Effectiveness of dance movement therapy and dance movement interventions on cancer patients' health-related outcomes: a systematic review and meta-analysis.

OBJECTIVES: This review examined the effectiveness of using dance movement therapy (DMT) and dance movement interventions (DMIs) with cancer and palliative care patients. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from inception to July 9, 2022, without limits on year or age. Searching was updated on July 10, 2023. The risk of bias was assessed by the Cochrane (RoB 2) and ROBINS-I tools. Meta-analyses were conducted to pool estimates of the effects of DMT and DMI on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: Among a total of 16 studies included in this review, nine were randomized controlled trials and seven were non-randomized trials, with a total of 893 participants. Only six of these studies were fully or partially described as true DMTs (some with less clarity than others), whereas the majority (n = 10) were DMIs with unclear therapeutic alignment. Most studies focused on female patients with breast cancer. Cancer patients undergoing palliative care received little attention. The overall risk of bias from the evaluated studies was high. Meta-analysis of two trials revealed that DMTs had no effect on QOL in cancer patients (SMD - 0.09, 95% CI - 0.21-0.40, P = 0.54), while narrative analysis and non-randomized trials showed no overall effect of DMTs on anxiety, depression, body image, self-esteem, or sleep disturbance but significant positive effects on perceived stress, pain severity, and pain interference. DMIs had significant positive effects on cancer patients' depression (SMD - 0.53, 95% CI - 0.93 to - 0.14, P = 0.008) and fatigue (SMD - 0.42, 95% CI - 0.70 to - 0.14, P = 0.003). DMI trials synthesized narratively showed an effect on patients' body image, self-esteem, physical function, right and left handgrip strength, life satisfaction, and the mental component of QOL. CONCLUSION: Both DMT and DMIs had promising effects on several health outcomes, but results were inconsistent, and the evidence was weak. The reviewed studies' low evidence quality and small sample sizes affected the findings' robustness and reliability. Large-scale, high-quality randomized controlled trials with sufficient sample sizes, and clear and veracious DMT and DMI protocols and data are required to provide more credible research evidence and influence practice.

Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis.

INTRODUCTION: Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence. METHODS: Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE. RESULTS: Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls. CONCLUSIONS: There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found. PROSPERO REGISTRATION: CRD42022382908.

Flipping and other astonishing transporter dance moves in fungal drug resistance.

In all domains of life, transmembrane proteins from the ATP-binding cassette (ABC) transporter family drive the translocation of diverse substances across lipid bilayers. In pathogenic fungi, the ABC transporters of the pleiotropic drug resistance (PDR) subfamily confer antibiotic resistance and so are of interest as therapeutic targets. They also drive the quest for understanding how ABC transporters can generally accommodate such a wide range of substrates. The Pdr5 transporter from baker's yeast is representative of the PDR group and, ever since its discovery more than 30 years ago, has been the subject of extensive functional analyses. A new perspective of these studies has been recently provided in the framework of the first electron cryo-microscopy structures of Pdr5, as well as emergent applications of machine learning in the field. Taken together, the old and the new developments have been used to propose a mechanism for the transport process in PDR proteins. This mechanism involves a "flippase" step that moves the substrates from one leaflet of the bilayer to the other, as a central element of cellular efflux.

Jumping demands during classical ballet class.

