ArticlePDF AvailableLiterature Review

Physical Benefits of Dancing for Healthy Older Adults: A Review

Authors:

Abstract and Figures

Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B-level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults' lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.
Content may be subject to copyright.
1
Journal of Aging and Physical Activity, 2009, 17, 1-23
© 2009 Human Kinetics, Inc.
Physical Benets of Dancing for Healthy
Older Adults: A Review
Justin W.L. Keogh, Andrew Kilding, Philippa Pidgeon, Linda
Ashley, and Dawn Gillis
Dancing is a mode of physical activity that may allow older adults to improve their
physical function, health, and well-being. However, no reviews on the physical ben-
ets of dancing for healthy older adults have been published in the scientic litera-
ture. Using relevant databases and keywords, 15 training and 3 cross-sectional studies
that met the inclusion criteria were reviewed. Grade B–level evidence indicated that
older adults can signicantly improve their aerobic power, lower body muscle endur-
ance, strength and exibility, balance, agility, and gait through dancing. Grade C evi-
dence suggested that dancing might improve older adults’ lower body bone-mineral
content and muscle power, as well as reduce the prevalence of falls and cardiovascular
health risks. Further research is, however, needed to determine the efcacy of differ-
ent forms of dance, the relative effectiveness of these forms of dance compared with
other exercise modes, and how best to engage older adults in dance participation.
Keywords: dance, exercise, falls, functional ability
The aging process causes many changes in body composition and physiologi-
cal function. Older adults typically have signicantly greater body fat percentage,
reduced muscle mass (Fiatarone-Singh, 2002; Young, Stokes, & Crowe, 1985),
and less muscle strength and endurance (Harridge, Magnusson, & Saltin, 1997;
Hurley, Ree, & Newham, 1998; Imrhan & Loo, 1989), balance (Doyle, Dugan,
Humphries, & Newton, 2004; Hsiao-Wecksler & Robinovitch, 2007), and aerobic
power (Harridge et al.; Wiebe, Gledhill, Jamnik, & Ferguson, 1999) than young
adults. Although these reductions in body composition and physiological function
might be multifactorial in origin (Barry & Carson, 2004; Enoka et al., 2003), they
typically result in diminished levels of functional ability. This can be readily seen
in older adults taking longer to complete tasks such as the timed up-and-go, sit-to-
stand, stair climb, or timed walk (Hurley et al.; Steffen, Hacker, & Mollinger,
2002; Wagner & Kauffman, 2001). Of great concern is that a loss of these func-
tional abilities can result in a rapid downward spiral for the older adult (see Figure
1). This may involve an increased incidence of falls (Dite & Temple, 2002; Shum-
Keogh, Kilding, Pidgeon, and Ashley are with the School of Sport and Recreation, and Keogh, Kilding,
and Gillis, the Centre for Physical Activity and Nutrition Research, AUT University, Auckland, New
Zealand.
JAPA GALLEY PROOF
2 Keogh et al.
way-Cook, Brauer, & Woollacott, 2000), an increase in the fear of falling (Brou-
wer, Musselman, & Culham, 2004; Liu-Ambrose, Khan, Eng, Lord, & McKay,
2004), a reduction in gait (walking) velocity (Whitney, Marchetti, Morris, &
Sparto, 2007), and a reduced level of daily incidental physical activity (Brouwer
et al.; Carter, Williams, & Macera, 1993). This reduction in physical activity then
further increases the risk of falling and of developing chronic diseases such as
diabetes, stroke, cardiac infarction, and cancer (American College of Sports Med-
icine, 1998; Enoka, 1997; Fiatarone-Singh). Because falls-related injuries and
many chronic diseases are expensive to treat, at both an economical and social
level (Campbell et al., 2005; Gillespie et al., 2003), preventive methods to attenu-
ate falls-related injury and chronic disease in older adults should be investigated.
Exercise Benets for Older Adults
Numerous studies have found that exercise, be it resistance training (Deley et al.,
2007; Keogh, Morrison, & Barrett, 2007; Liu-Ambrose, Khan, Eng, Janssen et al.,
2004; Schlicht, Camaione, & Owen, 2001), aerobic exercise (Deley et al.; Seals,
Hagberg, Hurley, Ehsani, & Holloszy, 1984), balance training (Liu-Ambrose,
Khan, Eng, Janssen et al.; Nnodim et al., 2006), Tai Chi (Hill, Choi, Smith, &
Condron, 2005; Nnodim et al.), or even Tae Kwon Do (Cromwell, Meyers,
Meyers, & Newton, 2007) might offer many signicant physical benets for older
adults. These benets might include improvements in body composition, muscle
strength and endurance, aerobic power, balance, functional ability in activities of
daily living, and reduced incidence of falls. Unfortunately, each of these exercise
modes will not necessarily result in all of these adaptations, and not all older
adults are likely to commence, let alone adhere to, programs involving these forms
of exercise.
A review by Fiatarone-Singh (2002) indicates that although resistance train-
ing can signicantly increase older adults’ muscle mass, muscle strength, power,
and endurance, its effects on aerobic endurance and balance are less well demon-
Figure 1 — Relationship between functional ability, falls rate, fear of falling, and level of
physical activity in older adults.
JAPA GALLEY PROOF
Benets of Dance 3
strated. Conversely, although aerobic exercise may signicantly increase older
adults’ aerobic power and reduce their body fat percentage and risk of cardiovas-
cular disease, it has less effect on balance, muscle strength, power, and endurance
(Fiatarone-Singh). It is also known that exercise preferences of older individuals
vary considerably (Mills, Stewart, Sepsis, & King, 1997; Wilcox, King, Brassing-
ton, & Ahn, 1999). This means that older adults who enjoy walking (and therefore
regularly walk) might not necessarily be keen to participate in resistance- or bal-
ance-training programs. Thus, investigations into the benets of various forms of
exercise for older adults are warranted.
Possible Benets of Dance for Older Adults
Judge (2003) has proposed that dancing would be a benecial form of physical
activity for older adults, with its primary physical benets being improved bal-
ance and a reduced risk of falls. This assertion appears to be based on the fact that
many forms of dance (a) are similar to Tai Chi and Tae Kwon Do in that they are
generally performed in an upright posture and require substantial periods of uni-
lateral stance and the transfer of the line of gravity (vertical line through the body’s
center of mass) outside the base of support (Cromwell et al., 2007; Hill et al.,
2005; Judge; Nnodim et al., 2006), (b) can involve moderate to moderately high
ground-reaction forces and joint torques (Lin, Su, & Wu, 2005; Michaud, Rodri-
guez-Zayas, Armstrong, & Hartnig, 1993; Simpson & Kanter, 1997), and (c) can
result in relatively high heart rates (68–90% of age-predicted maximum heart
rate), levels of oxygen consumption (42–90% of VO2max), or ratings of perceived
exertion (up to 14 out of 20) in young (Guidetti, Emerenziani, Gallotta, & Baldari,
2007; Ozkan & Kin-Isler, 2007; Peidro et al., 2002; Wigaeus & Kilbom, 1980)
and older (Grant et al., 2002; Peidro et al.) adults.
Because dance can take many forms, be performed in a variety of settings,
and does not necessarily require much expense or equipment, it might appeal to a
wide range of individuals of all ages. Dancing may be less threatening to many
older adults than other exercise modes, given that many older individuals will
have had positive experiences of dance when they were younger (Dunlap & Barry,
1999; Lima & Vieira, 2007). Dance might also be an important promoter of suc-
cessful and healthy aging (Connor, 2000; Lima & Vieira; Wikstrom, 2004).
According to Connor, Lima and Vieira, and Wikstrom, dance might allow older
adults to maintain a connection to everyday life because it encourages fun and
enjoyment and promotes social interaction, a sense of community, appreciation of
aesthetics and continued health, physical activity, and mobility. Because of these
factors, dancing would appear to be a form of physical activity that may be more
likely to be adopted as part of many older adults’ exercise programs than other
exercise modes. Although dance has been shown to have considerable physical
benets for middle-aged and older adults with arthritis, osteoporosis, and neuro-
logical conditions (Berrol, Ooi, & Katz, 1997; Hackney, Kantorovich, & Earhart,
2007; Kudlacek, Pietschmann, Bernecker, Resch, & Willvonseder, 1997; Marks,
2005; Moffet, Noreau, Parent, & Drolet, 2000), no reviews on the physical bene-
ts of dance for healthy older adults have yet been published.
JAPA GALLEY PROOF
4 Keogh et al.
Methods
Literature-Search Methods
A search of Medline (PubMed), CINAHL, SportDiscus, ProQuest 5000 Interna-
tional, and Google Scholar was conducted using the keywords dance, dancing,
older adults, elder, and all of their derivatives. Additional search strategies
included using the “Related Articles” option in PubMed and perusing the refer-
ence lists of articles found in the initial searches. To be included in this review, the
studies had to have been published in peer-reviewed journals and involve groups
of apparently healthy older adults (>60 years old), who as a group were not all
diagnosed with medical conditions such as Parkinson’s disease, arthritis, or osteo-
porosis. These studies had to either compare a group of older dancers with an
age-matched group of nondancers or involve an exercise intervention that was
primarily dance based and lasted at least 8 weeks. Studies that used any form of
dance, such as more traditional folkloric dance, as well as those that used more
tness-associated aerobic and line dancing, were included. In addition, no restric-
tion was applied on the language or year in which the article was published.
Data Analysis
In accordance with Toussant and Kohia’s (2005) review on the benets of physical
therapy for older hip-fracture patients, we wished to critique the design of each of
the studies reviewed to describe the certainty of our recommendations. To achieve
these aims we used the critical evaluation methods of Megens and Harris (1998)
and Sackett (1989). Using these scales, each study reviewed was categorized
using a 5-point scale. Level I studies were large randomized controlled trials,
dened as those with more than 100 participants, in which the level of false posi-
tives and false negatives would likely be low. Level II studies were smaller ran-
domized controlled trials (<100 participants) that had greater chances for false
positives or false negatives to occur. Level III studies were nonrandomized, con-
current, cohort comparisons. Level IV studies were nonrandomized studies that
compared older adults who received the intervention (i.e., were regular dancers)
with those who were nondancers. Level V studies were case series or studies in
which no control group was used. The recommendations given were as follows:
Grade A recommendations required the support of at least one Level I study,
Grade B recommendations required the support of at least one Level II study, and
Grade C recommendations required the support of at least one Level III, IV, or V
study (Megens & Harris; Sackett).
