sleep Quality in University Students.” The Journal of Alternative and Complementary
Medicine 23 (7): 558–565. doi:10.1089/acm.2016.0365.
Loy, B. D., P. J. O’Connor, and R. K. Dishman. 2013. “The Effect of A Single Bout of Exercise on
Energy and Fatigue States: A Systematic Review and Meta-Analysis.” Fatigue: Biomedicine,
Health & Behavior 1 (4): 223–242. doi:10.1080/21641846.2013.843266.
Mikkelsen, K., L. Stojanovska, M. Polenakovic, M. Bosevski, and V. Apostolopoulos. 2017.
“Exercise and Mental Health.” Maturitas 106: 48–56. doi:10.1016/j.maturitas.2017.09.003.
National Institute of Mental Health. 2019. “Major depression.” Accessed 25 July 2019. https://
www.nimh.nih.gov/health/statistics/major-depression.shtml
Penninx Brenda, W. J. H., Y. Milaneschi, F. Lamers, and N. Vogelzangs. 2013. “Understanding the
Somatic Consequences of Depression: Biological Mechanisms and the Role of Depression
Symptom Profile.” BMC Medicine 11: 129. doi:10.1186/1741-7015-11-129.
Radloff, L. S. 1977. “The CES-D Scale: A Self-Report Depression Scale for Research in the General
Population.” Applied Psychological Measurement 1 (3): 385–401. doi:10.1177/
014662167700100306.
Rajan, T. M., and V. Menon. 2017. “Psychiatric Disorders and Obesity: A Review of Association
Studies.” Journal of Postgraduate Medicine 63 (3): 182. doi:10.4103/jpgm.JPGM712_16.
Sheets-Johnstone, M. 1966. The Phenomenology of Dance. Madison, WI: University of Wisconsin
Press.
RESEARCH IN DANCE EDUCATION 17
Sheets-Johnstone, M. 2003. “Child’s Play: A Multidisciplinary Perspective.” Human Studies 26 (4):
409–430. doi:10.1023/B:HUMA.0000003668.23164.7d.
Wheel: life. 2020. “Adaptive aerial yoga allows wheelchair users to fly.” Accessed 10 June 2020.
https://www.wheel-life.org/adaptive-aerial-yoga-allows-wheelchair-users-to-fly/
18 M. KOSMA ET AL.