Ballet class represents a considerable portion of professional ballet training, yet the external training load demands associated with class-and particularly the jumping demands-have not been investigated. The purpose of this study was to measure the jumping demands of ballet class by sex and rank. Eleven female and eight male elite professional ballet dancers participated in 109 ballet classes taught by 12 different teachers. Jump counts and jump heights were measured during each class. A Poisson generalized linear mixed effects model was used to examine the differences in jump counts between sexes and ranks. Greater jump counts were observed during class in men than in women (153, 95% confidence intervals [CI] [137, 170] vs. 119, 95% CI [109, 131], p = 0.004) and in junior ranking dancers compared with senior ranking dancers (151, 95% CI [138, 165] vs. 121, 95% CI [108, 135], p = 0.006). Female junior and senior ranking dancers jumped at rates of 9.2 ± 2.6 and 8.6 ± 4.7 jumps·min-1 , respectively, while male junior and senior ranking dancers jumped at rates of 9.1 ± 2.6 and 8.7 ± 2.6 jumps·min-1 , respectively. Across all classes, 73% of jumps observed were below 50% of maximum double-legged countermovement jump height. Unlike rehearsals and performances, class offers dancers an opportunity to self-regulate load, and as such, are a useful session to manage jump load, and facilitate gradual return-to-dance pathways. Communication between health care and artistic staff is essential to facilitate load management during class.

Moving together - benefits of an online dance program on physical and mental health for older women: an exploratory mixed-method study.

BACKGROUND: Previous studies show that in-person dance training is a beneficial form of physical activity that involves mental, social, and physical dimensions. This exploratory study investigated the benefits of a 12-week online dance training intervention on mental and physical health outcomes for older women. METHODS: A convergent parallel mixed-method design was used. Forty-five older adults (74.0 ± 5.3 yrs old, 44 women) were recruited through advertisements at activity and rehabilitation centers in the North Denmark region. The intervention consisted of two weekly 60-min classes of improvisation and salsa delivered online through video call applications. Changes in physical health outcomes (body mass and composition, resting blood pressure, Senior Fitness Test battery) and self-rated health and wellbeing (health-related quality of life (HRQOL), feelings of loneliness) were assessed prior to and after 12 weeks of dancing. Focus group interviews were conducted post-intervention to further explore the benefits as well as the participant's experience of the intervention. Thematic analysis of the qualitative data was conducted. RESULTS: Thirty-two participants (all women) completed the study. Significant improvements in fitness were found for the number of arm curls performed (baseline: 12.3 ± 3.0; post-intervention: 13.7 ± 3.0, P = 0.005), 2-min step test performance (baseline: 66.5 ± 20.0 reps.; post-intervention: 73.8 ± 22.6 reps., P = 0.016), and chair sit-and-reach (baseline: 0.4 ± 11.3 cm; post-intervention: 5.5 ± 10.1 cm, P < 0.001). There was a significant increase in body mass from baseline to post-intervention (P < 0.015). The themes from the focus groups included (1) Participation, (2) Challenges, (3) Progression, (4) Motivation, (5) Perceived health and wellbeing, and (6) Online dance instruction. No significant changes were reported in HRQOL and loneliness from the quantitative data, although the qualitative data did reveal improved feelings of physical health and wellbeing. CONCLUSIONS: The intervention improved several aspects of fitness in older women and improved the participants' perceptions of their own physical abilities and wellbeing. While most participants found the online intervention enjoyable, several participants missed the feedback from the instructors that naturally occurs with in-person instruction.

Effects of square dance exercise on cognitive function in elderly individuals with mild cognitive impairment: the mediating role of balance ability and executive function.

BACKGROUND: Square dancing is a kind of aerobic fitness exercise without environmental restrictions that yields many benefits for physical and mental health; this exercise is popular among middle-aged and elderly people in China and in these populations in other countries. This study aimed to evaluate the effects of square dance exercise on the overall cognitive function of elderly individuals with mild cognitive impairment (MCI) and to research its mechanisms. METHODS: A total of 60 elderly people with MCI (60-69 years old) without square dance experience were selected and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group participated in square dance exercise for 12 weeks, while the control group maintained their original lifestyle habits. One week before and after the intervention period, the overall cognitive function, physical fitness, and executive function of both groups were measured. RESULTS: According to the results, square dance exercise directly improved the overall cognitive function of elderly individuals with MCI and indirectly affected overall cognitive function through the mediating effects of balance ability and executive function. CONCLUSIONS: Square dance exercise represents a nonpharmacological intervention for the prevention and treatment of MCI. Importantly, it is best to combine this exercise with other forms of physical exercise and comprehensive treatment programs such as cognitive training, social interaction, and psychological intervention to realize its maximum effect.