The scientic rigor of each study was also evaluated using six criteria (Megens
& Harris, 1998; Sackett, 1989): having inclusion and exclusion criteria clearly
described, having the dance program adequately described, use of reliable out-
come measures, use of valid outcome measures, having assessors blinded to treat-
ment allocation, and having participants in the study accounted for. Studies labeled
with Y for “yes” in Table 1 fullled the specic criteria; those with an N for “no”
indicate that the criteria were not reached. In order for a study to be given a Y for
the reliability and validity criteria, they had to report their own adequately high
experimental reliability or validity data, refer to other studies that had shown high
JAPA GALLEY PROOF
5
Table 1 Evaluative Criteria for the Training Studies Reviewed
Study
Inclusion and
exclusion criteria
Treatment can
be replicated
Reliability of
outcome
measures
Validity of
outcome
measures
Blind assessment
of outcome
measures
Account for
attrition
Engels, Drouin, Zhu, &
Kazmierski (1998)
Y Y Y Y N N
Eyigor, Karapolat, Durmaz,
Ibisoglu, & Cakir (2009)b
Y Y Y Y Y N
Federici, Ballagamba, &
Rocchi (2005)b
Y Y Y Y N Ya
Hackney et al. (2007)bY Y Y Y Y Ya
Holmerová et al. (personal
communication)b
Y Y Y Y Y Ya
Hopkins, Murrah, Hoeger, &
Rhodes (1990)b
Y Y Y Y N N
Jeon et al. (2005) Y Y ? ? N N
Jeon, Ounpuu, & Davis
(2000)
Y Y N N N N
Kim, June, & Song (2003) Y Y Y Y N N
Kudlacek et al. (1997) Y ? Y Y N Ya
McKinley et al. (2008)bY Y Y Y Y N
Shigematsu et al. (2002)bY Y ? ? Y N
Soanidis, Hatzitaki, Douka,
& Grouios (2009)b
Y Y Y Y N N
Song, June, Kim, & Jeon
(2004)
Y N Y Y Y N
Young, Weeks, & Beck
(2007)b
Y Y Y Y N N
Note. Y = yes; N = no; ? = unclear or only partially.
aThese studies accounted for all participants in their pre–post analyses, although this might have just been because they had no dropouts. bStudies were randomized
controlled trials.
JAPA GALLEY PROOF
6 Keogh et al.
levels of reliability and validity, or use tests that are widely considered criterion or
gold standard.
Results
A relatively small number of peer-reviewed (3 cross-sectional and 15 training)
studies were found that examined the physical benets of dance for healthy older
adults. Nine of the 15 training studies were categorized as being Level II (Eyigor
et al., 2009; Federici et al., 2005; Hackney et al., 2007; Holmerová et al., personal
communication; Hopkins et al., 1990; McKinley et al., 2008; Shigematsu et al.,
2002; Soanidis et al., 2009; Young, Weeks, & Beck, 2007), with the other six
training studies being Level III–V (Engels et al., 1998; Jeon et al., 2005; Jeon et
al., 2000; Kim et al., 2003; Kudlacek et al., 1997; Song et al., 2004). All three
cross-sectional studies were categorized as being Level IV (Uusi-Rasi et al., 1999;
Verghese, 2006; Zhang, Ishikawa-Takata, Yamazaki, Morita, & Ohta, 2008).
Across these 18 studies, a variety of dance forms and outcome measures were
used. Of the 15 training studies, the most common forms of dance were traditional
Korean (Jeon et al., 2005; Jeon et al., 2000; Kim et al.; Song et al.) and aerobic
(Engels et al.; Hopkins et al.; Shigematsu et al.) dance. Aerobic power, muscle
endurance and strength, and static and dynamic balance were the most commonly
assessed outcome measures. Some studies also investigated changes in body com-
position, gait performance, prevalence of falls, and cardiovascular risk factors.
Cross-Sectional Studies
As summarized in Table 2, three cross-sectional studies compared the physical
function of older dancers with that of older nondancers (Uusi-Rasi et al., 1999;
Verghese, 2006; Zhang et al., 2008). These studies found that compared with older
nondancers, the older dancers had signicantly greater bone-mineral content,
aerobic power, muscle strength, muscle endurance, muscle power, balance, and
gait speed. Verghese also observed that older dancers’ gait was characterized by a
signicantly longer stride length and swing time, as well as shorter stance and
double-support times, than the nondancers. The gait differences reported by Ver-
ghese appear indicative of the older dancers’ having a more powerful and stable
gait pattern than their nondancing peers (Judge, Ounpuu, & Davis, 1996; Maki,
1997). Zhang et al. also found that older dancers had a signicantly lower body-
mass index and prevalence of diabetes and hypertension than older nondancers.
Training Studies
Fifteen longitudinal studies investigated the chronic physical benets of dancing
for older adults, and the results of these studies are summarized in Tables 3 and 4.
In Table 3, the results of nine studies that assessed changes in body composition
and/or physical tness are presented. Six of these nine studies reported signicant
increases in the muscle endurance of older adults (Engels et al., 1998; Eyigor et
al., 2009; Holmerová et al., personal communication; Hopkins et al., 1990;
McKinley et al., 2008; Young et al., 2007). Three studies reported signicant
increases in the older adults’ aerobic power (Engels et al.; Eyigor et al.; Hopkins
JAPA GALLEY PROOF
7
Table 2 Cross-Sectional Studies That Compared the Body Composition, Physical Fitness, and Functional Ability of
Older Dancers And Nondancers
Study Participants
Body
composition
Aerobic
power
Muscle
endurance
Muscle
strength
Muscle
power
Static
balance
Dynamic
balance/agility Gait speed
Uusi-Rasi
et al.
(1999)
117 M gymnasts
and folk danc-
ersa 62 ± 5 y,
116 M controls
62 ± 5 y
4% greater tibia-
shaft BMC and
8% distal-tibia
BMC in danc-
ers*
13% greater
VO2max in
dancers*
10% greater
knee-
extension
strength in
dancers*
13% greater
jump
height in
dancers*
8% faster gure-8
running in
dancers*
Verghese
(2006)
24 M and F social
dancers 80 y,
84 M and F
controls 81 y
13% quicker
5 STS in
dancers
10% greater
grip
strength in
dancers
41% greater
1-leg-
stance
time in
dancers*
13% greater
normal gait
speed in
dancers*
Zhang et
al. (2008)
112 M and F
social dancers,
112 M and F
controls, 50–87
y entire group
13% greater
postural-
stability
index in
dancers*
11% greater
maximum
gait speed
in dancersb
Note. M = male; y = years old; F = female; BMC = bone-mineral content; STS = sit-to-stand. Although the 5 STS time is considered a muscle-endurance measure in this table, it
could also be considered a measure of muscle strength.
aThis group consisted of 98 Finnish rhythmic gymnasts and 19 Finnish folk dancers. bThe between-groups difference approached signicance (p = .053).
*Signicantly better (p < .05) performance in dancers than controls (nondancers).
JAPA GALLEY PROOF
8
Table 3 Changes in Older Adults’ Body Composition and Physical Fitness as a Consequence of
Contemporary/Traditional and Aerobic Dance
Changes in Body Composition and Physical Fitness
Study Participants Dance style Duration Frequency
Body
composition
Aerobic
power Flexibility
Muscle
endurance
Muscle
strength
Contemporary/Traditional Dance
Eyigor et al.
(2009)
E 19 M 74 ± 8
y, C 18 M
71 ± 6 y
Turkish folk-
loristic
8 weeks 3/week 60
min/ses-
sion +
2/week
walking
for 30
min/ses-
sion
+17% 6-min
walk*,
+3%
6-min
walk
−19% 5
STS
time*,
−2%
5 STS
time
Holmerová et
al. (personal
communication)
E 27 M and
F 81 ± 10
y, C 25 M
and F 83 ±
8 y
Mixed ball-
room
3 months 1/week 60
min/ses-
sion
+77% sit-and-
reach*, −12%
sit-and-reach*
+38% 30-s
STS*,
−14%
30-s
STS*
Jeon et al. (2000) E 15 M, C 14
M, 65–75
y entire
group
Korean tradi-
tional
12 weeks 3/week 50
min/ses-
sion
+34% leg
ext*,
−10%
leg ext
Kudlacek et al.
(1997)
13 nonosteo-
porotic M
65 ± 2 y
Folkloristic,
Viennese
waltz, and
aerobic
12
months
3.3 ± 0.8 hr/
week
0% lumbar
BMD
(continued)
JAPA GALLEY PROOF
9
Table 3 (continued)
Changes in Body Composition and Physical Fitness
Study Participants Dance style Duration Frequency
Body
composition
Aerobic
power Flexibility
Muscle
endurance
Muscle
strength
Contemporary/Traditional Dance
McKinley et al.
(2008)
E 14 M and F
78 ± 8 y,
walking 11
M and F 75
± 8 y
Argentine
tango
10 weeks 2/week 90
min/ses-
sion
−24% 5
STS
time*,
−13%
5 STS
time
Aerobic/Line Dance
Engels et al.
(1998)
E + hand weights 12
M and F, E no
hand weights 11
M and F, C 11 M
and F; 67 ± 6 y
entire group
Aerobic 10 weeks,
10
weeks
3/week 60 min/
session, 3/
week 60
min/session
−2% ∑ skin-
folds, 0% ∑
skinfolds,
−2% ∑ skin-
folds
+10%
VO2max*,
+9%
VO2max*,
−2%
VO2max
0% hip
exion,
+3% hip
exion,
−2% hip
exion
−21% 5 STS
time*,
−21%
5 STS
time*,
+4% 5
STS time
+10% elbow
ext, +10%
elbow ext,
0% elbow
ext
Hopkins et al.
