Using theory knitting to conceptualize social phenomena in the design and evaluation of dance programs for people living with Parkinson's disease.

Dance programs for people living with Parkinson's disease (PwPD) offer participants an opportunity to exercise, engage in artistic self-expression, and form new relationships. While it is understood that the social dimension of dance programs for PwPD contributes to dancer satisfaction and program sustainability, the social mechanisms instrumental to program success are under-examined. Engaging with theory from wider disciplines, or "theory knitting" can help program designers and evaluators examine the mechanisms and contextual factors that make classes socially meaningful with greater detail and specificity. This study identified and examined three theoretical frameworks that program planners and evaluators could use to conceptualize social engagement in dance for PwPD contexts and inform practice. Each theory was assessed for fit using the T-CaST theory comparison and selection tool developed by Birken et al. (2018). As an example, we used anthropologist Victor Turner's (1970; 1977) theory of liminality and communitas to identify five key areas for fostering a sense of social connection in dance for PwPD contexts: (1) selecting a meaningful dance space (2) creating a joyous atmosphere (3) marking entrance into the liminal time and space with rituals (4) embodying liminality and anti-structure and (5) inverting power relations and embracing fluid roles.

Experiences of people living with Parkinson's disease and key stakeholders in dance-based programs: a systematic review and meta-ethnography.

PURPOSE: To identify and synthesize qualitative literature on the experiences of participants and key stakeholders in dance programs for people living with Parkinson's disease. Synthesizing the available literature can generate new insights into participant experience to inform current and future programs. MATERIALS AND METHODS: Qualitative and mixed methods studies were identified via a systematic search of six databases: CINAHL, Web of Science, Scopus, SPORTDiscus, PsycInfo, and MEDLINE. Articles were synthesized using the meta-ethnographic method developed by Noblit and Hare (1988). Key concepts across studies were related via reciprocal translation, ultimately forming a line-of-argument synthesis. RESULTS: 26 articles met the inclusion criteria. Four interrelated, overarching themes were developed: (1) dance communities provide peer support and insight into living with Parkinson's, (2) feeling safe, accepted, and included in the dance experience, (3) overcoming dance-based challenges contributes to sense of achievement, confidence, and connectedness, and (4) dance participation is an opportunity to re-imagine oneself. CONCLUSION: Participant experience is shaped by the instructor-participant relationship, the social environment of classes, and class difficulty level. In order to support participant experience, classes should be safe, supportive, and have an appropriate challenge-skill balance. These qualities facilitate creative immersion and the potential for personal and collective change.

Physical activity can improve functional ability and quality of life in people living with Parkinson's disease (PD).Dance is a safe, enjoyable form of physical activity for people with PD that creates opportunities for meaningful social engagement and artistic expression.The quality of the instructor-dancer relationship, the wider social environment, and the challenge-skill balance contribute to dancer experience.For a dance class for people with PD to be successful, it must be safe, socially accepting, and provide opportunities for dancers to experience positive growth and a sense of achievement.

Insights from an early-stage development mixed methods study on arts-based interventions for older adults following hospitalisation.

BACKGROUND: A period of hospitalisation can have negative consequences on physical function and autonomy for older adults, including functional decline, dependency and reduced quality of life. Older adults favour activity that focuses on social connectedness, fun and achievable skills. OBJECTIVE: The primary aim of this early-stage development mixed methods study was to determine the feasibility and acceptability of a randomised crossover trial design and two arts-based interventions tailored for older adults recently discharged from hospital. MATERIALS AND METHODS: Community-dwelling adults, aged 65 years and older, who reported reduced mobility and less than six weeks post discharge from hospital were invited to participate in the study. Two sites were randomised to either a four-week dance or music therapy intervention, followed by a four-week washout and subsequently to the alternate intervention. Participants and stakeholders were interviewed to share their views and perspectives of the study design and interventions developed. RESULTS: The arts-based interventions were acceptable and safe for participants. Randomisation was completed per protocol and no implementation issues were identified. The outcome measures used were acceptable and feasible for this group of patients and did not lead to fatigue or excessive assessment time. Participants were positive about their experience of the programme. CONCLUSIONS: This early development study provides a precursor and several imperative learning points to guide and inform future research in the area. Difficulties in recruitment and attrition were in part due to the barriers encountered when recruiting an incident cohort of vulnerable individuals post hospitalisation.

Impact of physical activity on monocyte subset CCR2 expression and macrophage polarization following moderate intensity exercise.

Coronary artery disease (CAD) is an immune-mediated disease in which CCR2 attracts classical, intermediate, and non-classical monocytes to the arterial intima where they differentiate to macrophages. Balance between pro-inflammatory M1 and anti-inflammatory M2 macrophages contributes to CAD prevention. Moderate to vigorous intensity physical activity (MVPA) elicits an immune response and reduces the incidence of CAD, however, the impact of prior MVPA on monocyte subset CCR2 expression and macrophage polarization following acute exercise is unknown. Purpose: To determine the impact of physical activity status on monocyte subset CCR2 surface expression and macrophage polarization in response to an acute bout of moderate intensity cycle ergometry. Methods: 24 healthy women and men (12 high physically active [HIACT]: ≥1500 METmin/wk MVPA & 12 low physically active [LOACT]: <600 METmin/wk MVPA) underwent an acute moderate intensity (60% VO2peak) bout of cycle ergometry for 30 â€‹min. Blood samples were collected prior to (PRE), immediately (POST), 1 â€‹h (1H), and 2 â€‹h (2H) following exercise. Monocyte CCR2 and macrophage CD86 (M1) and CD206 (M2) were analyzed by flow cytometry. Results: Intermediate monocyte CCR2 decreased in response to exercise in the HIACT group (PRE: 11409.0 â€‹± â€‹1084.0 vs. POST: 9524.3 â€‹± â€‹1062.4; p â€‹= â€‹0.034). Macrophage CD206 was lower in the LOACT compared to the HIACT group at 1H (HIACT: 67.2 â€‹± â€‹5.6 vs. LOACT: 50.1 â€‹± â€‹5.2%; p â€‹= â€‹0.040). Macrophage CD206 at 1H was associated with both PRE (r â€‹= â€‹0.446, p â€‹= â€‹0.043) and POST (r â€‹= â€‹0.464, p â€‹= â€‹0.034) non-classical monocyte CCR2. Conclusion: These data suggest that regular moderate to vigorous physical activity positively impacts both monocytes and macrophages following acute moderate intensity exercise and that this impact may contribute to the prevention of coronary artery disease.