Polydrug Use Typologies of Regular Ecstasy Users Visiting Electronic Dance Music Events: A Latent Class Analysis.

INTRODUCTION: Polydrug use patterns among young adults using ecstasy vary, as well as their willingness to change them. Polydrug use patterns are likely associated with different adverse health outcomes. It is unknown whether polydrug use patterns of young adults who use ecstasy are similar in different countries. This study aims to identify and compare polydrug use patterns and willingness to change them of young adults that use ecstasy in the United Kingdom (UK) and the Netherlands (NL), two countries with a high prevalence of ecstasy use and a large electronic dance music (EDM) scene. METHODS: The data from the online cross-sectional Electronic Music Scene Survey were used in a latent class analysis. The binary indicators used in the estimation were past-year substance use of 21 different substances. The sample consisted of young adult ecstasy users that regularly visit EDM events (age 18-34). RESULTS: A total of 1,077 respondents from the UK (age M = 23.1) and 1,178 from the NL (age M = 23.7) that regularly visit EDM events were included in the analyses. In both countries, three polydrug use patterns of ecstasy users were identified based on Bayesian Information Criterion fit indices: a traditional polydrug use class (UK: 28%; NL: 40%), a stimulant and ketamine polydrug use class (UK: 48%; NL: 52%), and an extensive polydrug use class (UK: 24%; NL: 8%) characterized by substantial use of stimulants, depressant, and psychedelic substances. Overall, young adults that used ecstasy in the UK consumed 3,4-methylenedioxymeth-amphetamine (MDMA) more often as powder/crystalline and at higher dosages compared to young adults in the NL who preferred MDMA tablets. Regardless of polydrug class or country, most respondents indicated that they had the intention to reduce but not quit their use. CONCLUSION: In both countries, structurally similar polydrug use patterns among young adults that use ecstasy were found, while the use frequencies of individual substances and preferred MDMA form varied between the countries.

Balletic bodies under lockdown: The consequences of a pandemic for highly disciplined habitus.

Like other elite athletes, ballet dancers are highly dedicated to the pursuit of their vocation. They work to perfect their bodies, their movements and their expression of the art form. The lockdowns that occurred during the COVID-19 pandemic represented a significant interruption to the extraordinary but everyday lives of ballet dancers, creating unique environments where exploration of the embodied habitus of ballet can be further investigated. The impacts of lockdown upon dancers were explored via a series of interviews with 12 professional dancers from Germany. Framed by previous research, theorising the balletic body from a Bourdieusian perspective, interview data were analysed using Interpretative Phenomenological Analysis. Our research highlights the way in which COVID-19 lockdowns and associated restrictions disrupt the habitus of dancers and results in a form of suffering that is comparable to injury or chronic illness. Our research suggests that individuals respond to the 'structural injuries' of lockdown measures in a manner comparable to the way they respond to physiological injury. Thus, dancers sought to repair or re-establish the social structures they ordinarily inhabit whilst the inevitable limitations of such efforts engendered occasions for reflexive thinking about their role, careers and identity as dancers.

Differences in Achilles tendon mechanical properties between professional ballet dancers and collegiate athletes utilizing shear wave elastography.