(1990)
E 30 M 65 ± 4 y, C
23 M 66 ± 4 y
Aerobic 12 weeks 3/week 50 min/
session
−5% ∑ skin-
folds, −1% ∑
skinfolds
+13% half-
mile
walk*,
−4%
half-mile
walk
+9% sit-and-
reach*,
0% sit-
and-reach
+62% 30-s
STS*, 0%
30-s STS
(continued)
JAPA GALLEY PROOF
10
Table 3 (continued)
Aerobic/Line Dance
Shigematsu et al.
(2002)
E 20 M 79 ± 4 y, C
18 M 80 ± 5 y
Aerobic 12 weeks 3/week 60 min/
session
−9% 3-min-
walk
distance,
+4%
3-min-
walk
distance
−7% isomet-
ric squat
time, −7%
isometric
squat time
−3%
handgrip,
+2%
handgrip
Young et al.
(2007)
E 10 M 65 ± 8 y, E
+ squats 10 M 63
± 4 y, E + squats
+ foot stomps 12
M 65 ± 8 y
Line 12 months 1/week, squats
5/week,
squats + foot
stomps, 5/
week
0% lumbar
BMD, 0%
lumbar
BMD, −1%
lumbar
BMD
+150% squat
reps with
12 kg*,
+225%
squat
reps with
12 kg*,
+600%
squat reps
with 12
kg*
Note. E = experimental; M = male; y = years old; C = control; BMD = bone-mineral density, STS = sit-to-stand; ext = extension. Although the 5 STS time is considered
a muscle-endurance measure in this table, it could also be considered a measure of muscle strength.
*Indicates signicantly better (p < .05) performance in experimental than control group.
JAPA GALLEY PROOF
11
Table 4 Changes in Older Adults’ Falls Prevalence and Functional Ability as a Consequence of Contemporary/
Traditional and Aerobic Dance
Falls and Functional Ability Changes
Study Participants Dance style Duration Frequency
Falls
prevalence Static balance
Dynamic balance/
agility Gait speed
Contemporary/Traditional Dance
Eyigor et al.
(2009)
E 9 M 74 ± 8 y, C
18 M 71 ± 6 y
Turkish folk-
loristic
8 weeks 3/week 60 min/
session + 2/
week walking
for 30 min/
session
+2% Berg Bal-
ance*, 0%
Berg Balance
−11% stair-climb
time*, −2%
stair-climb
time
Federici et al.
(2005)
E 20 M and F 63 ±
4 y, C 20 M and
F 64 ± 4 y
Caribbean 3 months 2/week 30–60
min/session
+18% Rom-
berg*, 0%
Romberg
−13% SUG time*,
0% SUG time
Hackney et al.
(2007)a
E 9, Str & Flex 10;
M and F age
unknown
Argentine
tango
12 weeks 2/week 60 min/
session
+12% 1-foot
stance*,
+44% 1-foot
stance*
+14% gait veloc-
ity, +7% gait
velocity
Holmerová et
al. (personal
communication)
E 27 M and F 81
± 10 y, C 25 M
and F 83 ± 8 y
Mixed ball-
room
3 months 1/week 60 min/
session
−8% TUG time,
+16% TUG time
Jeon et al. (2005) E 130, C 123; M
and F 60–79 y
entire group
Korean tradi-
tional
12 weeks 3/week +27–34% 1-foot
stance*,
−11–0%
1-foot stance
(continued)
JAPA GALLEY PROOF
12
Table 4 (continued)
Falls and Functional Ability Changes
Study Participants Dance style Duration Frequency
Falls
prevalence Static balance
Dynamic balance/
agility Gait speed
Contemporary/Traditional Dance
Jeon et al. (2000) E 15, C 14; M
65–75 y entire
group
Korean tradi-
tional
12 weeks 3/week +5% balance
eyes closed*,
−21% bal-
ance eyes
closed
+31% walk with
turn*, −23% walk
with turn
McKinley et al.
(2008)
E 14 M and F 78
± 8 y, walking
11 M and F 75
± 8 y
Argentine
tango
10 weeks 2/week 90 min/
session
+17% ABC*, +2%
ABC
+16% gait veloc-
ity*, +12%
gait velocity
Soanidis et al.
(2009)
E 14 M and F 69 ±
4 y, C 12 M and
F 73 ± 5 y
Traditional
Greek
10 weeks 2/week 40–60
min/session
−41% ML
sway 1-foot
stance*,
−14% ML
sway 1-foot
stance
+21% trunk rotation
in ML weight-
shift task*, 0%
trunk rotation in
ML weight-shift
task
Song et al. (2004) E 46 M and F 76 ±
8 y, C 27 M and
F 74 ± 8 y
Korean tradi-
tional
6 months 3/week 50 min/
session
10% had a
fall*, 21%
had a fall
+5% SIP mobility*,
+37% SIP mobil-
ity
−39% SIP ambu-
lation*, +30%
SIP ambula-
tion
(continued)
JAPA GALLEY PROOF
13
Table 4 (continued)
Aerobic/Line Dance
Engels et al.
(1998)
E + hand weights
12 M and F,
E no hand
weights 11 M
and F, C 11 M
and F; 67 ± 6 y
entire group
Aerobic, aero-
bic
10 weeks,
10
weeks
3/week 60 min/
session, 3/
week 60 min/
session
+13% forward
reach, +7%
forward
reach, +2%
forward
reach
Hopkins et al.
(1990)
E 30 M 65 ± 4 y, C
23 M 66 ± 4 y
Aerobic 12 weeks 3/week 50 min/
session
+12% 1-foot
stance*, 0%
1-foot stance
−13% chair agility
time*, +3% chair
agility time
Shigematsu et al.
(2002)
E 20 M 79 ± 4 y, C
18 M 80 ± 5 y
Aerobic 12 weeks 3/week 60 min/
session
+10% forward
reach*, −3%
forward
reach
−19% cone walk
time*, +3% cone
walk time
Young et al. (2007)E 10 M 65 ± 8 y,
E + squats 10
M 63 ± 4 y, E
+ squats + foot
stomps 12 M 65
± 8 y
Line 12 months 1/week, squats 5/
week, squats
+ foot stomps
5/week
+186% 1-foot
stance*,
+86% 1-foot
stance*,
+115%
1-foot
stance*
10% TUG time*,
−20% TUG
time*, −20%
TUG time*
Note. E = experimental; M = male; C = control; y = years old; F = female; SUG = sit-up-and-go; Str & Flex = strength and exibility training; TUG = timed up-and-go; ABC =
activities-specic balance condence; ML = mediolateral; SIP = Sickness Impact Prole. A higher SIP score indicates a greater limitation in function.
aNo mean age was listed for either of the groups in this study, although the minimum age was 55 years. Furthermore, the “control” group was an exercise group that performed a
variety of resistance and exibility exercises for the same frequency and duration as the dance group.
*Signicantly better (p < .05) performance in experimental than control group.
JAPA GALLEY PROOF
14 Keogh et al.
et al.), and two found signicant increases in exibility (Holmerová et al., per-
sonal communication; Hopkins et al.). It is interesting that all of the studies that
investigated dance-related changes in the body composition of older adults found
no signicant change in adiposity (Engels et al.; Hopkins et al.) or bone-mineral
content of the lower limb (Kudlacek et al., 1997; Young et al., 2007).
Although increasing muscle endurance and aerobic power are important out-
comes for older adults, improving balance and functional ability and reducing
falls might be of even more benet. A summary of the 13 studies that investigated
changes in falls prevalence, balance, and functional ability are presented in Table
4. Most of these studies reported that dancing signicantly improved older adults’
static and dynamic balance. The gait performance of the older adults was also
markedly increased. Specically, signicant improvements in gait speed when
moving in a straight line, around obstacles, and up stairs (Eyigor et al., 2009;
Federici et al., 2005; Hackney et al., 2007; Hopkins et al., 1990; Jeon et al., 2000;
McKinley et al., 2008; Shigematsu et al., 2002; Song et al., 2004; Young et al.,
2007) also indicated an overall improvement in the older adults’ agility. Further-
more, and perhaps most important, dancing could also signicantly reduce the
prevalence of falls in older adults (Jeon et al., 2005).
Kim et al. (2003) also found that a 12-week dance program resulted in signi-
cant reductions in total cardiovascular health risk, as well as cholesterol and trig-
lyceride levels, of the older adults.
Grade Recommendations
Based on the results summarized in Tables 2–4, we propose a number of
recommendations.
Because none of the studies were randomized controlled trials involving more
than 100 participants, no recommendations could be given Level A status (Sack-
ett, 1989).
Grade B recommendations were as follows: A dance-based exercise program
can improve older adults’
• Aerobic power (Eyigor et al., 2009; Hopkins et al., 1990)
• Muscle endurance of the lower extremities (Eyigor et al., 2009; Holmerová et
al., personal communication; Hopkins et al.; McKinley et al., 2008; Young et
al., 2007)
• Muscle strength of the lower extremities (Eyigor et al.; McKinley et al.)
• Flexibility of the lower extremities (Holmerová et al., personal communication;
Hopkins et al.)
• Static balance (Eyigor et al.; Federici et al., 2005; Hackney et al., 2007; Hopkins
et al.; Shigematsu et al., 2002; Soanidis et al., 2009; Young et al., 2007)
Dynamic balance and agility (Federici et al.; Hopkins et al.; McKinley et al.;
Shigematsu et al.; Soanidis et al.; Young et al., 2007)
• Gait speed (Eyigor et al.; Hackney et al.; McKinley et al.)
Grade C recommendations were as follows: A dance-based exercise program
for older adults may
• Increase bone-mineral content in the lower body (Uusi-Rasi et al., 1999)
JAPA GALLEY PROOF
Benets of Dance 15
• Increase muscle power of the lower extremities (Uusi-Rasi et al.)