PURPOSE: To report normative stiffness parameters obtained using shear wave elastography in dorsiflexion from the Achilles tendons in asymptomatic professional ballet dancers and compare them with college-level athletes. METHODS: An Institutional Review Board (IRB)-approved study consists of 28 professional ballet dancers and 64 asymptomatic collegiate athletes. The athletes were further subdivided into runner and non-runner disciplines. Shear wave elastography (SWE) measurements were made in maximum ankle dorsiflexion position. RESULTS AND DISCUSSION: Forty-eight (52%) males and 44 (48%) females were examined with an overall mean age of 22.2 (± 3.8 years). There were no significant SWE differences between dominant and non-dominant legs in both groups and comparing spin vs. non-spin leg of ballet dancers (p > 0.05). Ballet dancers had significantly higher short-axis velocity values than runners and non-runners (2.34 m/s increase and 2.79 m/s increase, respectively, p < 0.001). Long-axis velocity was significantly higher in ballet dancers compared to non-runners (by 0.80 m/s, p < 0.001), but was not different between ballet dancers and runners (p > 0.05). Short-axis modulus was significantly higher in dancers compared to runners and non-runners (by 135.2 kPa and 159.2 kPa, respectively, p < 0.001). Long-axis modulus (LAM) was not significantly different in ballet dancers when compared to runners. CONCLUSION: Asymptomatic professional ballet dancers exhibit greater short-axis tendon stiffness compared to athletes and greater long-axis tendon stiffness compared to non-runners but similar to runners. The functional benefit from elevated short-axis stiffness in dancers is not clear but may be related to greater axial loading and adaptations of the tendon matrix.

Efficacy of Digital Dance on Brain Imagery, Cognition, and Health: Randomized Controlled Trial.

BACKGROUND: Multidomain interventions have demonstrable benefits for promoting healthy aging, but self-empowerment strategies to sustain long-term gains remain elusive. OBJECTIVE: This study evaluated the effects of digital somatosensory dance game participation on brain imagery changes as primary outcomes and other physical and mental health measures as secondary outcomes related to healthy aging. METHODS: Between August 31, 2020, and June 27, 2021, this randomized controlled trial recruited 60 eligible participants older than 55 years with no recent engagement in digital dance games. A computer-generated randomization sequence was used to allocate participants 1:1, without stratification, to an intervention group (n=30) who underwent digital somatosensory dance game training or a control group (n=30). An anonymized code masked the intervention allocations from the investigators, and individuals who assigned the interventions were not involved in analyzing the study data. The intervention entailed two 30-minute dance game sessions per week for 6 months, and the control group received healthy aging education. Primary outcomes were brain imagery changes. All variables were measured at baseline and the 6-month follow-up, and intervention effects were estimated using t tests with intention-to-treat analyses. RESULTS: Compared with the control group, intervention participants had significantly different brain imagery in the gray matter volume (GMV) of the left putamen (estimate 0.016, 95% CI 0.008 to 0.024; P<.001), GMV of the left pallidum (estimate 0.02, 95% CI 0.006 to 0.034; P=.004), and fractional amplitude of low frequency fluctuations of the left pallidum (estimate 0.262, 95% CI 0.084 to 0.439; P=.004). Additionally, the intervention group had different imagery in the cerebellum VI GMV (estimate 0.011, 95% CI 0.003 to 0.02; P=.01). The intervention group also had improved total Montreal Cognitive Assessment scores (estimate 1.2, 95% CI 0.27 to -2.13; P<.01), quality of life (estimate 7.08, 95% CI 2.35 to 11.82; P=.004), and time spent sitting on weekdays (estimate -1.96, 95% CI -3.33 to -0.60; P=.005). Furthermore, dance performance was significantly associated with cognitive performance (P=.003), health status (P=.14), resilience (P=.007), and demoralization (P<.001). CONCLUSIONS: Digital somatosensory dance game participation for 6 months was associated with brain imagery changes in multiple regions involving somatosensory, motor, visual, and attention functions, which were consistent with phenotypic improvements associated with healthy aging. TRIAL REGISTRATION: ClinicalTrials.gov NCT05411042; https://clinicaltrials.gov/study/NCT05411042.

Analysis of the centre of pressure in bipedal stance among individuals with and without intellectual disabilities, individuals with Down syndrome and dancers with Down syndrome.