• Reduce the rate of falls (Jeon et al., 2005)
• Reduce cardiovascular health risk (Kim et al., 2003; Zhang et al., 2008)
Discussion
Using the rules of evidence described by Sackett (1989), there is relatively strong
(i.e., Grade B) evidence that dancing can signicantly improve the aerobic power,
muscle endurance, strength, and exibility of the lower body; static and dynamic
balance/agility; and gait speed of older adults. Although the Grade B evidence
was based on only nine studies, the scientic rigor of these studies was generally
high (Eyigor et al., 2009; Federici et al., 2005; Hackney et al., 2007; Holmerová
et al., personal communication; Hopkins et al., 1990; McKinley et al., 2008;
Shigematsu et al., 2002; Soanidis et al., 2009; Young et al., 2007). With the
exception of Shigematsu et al., who might have used some “questionable” tests to
assess changes in the muscle endurance and strength of the older adults, the eight
other studies all had clear inclusion/exclusion criteria and clearly described dance
programs and used reliable and valid outcome measures.
Because of the relative strength of this literature, further development and
promotion of older-adult-specic dance classes, similar to that done with Tai Chi
and resistance training (Faber, Bosscher, Chin, & van Wieringen, 2006; Hill et al.,
2005; Liu-Ambrose, Khan, Eng, Janssen et al., 2004), might be recommended. If
the accessibility of such dance classes for older adults were to increase, we believe
that many older adults would dance, because there is considerable intragroup vari-
ability in the preferred forms of physical activity for older adults (Mills et al.,
1997; Wilcox et al., 1999), it might be less threatening to many older adults than
other exercise modes (Dunlap & Barry, 1999), and it can be an important pro-
moter of successful aging (Wikstrom, 2004).
The reader should, however, be aware of the limitations of this review and
hence regard some of these recommendations with a degree of caution. The major
limitations included the relatively small number of studies and the variety of dance
forms used in the studies, predominance of female participants in the studies, and
somewhat conicting evidence for the effect of dance on muscle strength. These
issues will now be discussed in further detail.
The review consisted of only 15 training and 3 cross-sectional studies. Within
this relatively small sample of literature, there was considerable diversity with
respect to the forms of dance used. The three cross-sectional studies used mixed
samples of older dancers, with ballroom, line, and Finnish folk dance being some
of the dance forms that the participants practiced most often. Of the 15 training
studies, 11 involved traditional forms of dance such as Korean, ballroom, Argen-
tine tango, Turkish folkloristic, Greek, and Caribbean and 4 used aerobic or line
dance. To dance purists, the inclusion of aerobic or even line dancing in this review
might seem inappropriate. Although we agree with this contention at an aesthetic
and creative level, we included these forms of dance for two reasons: these were
the relatively small number of eligible studies and because aerobic, line, and more
traditional dance styles appear to offer somewhat similar biomechanical and phys-
iological challenges to the older adult, with this appearing sufciently high to
JAPA GALLEY PROOF
16 Keogh et al.
cause improvements in many aspects of physical function (Grant et al., 2002;
Guidetti et al., 2007; Ozkan & Kin-Isler, 2007; Wigaeus & Kilbom, 1980). Inspec-
tion of the data found in Tables 2–4 indicated that older adults were able to obtain
signicant physical benets from traditional, as well as aerobic and line, dance
styles. This supports our contention that all forms of dance will have some physi-
cal benets for many older adults. However, any intradance variation in technical
requirements and movement patterns would still alter the biomechanical and/or
physiological demands of the dance style in some way, resulting in somewhat
specic adaptations to each dance form (Harris, Cronin, & Keogh, 2007; Schoene,
2007).
Of the 18 studies included in this review, 7 of the 15 training (Eyigor et al.,
2009; Hopkins et al., 1990; Jeon et al., 2000; Kim et al., 2003; Kudlacek et al.,
1997; Shigematsu et al., 2002; Young et al., 2007) and 1 of the 3 cross-sectional
(Uusi-Rasi et al., 1999) studies involved only female participants. Although the
other eight training (Engels et al., 1998; Federici et al., 2005; Hackney et al.,
2007; Holmerová et al., personal communication; Jeon et al., 2005; McKinley et
al., 2008; Soanidis et al., 2009; Song et al., 2004) and two cross-sectional (Ver-
ghese, 2006; Zhang et al., 2008) studies used mixed samples, these studies were
still typically dominated by female participants. Therefore, it is still somewhat
unclear whether older men can derive the same physical benets from dancing as
do older women.
In a number of the studies, the validity and reliability of several of the tests
and outcome measures may not have been sufciently high. For example, signi-
cant improvements in balance were often observed in static standing tasks (Fed-
erici et al., 2005; Hackney et al., 2007; Hopkins et al., 1990; Jeon et al., 2005;
Soanidis et al., 2009; Young et al., 2007). Because most falls occur during
dynamic activities such as walking, turning, and reaching (Judge, 2003; Lockhart,
Woldstad, & Smith, 2003; Overstall, 2004) and there is often a low correlation
between static and dynamic balance (Hrysomallis, McLaughlin, & Goodman,
2006), it is unclear whether changes in static balance would translate to an
improvement in overall physical function or a reduction in the falls rate in older
adults. Another possible issue is the use of the Berg Balance Scale (BBS) by
Eyigor et al. (2009) to assess changes in the dynamic balance of their participants.
Although the BBS is a validated measure of dynamic balance and functional abil-
ity in older adults (Berg, Wood-Dauphinee, Williams, & Maki, 1992), it is unclear
whether the statistically signicant change in the BBS reported by Eyigor et al.
for the dance group (preintervention 54.1 vs. postintervention 55.3) is of any clini-
cal signicance. The BBS involves 14 activities of daily living scored on a scale
of 0–4, where 0 means being unable to perform the task, and 4, being able to com-
plete the task based on the criterion (Berg et al.; Steffen et al., 2002). Because the
maximum score on the BBS is 56, this test can suffer ceiling effects in studies like
that of Eyigor et al., in which the older adults were well functioning before start-
ing the dance program. It could therefore be recommended that although the BBS
might be useful to describe the pretraining status of older adults in such studies,
its use as an outcome measure might be most appropriate for frailer older adults
who have lower pretraining scores.
There are similar concerns regarding the validity and reliability of some tests
of muscle function—for example, elbow-extension and handgrip strength and
JAPA GALLEY PROOF
Benets of Dance 17
half-squat isometric muscle endurance—used in some of the reviewed studies
(Engels et al., 1998; Shigematsu et al., 2002). The use of these potentially “ques-
tionable” tests may have contributed to the somewhat conicting results for the
effect of dancing on older adults’ muscle strength, whereby signicant increases
(Engels et al.; Eyigor et al., 2009; Jeon et al., 2000) and no signicant change
(Engels et al.; Shigematsu et al., 2002) were both reported.
The somewhat conicting results for the effect of dance on older adults’
muscle strength might also reect between-study differences in the specicity of
training and testing. The principle of specicity states that the greater the similar-
ity in factors such as posture, range of motion, velocity, and mode of contraction
between the training and testing tasks, the greater the training-related benets
(Harris et al., 2007). When comparing these studies, it was apparent that when
lower body strength was assessed, signicant increases in strength were demon-
strated (Engels et al., 1998; Eyigor et al., 2009; Jeon et al., 2000; McKinley et al.,
2008), whereas no signicant change in strength was found when upper body
strength was tested (Engels et al.; Shigematsu et al., 2002). Research indicates
that one of the primary stimuli for improving strength is the production of high
levels of force by specic muscle groups (Crewther, Cronin, & Keogh, 2005).
Because dance typically involves the production of substantially greater lower
than upper body forces and torques (Lin et al., 2005; Michaud et al., 1993; Simp-
son & Kanter, 1997), the dance-related signicant increases in lower but not upper
body strength are not surprising.
Conclusion
The results of this literature review demonstrate the potential for dancing to
improve the physical function of older adults. Although the size of this literature
sample is still relatively small, there appears sufcient Grade B evidence to sug-
gest that dancing can improve the aerobic power, lower body muscle endurance,
strength and exibility, static and dynamic balance/agility, and gait speed of older,
especially female, adults. The further development and promotion of older-adult-
specic dance classes would therefore be useful because it would provide older
adults with another physical activity option that might signicantly improve their
physical capabilities.
Future research in this area is most warranted and should concentrate on a
number of areas. Some research should investigate how best to structure dance
programs for older adults to maximize gains in physical function while ensuring
participant safety and enjoyment. This may involve investigating the optimal fre-
quency and duration of dancing, as well as comparing the relative effectiveness
and safety of a variety of dance styles with other activities such as Tai Chi and
resistance training. Because any group of older adults will have members with
varying physical abilities and limitations, these studies should use dance programs
that allow differentiation of ability and ensure appropriate progression for all par-
ticipants. Furthermore, research into the factors that inuence the uptake of and
adherence to a dance-based exercise program in this population should also be
conducted.
JAPA GALLEY PROOF
18 Keogh et al.
Acknowledgments
The authors wish to thank Sport and Recreation New Zealand (SPARC) for funding this
research. A preliminary report of this paper was presented at the 2007 New Zealand
Association of Gerontology Conference.
References
American College of Sports Medicine. (1998). Position stand: Exercise and physical activ-
ity for older adults. Medicine and Science in Sports and Exercise, 30(6), 992–1008.
Barry, B.K., & Carson, R.G. (2004). The consequences of resistance training for movement
control in older adults. The Journals of Gerontology. Series A, Biological Sciences
and Medical Sciences, 59(7), 730–754.
Berg, K.O., Wood-Dauphinee, S.L., Williams, J.I., & Maki, B. (1992). Measuring bal-
ance in the elderly: Validation of an instrument. Canadian Journal of Public Health,
83(Suppl. 2), S7–S11.
Berrol, C.F., Ooi, W.L., & Katz, S.S. (1997). Dance/movement therapy with older adults
who have sustained neurological insult: A demonstration project. American Journal
of Dance Therapy, 19(2), 135–160.
Brouwer, B., Musselman, K., & Culham, E. (2004). Physical function and health status
among seniors with and without a fear of falling. Gerontology, 50(3), 135–141.
Campbell, A.J., Robertson, M.C., La Grow, S.J., Kerse, N.M., Sanderson, G.F., Jacobs,
R.J., et al. (2005). Randomised controlled trial of prevention of falls in people aged
> or =75 with severe visual impairment: The VIP trial. British Medical Journal,
331(7520), 817.
Carter, J.S., Williams, H.G., & Macera, C.A. (1993). Relationships between physical activ-
ity habits and functional neuromuscular capacities in healthy older adults. Journal of
Applied Gerontology, 12(2), 283–293.
Connor, M. (2000). Recreational folk dance: A multicultural exercise component in healthy
ageing. Australian Occupational Therapy Journal, 47(2), 69–76.
Crewther, B., Cronin, J., & Keogh, J. (2005). Possible stimuli for strength and power
adaptation: Acute mechanical responses. Sports Medicine (Auckland, N.Z.), 35(11),
967–989.
Cromwell, R.L., Meyers, P.M., Meyers, P.E., & Newton, R.A. (2007). Tae Kwon Do: An
effective exercise for improving balance and walking ability in older adults. The
Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 62(6),
641–646.
Deley, G., Kervio, G., Van Hoecke, J., Verges, B., Grassi, B., & Casillas, J.M. (2007).
Effects of a one-year exercise training program in adults over 70 years old: A study
with a control group. Aging Clinical and Experimental Research, 19(4), 310–315.
Dite, W., & Temple, V.A. (2002). A clinical test of stepping and change of direction to
identify multiple falling older adults. Archives of Physical Medicine and Rehabilita-
tion, 83(11), 1566–1571.
Doyle, T.L.A., Dugan, E., Humphries, B., & Newton, R.U. (2004). Discriminating between
elderly and young using a fractal dimension analysis of centre of pressure. Interna-
tional Journal of Medical Sciences, 1(1), 11–20.
Dunlap, J., & Barry, H.C. (1999). Overcoming exercise barriers in older adults. The Physi-
cian and Sportsmedicine, 27(11), 69–75.
Engels, H.J., Drouin, J., Zhu, W., & Kazmierski, J.F. (1998). Effects of low-impact, moder-
ate-intensity exercise training with and without wrist weights on functional capacities
and mood states in older adults. Gerontology, 44(4), 239–244.
JAPA GALLEY PROOF
Benets of Dance 19
Enoka, R.M. (1997). Neural adaptations with chronic physical activity. Journal of Biome-
chanics, 30(5), 447–455.
Enoka, R.M., Christou, E.A., Hunter, S.K., Kornatz, K.W., Semmler, J.G., Taylor, A.M., et
al. (2003). Mechanisms that contribute to differences in motor performance between
young and old adults. Journal of Electromyography and Kinesiology, 13, 1–12.
Eyigor, S., Karapolat, H., Durmaz, B., Ibisoglu, U., & Cakir, S. (2009). A randomized con-
trolled trial of Turkish folklore dance on the physical performance, balance, depres-
sion and quality of life in older women. Archives of Gerontology and Geriatrics,
48(1), 84–88.
Faber, M.J., Bosscher, R.J., Chin, A.P.M.J., & van Wieringen, P.C. (2006). Effects of exer-
cise programs on falls and mobility in frail and pre-frail older adults: A multicenter
randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 87(7),
885–896.
Federici, A., Bellagamba, S., & Rocchi, M.B. (2005). Does dance-based training improve
balance in adult and young old subjects? A pilot randomized controlled trial. Aging
Clinical and Experimental Research, 17(5), 385–389.
Fiatarone-Singh, M.A. (2002). Exercise comes of age: Rationale and recommendations for
a geriatric exercise prescription. The Journals of Gerontology. Series A, Biological
Sciences and Medical Sciences, 57(5), M262–M282.
Gillespie, L.D., Gillespie, W.J., Robertson, M.C., Lamb, S.E., Cumming, R.G., & Rowe,
B.H. (2003). Interventions for preventing falls in elderly people. Cochrane Database
of Systematic Reviews (Online : Update Software), 4, CD000340.
Grant, S., Corbett, K., Todd, K., Davies, C., Aitchison, T., Mutrie, N., et al. (2002). A
comparison of physiological responses and rating of perceived exertion in two modes
of aerobic exercise in men and women over 50 years of age. British Journal of Sports
Medicine, 36(4), 276–281.
Guidetti, L., Emerenziani, G.P., Gallotta, M.C., & Baldari, C. (2007). Effect of warm up
on energy cost and energy sources of a ballet dance exercise. European Journal of
Applied Physiology, 99(3), 275–281.
Hackney, M., Kantorovich, S., & Earhart, G. (2007). A study on the effects of Argentine
tango as a form of partnered dance for those with Parkinson disease and the healthy
elderly. American Journal of Dance Therapy, 29(2), 109–127.
Harridge, S., Magnusson, G., & Saltin, B. (1997). Life-long endurance-trained elderly men
have high aerobic power, but have similar muscle strength to non-active elderly men.
Aging, 9(1-2), 80–87.
Harris, N., Cronin, J., & Keogh, J. (2007). Contraction force specicity and its relationship
to functional performance. Journal of Sports Sciences, 25(2), 201–212.
Hill, K., Choi, W., Smith, R., & Condron, J. (2005). Tai Chi in Australia: Acceptable and
effective approach to improve balance and mobility in older people? Australasian
Journal on Ageing, 24(1), 9–13.
Hopkins, D.R., Murrah, B., Hoeger, W.W., & Rhodes, R.C. (1990). Effect of low-impact
aerobic dance on the functional tness of elderly women. The Gerontologist, 30(2),
189–192.
Hrysomallis, C., McLaughlin, P., & Goodman, C. (2006). Relationship between static and
dynamic balance tests among elite Australian footballers. Journal of Science and
Medicine in Sport, 9(4), 288–291.
Hsiao-Wecksler, E.T., & Robinovitch, S.N. (2007). The effect of step length on young and
elderly women’s ability to recover balance. Clinical Biomechanics (Bristol, Avon),
22(5), 574–580.
Hurley, M.V., Ree, J., & Newham, D.J. (1998). Quadriceps function, proprioceptive acuity
and functional performance in healthy young, middle-aged and elderly subjects. Age
and Ageing, 27, 55–62.
JAPA GALLEY PROOF
20 Keogh et al.
Imrhan, S.N., & Loo, C.H. (1989). Trends in nger pinch strength in children, adults, and
the elderly. Human Factors, 31(6), 689–701.
Jeon, M.Y., Bark, E.S., Lee, E.G., Im, J.S., Jeong, B.S., & Choe, E.S. (2005). The effects
of a Korean traditional dance movement program in elderly women. Taehan Kanho
Hakhoe Chi, 35(7), 1268–1276.
Jeon, M.Y., Choe, M.A., & Chae, Y.R. (2000). Effect of Korean traditional dance move-
ment training on balance, gait and leg strength in home bound elderly women. Journal
of Korean Academy of Nursing, 30(3), 647–658.
Judge, J.O. (2003). Balance training to maintain mobility and prevent disability. American
Journal of Preventive Medicine, 25(3, Suppl. 2) 150–156.
Judge, J.O., Ounpuu, S., & Davis, R.B., III. (1996). Effects of age on the biomechanics and
physiology of gait. Clinics in Geriatric Medicine, 12(4), 659–678.
Keogh, J.W., Morrison, S., & Barrett, R. (2007). Strength-training improves the tri-digit
nger-pinch force control of older adults. Archives of Physical Medicine and Reha-
bilitation, 88, 1055–1063.
Kim, C-G., June, K-J., & Song, R. (2003). Effects of a health-promotion program on car-
diovascular risk factors, health behaviors, and life satisfaction in institutionalized
elderly women. International Journal of Nursing Studies, 40(4), 375–381.
Kudlacek, S., Pietschmann, F., Bernecker, P., Resch, H., & Willvonseder, R. (1997). The
impact of a senior dancing program on spinal and peripheral bone mass. American
Journal of Physical Medicine & Rehabilitation, 76(6), 477–481.
Lima, M., & Vieira, A. (2007). Ballroom dance as therapy for the elderly in Brazil. Ameri-
can Journal of Dance Therapy, 29(2), 129–142.
Lin, C.F., Su, F.C., & Wu, H.W. (2005). Ankle biomechanics of ballet dancers in releve en
pointe dance. Research in Sports Medicine, 13(1), 23–35.
Liu-Ambrose, T., Khan, K.M., Eng, J.J., Janssen, P.A., Lord, S.R., & McKay, H.A. (2004).
Resistance and agility training reduce fall risk in women aged 75 to 85 with low bone
mass: A 6-month randomized, controlled trial. Journal of the American Geriatrics
Society, 52(5), 657–665.
Liu-Ambrose, T., Khan, K.M., Eng, J.J., Lord, S.R., & McKay, H.A. (2004). Balance con-
dence improves with resistance or agility training. Increase is not correlated with
objective changes in fall risk and physical abilities. Gerontology, 50(6), 373–382.
Lockhart, T.E., Woldstad, J.C., & Smith, J.L. (2003). Effects of age-related gait changes on
the biomechanics of slips and falls. Ergonomics, 46(12), 1136–1160.
Maki, B.E. (1997). Gait changes in older adults: Predictors of falls or indicators of fear.
Journal of the American Geriatrics Society, 45(3), 313–320.
Marks, R. (2005). Dance-based exercise and Tai Chi and their benets for people with
arthritis: A review. Health Education, 105, 374–391.
McKinley, P., Jacobson, A., Leroux, A., Bednarczyk, V., Rossignol, M., & Fung, J. (2008).
Effect of a community-based Argentine tango dance program on functional balance
and condence in older adults. Journal of Aging and Physical Activity, 16(4), 435–
453.
Megens, A., & Harris, S.R. (1998). Physical therapist management of lymphedema fol-
lowing treatment for breast cancer: A critical review of its effectiveness. Physical
Therapy, 78, 1302–1311.
Michaud, T.J., Rodriguez-Zayas, J., Armstrong, C., & Hartnig, M. (1993). Ground reaction
forces in high impact and low impact aerobic dance. Journal of Sports Medicine and
Physical Fitness, 33(4), 359–366.
Mills, K.M., Stewart, A.L., Sepsis, P.G., & King, A.C. (1997). Consideration of older
adults’ preferences for format of physical activity. Journal of Aging and Physical
Activity, 5, 50–58.
JAPA GALLEY PROOF
Benets of Dance 21
Moffet, H., Noreau, L., Parent, E., & Drolet, M. (2000). Feasibility of an eight-week dance-
based exercise program and its effects on locomotor ability of persons with functional
Class III rheumatoid arthritis. Arthritis Care and Research, 13(2), 100–111.
Nnodim, J.O., Strasburg, D., Nabozny, M., Nyquist, L., Galecki, A., Chen, S., et al. (2006).
Dynamic balance and stepping versus Tai Chi training to improve balance and step-
ping in at-risk older adults. Journal of the American Geriatrics Society, 54(12), 1825–
1831.
Overstall, P. (2004). Falls and gait disorders in the elderly—Principles of rehabilitation. In
A.M. Bronstein, T. Brandt, M.H. Woollacott, & J.G. Nutt (Eds.), Clinical disorders of
balance, posture and gait (2nd ed., pp. 404–421). London: Arnold.
Ozkan, A., & Kin-Isler, A. (2007). The reliability and validity of regulating exercise inten-
sity by ratings of perceived exertion in step dance classes. Journal of Strength and
Conditioning Research, 21(1), 296–300.
Peidro, R.M., Osses, J., Caneva, J., Bion, G., Angelino, A., Kerbage, S., et al. (2002). Tango
modicaciones cardiorespiratorias durante el baile. Revista Argentina de Cardiologia,
70, 358–363.
Sackett, D.L. (1989). Rules of evidence and clinical recommendations on the use of anti-
thrombotic agents. Chest, 95, 2S–4S.
Schlicht, J., Camaione, D.N., & Owen, S.V. (2001). Effects of intense strength training on
standing balance, walking speed, and sit-to-stand performance in older adults. The
Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(5),
M281–M287.
Schoene, L.M. (2007). Biomechanical evaluation of dancers and assessment of their chance
of injury. Journal of the American Podiatric Medical Association, 97(1), 75–80.
Seals, D.R., Hagberg, J.M., Hurley, B.F., Ehsani, A.A., & Holloszy, J.O. (1984). Endurance
training in older men and women I. Cardiovascular response to exercise. Journal of
Applied Physiology, 57(4), 1024–1029.
Shigematsu, R., Chang, M., Yabushita, N., Sakai, T., Nakagaichi, M., Nho, H., et al. (2002).
Dance-based aerobic exercise may improve indices of falling risk in older women.
Age and Ageing, 31(4), 261–266.
Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for
falls in community-dwelling older adults using the Timed Up & Go Test. Physical
Therapy, 80(9), 896–903.
Simpson, K.J., & Kanter, L. (1997). Jump distance of dance landings inuencing inter-
nal joint forces: I. Axial forces. Medicine and Science in Sports and Exercise, 29(7),
916–927.
Soanidis, G., Hatzitaki, V., Douka, S., & Grouios, G. (2009). Effect of a 10-week tradi-
tional dance program on static and dynamic balance control in elderly adults. Journal
of Aging and Physical Activity, 17(2), 167–180.
Song, R., June, K.J., Kim, C.G., & Jeon, M.Y. (2004). Comparisons of motivation, health
behaviors, and functional status among elders in residential homes in Korea. Public
Health Nursing (Boston, Mass.), 21(4), 361–371.
Steffen, T.M., Hacker, T.A., & Mollinger, L. (2002). Age- and gender-related test perfor-
mance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance
Scale, Timed Up & Go Test, and gait speeds. Physical Therapy, 82, 128–137.
Toussant, E.M., & Kohia, M. (2005). A critical review of literature regarding the effective-
ness of physical therapy management of hip fracture in elderly persons. The Journals
of Gerontology. Series A, Biological Sciences and Medical Sciences, 60(10), 1285–
1291.
Uusi-Rasi, K., Sievanen, H., Vuori, I., Heinonen, A., Kannus, P., Pasanen, M., et al. (1999).
Long-term recreational gymnastics, estrogen use, and selected risk factors for osteo-
porotic fractures. Journal of Bone and Mineral Research, 14(7), 1231–1238.
JAPA GALLEY PROOF
22 Keogh et al.
Verghese, J. (2006). Cognitive and mobility prole of older social dancers. Journal of the
American Geriatrics Society, 54(8), 1241–1244.
Wagner, M.B., & Kauffman, T.L. (2001). The aging process. In B.R. Bonder & M.B.
Wagner (Eds.), Functional performance in older adults (2nd ed., pp. 59–85). Phila-
delphia: FA Davis.
Whitney, S.L., Marchetti, G.F., Morris, L.O., & Sparto, P.J. (2007). The reliability and
validity of the Four Square Step Test for people with balance decits secondary to
a vestibular disorder. Archives of Physical Medicine and Rehabilitation, 88(1), 99–
104.
Wiebe, C.G., Gledhill, N., Jamnik, V.K., & Ferguson, S. (1999). Exercise cardiac function
in young through elderly endurance trained women. Medicine and Science in Sports
and Exercise, 31(5), 684–691.
Wigaeus, E., & Kilbom, A. (1980). Physical demands during folk dancing. European Jour-
nal of Applied Physiology, 45(2–3), 177–183.
Wikstrom, B.M. (2004). Older adults and the arts: The importance of aesthetic forms of
expression in later life. Journal of Gerontological Nursing, 30(9), 30–36.
Wilcox, S., King, A.C., Brassington, G.S., & Ahn, D.K. (1999). Physical activity prefer-
ences of middle-aged and older adults: A community analysis. Journal of Aging and
Physical Activity, 7, 386–399.
Young, A., Stokes, M., & Crowe, M. (1985). The size and strength of the quadriceps mus-
cles of old and young men. Clinical Physiology (Oxford, England), 5, 145–154.
Young, C.M., Weeks, B.K., & Beck, B.R. (2007). Simple, novel physical activity maintains
proximal femur bone mineral density, and improves muscle strength and balance in
sedentary, postmenopausal Caucasian women. Osteoporosis International, 18(10),
1379–1387.
Zhang, J.G., Ishikawa-Takata, K., Yamazaki, H., Morita, T., & Ohta, T. (2008). Postural sta-
bility and physical performance in social dancers. Gait & Posture, 27(4), 697–701.
JAPA GALLEY PROOF
... Dance is a specific form of exercise that occurs in pleasant and energetic environments [12,13] and contributes to successful aging [12,14]. Dance can improve motor skills, balance, coordination, aerobic endurance, social relationships, and positive emotions [12,[14][15][16][17]. In particular, creative dance has been shown to improve proprioception [18], strength, aerobic endurance, flexibility, agility and dynamic balance, body composition, and life satisfaction [19]. ...
... However, Cruz-Ferreira et al. [19] found that physical exercise specifically focused on creative dance revealed beneficial effects of this practice on lower limb strength in 21% of practitioners, lower limb flexibility, agility, and dynamic balance in 13%, aerobic endurance in 10%, waist circumference in 8%, body mass index in 5% and satisfaction with life in 34%. In the same manner, other scientific research reported beneficial effects of dance practice not only on promoting balance, proprioception, strength, flexibility, posture, and aerobic endurance but also on improving social relationships and promoting positive emotions, thereby contributing to healthy aging [14][15][16][17][18]. Benefits from dance practice seem to come from the stimulation of brain functions related to memory, cardiovascular stimulation, cognitive stimulation, and the social and emotional interactions promoted in this type of activity [14]. ...
Article
Full-text available
Background Multimodal forms of exercise can influence several physical and mental factors important for successful aging. In the present study, we introduce a new type of multimodal intervention, combining movement (creative dance) with traditional singing. This study aims to compare physical fitness, functional physical independence, depressive symptoms, general cognitive status, and daytime sleepiness among older adults participating in multimodal exercise, those participating in traditional physical exercise, and those not actively engaged in physical exercise. Methods This cross-sectional study included 112 people aged ≥ 65 years (75.3 ± 0.7 years) living independently in the community, divided into 3 groups: multimodal exercise (n = 34), traditional exercise (n = 41), and no physical exercise (n = 37). Results The multimodal exercise group showed greater flexibility of the lower limbs and upper limbs/shoulders and better general cognitive status than the traditional exercise group (p < 0.05). The traditional exercise group had better agility and dynamic balance, aerobic endurance, and strength of the lower and upper limbs than the no-exercise group (p < 0.05). Conclusions The results suggest that the two types of programs studied may have different impacts on some of the variables investigated and support the design of future experimental studies that include interventions based on the combination of creative dance and traditional Portuguese singing.
... However, resistance training is not the only exercise modality that can be implemented to develop muscle power. Interventions that target exercise coupled with socialization such as dancing have been shown to improve physical (Keogh, Kilding, Pidgeon, Ashley, & Gillis, 2009;Liu, Shen, & Tsai, 2021) and cognitive health (Hewston et al., 2021). Recently, Chipperfield and Stephenson (2022) reported that participants in a 12-month social ballroom dancing program demonstrated substantial improvements in strength, balance, and wellbeing. ...
... Moreover, the duration of standing on a single leg was significantly longer in the NW group. Although many previous studies have reported improvements in balance after dance intervention [31,39,[122][123][124], our results did not show that such changes occurred after dance training. In the NW and dance groups, the angle of the heel lift was significantly improved, but there was no change in the toe lift. ...
Article
Full-text available
Aerobic exercise improves executive function—which tends to decline with age—and dual-task training with aerobic exercise improves the global cognitive function. However, home-based older adults could not follow these programs due to social isolation during the coronavirus disease 2019 pandemic. Therefore, we conducted a single-blind randomized controlled trial with 88 healthy older adults without dementia or sarcopenia who were randomly assigned into the Nordic walking (aerobic exercise), dance (dual-task training with aerobic exercise), or control group. The participants in both exercise intervention groups trained for 30 min, three times per week, for 4 weeks. All groups consumed amino acid-containing foods three times per week. We found that both exercise intervention groups showed improvements in executive function, while the dance group showed additional improvement in global cognitive function. The dance group showed a higher maximum gait speed, greater improvement in imitation ability, and improved executive function and cognitive function than the Nordic walking group. The intervention programs did not significantly affect the muscle mass or muscle output than the control group; however, both programs improved the participant neurological functions such as the heel lift, with dance training being the most effective intervention. In conclusion, dance training effectively improves cognitive function.
... Latinos have cited dance as an important and desirable component to community-based programs (Larsen et al., 2015;Predovan et al., 2019). Furthermore, engaging in dance has been shown to improve or maintain cognition (Hamacher et al., 2015;Hwang and Braun, 2015;Merom et al., 2016;Predovan et al., 2019;Muiños and Ballesteros, 2021), partly due to the learning component and coordination of dancing (Voelcker-Rehage and Niemann, 2013;Rehfeld et al., 2017), the multisensory demands of the activity (Thøgersen-Ntoumani et al., 2018), the timing, synchronization and sequences of moves, and the energy expenditure associated with movement (Keogh et al., 2009). Randomized controlled trials (RCTs) have examined changes in cognitive performance among several types of dance styles including, ballroom dancing (Lazarou et al., 2017), Cha-Cha (Kim et al., 2011), and a blend of styles (e.g., line dance, jazz dance, rock'n roll, Latin, and square dance) (Hamacher et al., 2015) and have demonstrated changes in global cognition, executive function, episodic and working memory, and attention. ...
Article
Full-text available
Background Physical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains. Methods Our 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score. Results The ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [ F (1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [ F (2,328) = 0.229, p = 0.80, Cohen’s d = 0.07] or episodic memory [ F (2,328) = 0.241, p = 0.78, Cohen’s d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (β = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [β = 0.035, 95% CI (0.0041, 0.0807)]. Conclusion A 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos. Clinical Trial Registration [ www.ClinicalTrials.gov ], identifier [NCT01988233].
... AD is characterized by a sequence of impact movements choreographed to the rhythm of the music. Several studies have proposed that AD improves muscular strength, cardiorespiratory endurance, body agility, flexibility [22,23], lower body function [24] and locomotion/agility and balance, thus attenuating risks of falling in elderly adults [25]. AD exercise programs have been shown to reduce body weight, fat mass and cardiovascular disease risks in overweight and obese women [26], as well as improve maximal oxygen uptake (VO 2 ), decrease MDA levels and enhance antioxidant capacity [27]. ...
Article
Full-text available
Background: Obesity is a global health problem associated with a high number of comorbidities that decrease functional capacity, especially in elderly people. Aerobic dance is considered a viable strategy to prevent the effects of aging, mainly in obese and overweight elderly people. This study aimed to evaluate the effects of aerobic dance on an air dissipation platform (ADP) on body composition, oxidative stress and muscular and cardiorespiratory fitness in elderly people. Methods: In total, 32 elderly adults (67.1 ± 3.6) were divided into 3 groups based on body mass index: healthy (HG), overweight (OWG) and obese (OG). Training program of aerobic dance on an ADP was carried out twice a week for 12 weeks. Results: OWG (p = 0.016) and OG decreased their weight (p < 0.001). There was a significant decrease in malondialdehyde concentrations in all experimental groups (p < 0.05). OWG and OG significantly improved their peak oxygen uptake (p < 0.01). HG increased the vertical jump height (p < 0.05), and HG and OG improved the power output of the lower extremities (p < 0.05). Conclusions: The aerobic dance on an ADP may be an effective alternative to lose weight, prevent oxidative stress and improve cardiorespiratory fitness in obese and overweight elderly people.
... Rare studies have been conducted in the subacute phase (89,90). Keogh et al. stated that dance significantly strengthens muscles in the elderly, improving aerobic power, endurance, strength, lower body flexibility, walking speed, and static and dynamic balance (91). Dance is an effective way for people after a stroke to improve physical, psychosocial, and cognitive functions, as well as to develop meaningful social relationships within society. ...
Conference Paper
Full-text available
ABSTRACT Stroke, which is the second leading cause of long-term disability and cognitive impairment, is a disease characterized by acute cerebral circulatory disorder caused by arterial stenosis, occlusion, or rupture resulting from various factors. According to the Global Burden of Disease Study Report, stroke is the leading cause of mortality and morbidity globally, with approximately 6.5 million deaths, 12.2 million new cases, and a total rate of 101 million cases in 2019, an indicator of 143 million disability-adjusted life years. Stroke is also a leading cause of long-term disability, which can lead to physical, psychological, and cognitive impairments that affect social participation and activity. 90% of strokes in each of the world's major populations are associated with modifiable risk factors. Recent advances in stroke treatment and care have increased the survival rate after stroke. Physical and cognitive problems in stroke patients include cognitive, sensory-motor, coordination, sleep, and vision disorders, aphasia, dysphagia, pain, depression, tone, impaired bladder, and bowel control. In addition, post-stroke patients develop physical muscle weakness, foot drop, burnout, pain, and spasticity. Again, although balance and gait are affected in most of the patients, it is observed that they are unaware of the movement and position of the extremities, hypoesthesia, hyperesthesia, dysesthesia, paresthesia, and feeling less warm. Dance is an artistic and emotional form of expression that emerges when a person moves his body rhythmically according to the music. Dance is performed with conscious movements that have value. By its very nature, dance is the basis of motor learning, including special training of cognitive-motor functions, sensory feedback, and social participation. Because dance is an enjoyable activity, it promotes interpersonal harmony and at the same time helps to improve both physical and cognitive disorders of stroke patients by providing multiple stimulations. If stroke patients are treated early, they are more likely to return to their daily lives without any sequelae. In this context, it is important to direct stroke patients to dance interventions to prevent neurological sequelae in the subacute and chronic periods and to improve physical and cognitive functions after stroke. Keywords:Cognitive function, dance intervention, physical function, stroke.
... Dance has recently been offered an attractive physical activity option for older women who tend to be less physically active than older men, yet enjoy the fitness gains, socialness, and movement aesthetics of dance (e.g., Cooper and Thomas, 2002). Provided these benefits attached to dance for aging women, it is not surprising that the majority of research focuses on the physiological and psychological benefits usually obtained in recreational social dance (e.g., Judge, 2003;McKinley et al., 2008;Zhang et al., 2008;Eyigor et al., 2009;Hui et al., 2009;Keogh et al., 2009;Sofianidis et al., 2009;Dewhurst et al., 2014;Marks, 2016;Merom et al., 2016). While these findings emphasize the importance of the "social" health benefits of dance, there is less socio-cultural research on ageism and its impact on mature women's experiences of their activity. ...
Article
Full-text available
Professional dancers typically retire before age 40. Although the physical requirements for dance performance are often considered the reason for retirement, there is an increasing number dance researchers who demonstrate that the idealization of youthfulness on the stage is also a result of complex cultural, social, and economic realities and as such, in need of critique. As a group of mature women dancers who continue to perform, we aim to critique the idealization of youthfulness as a form of ageism in professional dance. In this paper, we present findings from our feminist memory-work study in which we critically reflected the rehearsals and performance of a choreography titled “Initiation.” We detail three main themes—”It Will Only Get Worse;” “It Can Be Magic;” “Once a Dancer Always a Dancer”—that emerged from our study. We conclude that we gained critical awareness of the gendered and ageist construction of dance as a performing art. As a result, we now feel empowered to continue our work as mature dance artists.
... Research on older people's dancing has been dominated by a medical perspective with its focus on health and interventions (see, e.g., reviews by Keogh et al., 2009;Connolly and Redding, 2010;Guzmán-García et al., 2013). Studies show that dance enhances life quality (Brustio et al., 2018), life satisfaction (Cruz-Ferreira et al., 2015), and psychological wellbeing (Hui et al., 2009), thus indicating that emotions play an important role in dancing in old age. ...
Article
Full-text available
While there is a growing body of research on the social aspects of older people's dance, studies focusing on emotions are rare. In this study, we use an interactionist sociological perspective to examine the role of emotions in older social dancers' experiences in Sweden. Through qualitative interviews with 29 active or previously active dancers, we found that their experiences of emotional energy and experiences of flow override concerns of age and aging. Age, however, did become significant as the age differences at dance events could bring forth feelings of alienation associated with feeling old. In addition, cultural and gendered norms of appropriate age differences between dancing partners produced shame and pride as well as feelings of being either old or young. Moreover, certain bodily experiences were interpreted in terms of age. Overall, the study contributes to the discussions of the complexity of subjective experiences of age by highlighting its emotional aspects through social partner dancing.
Article
Full-text available
Recreational dance is practiced worldwide as a multidimensional physical activity with a potential for prevention of a sedentary lifestyle and overweight/obesity. This study explored in young (7–15 year; n = 21) girls the effect of long-term (>1 year) exposure to recreational (2 h/w) dancing on three-compartment body composition. Recreational dancers (RD) were compared with recreational (≤4 h/w) artistic gymnasts (RG, n = 22) and physically active young girls not involved in structured extracurricular physical activity (control; C, n = 22), adjusting for confounding variables (age, body mass, menarche). We hypothesized for RD an intermediate body composition between RG and C. The three groups had similar age and body mass index. Body composition indices in RD were intermediate between that of C and RG, but RD values were not statistically significantly different vs. C. This agreed with the not statistically significant higher energy expenditure (MET-min/w) in RD vs. C (1357.7 ± 805.32 and 1090.9 ± 596.63, p = 0.172). In conclusion, long-term recreational dance exposure at low volume had limited positive effect on body composition of young girls vs. unstructured extracurricular physical activity. Future work will explore the potential of recreational dance at higher volume (3–4 h/w) to improve body composition in young girls.
Article
Purpose This study examined the influence of traditional dance “Molong Kopi” for maintaining health status of older adult (OA) in long-term care of Indonesia. Design/methodology/approach A randomized control trial study conducted 21 of OA intervention group and 20 of OA control group. Molong Kopi dance intervention was carried out for eight weeks. Health status was measured on blood pressure, risk for fall, balance and quality of sleep of OA. Findings There was a significant differences between the intervention group and the control group on systole blood pressure, fall risk and sleep quality ( p < 0.05). The number of OA who were not at risk for fall after the intervention were increased from 14 to 38%. The quality of sleep of OA was also changed to good sleep quality from 43 to 90%. Originality/value Molong Kopi dance in OA can reduce systolic blood pressure, reduce the risk of falls and improve sleep quality better.
Article
Full-text available
【The purpose of this study was to determine the effect of Korean traditional dance movement training on balance, gait and leg strength in elderly women who are forced to remain at home. Fifteen elderly women of an experimental group between the ages 65 and 75 years who have normal vision and passed the hearing and Romberg test, participated in the 12 weeks' dance movement training. Fourteen subjects of a control group were selected. Korean traditional dance movement training was developed on the basis of Korean traditional dance and music by the authors. It took approximately 50 minutes to perform the dance movement program. The subjects of the experimental group practiced dance training for 3 times a week during 12 weeks. During the 50 minutes workout, the subjects practiced 15 minutes of a warm-up dance, 25 minutes of a conditioning dance, and 10 minutes of a cool-down dance. The intensity for the conditioning phase was between 60% and 65% of age-adjusted maximum heart rates. The balance, gait and leg strength were measured prior to and after the experimental treatment. Total balance scores of the experimental group were significantly higher than those of the control group. Scores of sternal nudge, one leg standing balance and reaching up among 13 items have significantly increased after the dance movement training. Total scores of gait of the experimental group were significantly higher than those of the control group following the korean traditional dance movement training. Scores of experimental group in step height, path deviation and turning while walking among 9 items have increased significantly following 12 weeks of dance movement training. The leg strength of experimental group was significantly higher than those of the control group following the Korean traditional dance movement training. The balance, gait and leg strength have significantly correlated in the experimental group following the Korean traditional dance movement training. The results suggest that Korean traditional dance movement training can improve balance, gait and leg strength in home bound elderly women.】
Article
Full-text available
Purpose – The first aim of this review article is to systematically summarise, synthesise, and critically evaluate the research base concerning the use of two art forms, namely, dance‐based exercises and Tai Chi, as applied to people with arthritis (a chronic condition that results in considerable disability and, particularly in later life, severely impacts the life quality of the individual with this condition). A second is to provide directives for health educators who work or are likely to work with this population in the future. Design/methodology/approach – The material specifically focuses on examining the efficacy of dance therapy and Tai Chi as intervention strategies for minimising arthritis disability and dependence and improving life quality. The paper includes a review of all relevant articles published in the English language on the topic. Findings – Collectively, these data reveal that dance‐based exercises and Tai Chi – practiced widely in China for many centuries as an art form, as well as a religious ritual, relaxation technique, exercise, and self‐defence method – may be very useful rehabilitation strategies for people with different forms of arthritis. Originality/value – While more research is indicated, health educators working with people who have chronic arthritis can safely recommend these two forms of exercise to most people with arthritis with the expectation that both will heighten the life quality of the individual with this condition.
Article
Physical activity interventions are most effective when they are tailored to individual preferences. This study examined preferences for exercising on one's own with some instruction vs. in a class in 1,820 middle- aged and 1,485 older adults. Overall, 69% of middle-aged and 67% of older adults preferred to exercise on their own with some instruction rather than in an exercise class. The study identified subgroups - 5 of middle-aged and 6 of older adults - whose preferences for exercising on their own with some instruction ranged from 33-85%. Less educated women younger than 56, healthy women 65-71, and older men reporting higher stress levels were most likely to prefer classes. All other men and most women preferred exercising on their own. The identification of these subgroups enables us to tailor exercise recommendations to the preferences of middle-aged and older adults, with increased rates of physical activity adoption and maintenance a likely result.
Article
Most community-based physical activity interventions for older adults prescribe class-based activities that may not appeal to everyone. This paper describes physical activity format preferences in a sample of 98 older adults (mean age = 76 ± 8 years) enrolled in an exercise promotion program encouraging participation in class-based activities offered by the community; the study explores how these preferences are related to activity adoption and maintenance. Thirty-four percent of respondents preferred to exercise individually, 28% preferred to exercise in a group, and 39% had no preference. Those who preferred exercising individually were less likely to adopt a new class than those who preferred to exercise in a group and those who had no preference (p < .01). Programs taking into account individual preferences may be more successful than those offering specific formats.
Article
This paper examines the physiological mechanisms responsible for differences in the amplitude of force fluctuations between young and old adults. Because muscle force is a consequence of motor unit activity, the potential mechanisms include both motor unit properties and the behavior of motor unit populations. The force fluctuations, however, depend not only on the age of the individual but also on the muscle group performing the task, the type and intensity of the muscle contraction, and the physical activity status of the individual. Computer simulations and experimental findings performed on tasks that involved single agonist and antagonist muscles suggest that differences in force fluctuations are not attributable to motor unit twitch force, motor unit number, or nonuniform activation of the agonist muscle, but that they are influenced by the variability and common modulation of motor unit discharge in both the agonist and antagonist muscles. Because the amplitude of the force fluctuations does not vary linearly with muscle activation, these results suggest that multiple mechanisms contribute to the differences in force fluctuations between young and old adults, although the boundary conditions for each mechanism remain to be determined.
Article
There is general agreement that to maintain quality of life for an aging individual, independence and self-direction need to be sustained. Relationships between levels of physical activity and changes in neuromuscular capacities among 30 women and 32 men (average age = 71 years) were examined, and four dimensions of functional neuromuscular capacities were evaluated: body agility, balance, upper-extremity function, and speed of movement planning/execution. Selected anthropometric and phystological characteristics were also measured. Physical activity habits were assessed by questionnaire and interview. Positive and potentially important relationships between physical activity levels and selected neuromuscular abilities were found. Activity habits were significantly related to general anthropometric and physiological characteristics. This study suggests that selected functional neuromuscular capacities are better maintained in healthy, physically active older adults, and the nature of capacities affected may be different for men and women.
Article
ACSM Position Stand on Exercise and Physical Activity for Older Adults. Med. Sci. Sports. Exerc., Vol. 30. No. 6, pp. 992-1008, 1998. By the year 2030, the number of individuals 65 yr and over will reach 70 million in the United States alone; persons 85 yr and older will be the fastest growing segment of the population. As more individuals live longer, it is imperative to determine the extent and mechanisms by which exercise and physical activity can improve health, functional capacity, quality of life, and independence in this population. Aging is a complex process involving many variables (e.g., genetics, lifestyle factors, chronic diseases) that interact with one another, greatly influencing the manner in which we age. Participation in regular physical activity (both aerobic and strength exercises) elicits a number of favorable responses that contribute to healthy aging. Much has been learned recently regarding the adaptability of various biological systems, as well as the ways that regular exercise can influence them. Participation in a regular exercise program is an effective intervention/modality to reduce/prevent a number of functional declines associated with aging. Further, the trainability of older individuals (including octo- and nonagenarians) is evidenced by their ability to adapt and respond to both endurance and strength training. Endurance training can help maintain and improve various aspects of cardiovascular function (as measured by maximal V˙O2, cardiac output, and arteriovenous O2 difference), as well as enhance submaximal performance. Importantly, reductions in risk factors associated with disease states (heart disease, diabetes, etc.) improve health status and contribute to an increase in life expectancy. Strength training helps offset the loss in muscle mass and strength typically associated with normal aging. Additional benefits from regular exercise include improved bone health and, thus, reduction in risk for osteoporosis; improved postural stability, thereby reducing the risk of falling and associated injuries and fractures; and increased flexibility and range of motion. While not as abundant, the evidence also suggests that involvement in regular exercise can also provide a number of psychological benefits related to preserved cognitive function, alleviation of depression symptoms and behavior, and an improved concept of personal control and self-efficacy. It is important to note that while participation in physical activity may not always elicit increases in the traditional markers of physiological performance and fitness (e.g., V˙O2max, mitochondrial oxidative capacity, body composition) in older adults, it does improve health (reduction in disease risk factors) and functional capacity. Thus, the benefits associated with regular exercise and physical activity contribute to a more healthy, independent lifestyle, greatly improving the functional capacity and quality of life in this population.
Article
Objective: To evaluate the effects of 24 form Tai Chi Quan (TCQ) on balance and related measures, and factors associated with participation in the program. Methods: Twenty-three older subjects (mean age 71.0 years, SD 5.6 years) commenced the three times weekly 1 h TCQ sessions. Subjects were measured on balance (Functional Reach, Step Test), gait (velocity, double support phase duration), activity level, leg muscle strength, and the Modified Falls Efficacy Scale (MFES) before and following the 3 month program. Participants also completed a survey investigating participation and perceived benefit of the program. Results: Nineteen participants completed the program, averaging attendance at 68% of classes. There was significant improvement in balance (Step Test, P < 0.01) and non-significant improvement in gait double support duration (P = 0.04), Functional Reach (P = 0.04) and activity level (P = 0.06). Most participants incorporated some home practice as well as the formal program, and reported both the physical (balance) components and remembering sequences of movements as the most challenging aspects of the program. Conclusions:Twenty-four form TCQ is a practical form of exercise for older people that improves dynamic balance performance.