BACKGROUND: Individuals with intellectual disabilities (IDs) often present deficiencies in motor, balance and postural control. On the other hand, the practice of physical activity and dance usually reduces these deficiencies. Therefore, in this study, we aimed to compare the control of the centre of pressure (COP) in people with Down syndrome (DS) or other causes of ID in relation to people without disabilities and to observe the influence of vision and the practice of dance. METHODS: This cross-sectional study analyses the COP in a static standing position with open and closed eyes in four study groups. A total of 273 people were recruited (80 adults without ID, 46 adults with DS, 120 adults with other causes of ID and 27 dancers with DS). RESULTS: A greater area of oscillation and path of the COP was observed in the participants with ID compared with the participants without ID, especially in the sway area of the COP. The oscillation speed of the COP was also higher. When analysing the displacement of the COP, anteroposterior and mediolateral components, there were also differences, except when comparing the group of dancers with DS with respect to the group without ID. The visual condition only influenced the group of participants without disabilities. CONCLUSIONS: The results of our study show that there is a less efficient static postural control in people with ID, as greater displacements were observed in the COP of the participants with ID. The differences in some specific variables that analyse the displacement of the COP were smaller when comparing the group of dancers with DS and the individuals without ID.

Single-Leg Heel Raise Capacity is Lower, and Perceived Ankle Instability is Greater, in Dancers and Athletes With Posterior Ankle Impingement Syndrome.

OBJECTIVE: To compare clinical assessment findings between elite athletic populations with and without a clinical diagnosis of posterior ankle impingement syndrome (PAIS). DESIGN: Cross-sectional case-control study. SETTING: Elite ballet and sport. PARTICIPANTS: Ten male and female professional ballet dancers and athletes with a clinical diagnosis of PAIS and were matched for age, sex, and activity to 10 professional ballet dancers and athletes without PAIS. INDEPENDENT VARIABLES: Posterior ankle pain on body chart and a positive ankle plantarflexion pain provocation test. MAIN OUTCOME MEASURES: Single-leg heel raise (SLHR) endurance test, range of motion testing for weight-bearing ankle dorsiflexion, passive ankle plantarflexion, and first metatarsophalangeal joint dorsiflexion, and Beighton score for generalized joint hypermobility. Participants also completed the Cumberland Ankle Instability Tool (CAIT) questionnaire. RESULTS: The group with PAIS achieved significantly fewer repetitions on SLHR capacity testing ( P = 0.02) and were more symptomatic for perceived ankle instability according to CAIT scores ( P = 0.004). CONCLUSIONS: Single-leg heel raise endurance capacity was lower, and perceived ankle instability was greater in participants with PAIS. The management of this presentation in elite dancers and athletes should include the assessment and management of functional deficits.

Movement through motherhood: Exploring mood, wellbeing, and prenatal emotional availability (EA) through EA-based dance intervention.

Emotional availability (EA) is a construct that describes the observed emotional connection in parent-child relationships. During pregnancy, EA is assessed only using caregiver sensitivity and nonhostility. We used the nonverbal aspects of these qualities to create a new dance/movement intervention ("EA-Based Dance Intervention"). Given the scarcity of pregnancy interventions, we provided training to participants on how to be emotionally engaged with their unborn babies through dance/movement. The EA-Based Dance Intervention alone comprised the first intervention arm (n = 12). A second intervention arm involved the combination of EA-Based Dance Intervention with brief psychoeducation (n = 10). The third arm was a control group, which received only the assessments (n = 7). Measures of self-reported symptoms of depression and anxiety, emotional expressivity, flourishing, and the (newly developed) self-reported prenatal EA were used at pre- and posttest. The measure of observed prenatal EA was used to compare intervention versus control at posttest only. In this pilot study, we found that participants receiving the EA-Based Dance Intervention alone or combined with psychoeducation, self-reported improved anxiety symptoms and self-reported higher prenatal EA. When compared with the control group, those experiencing EA-Based Dance Intervention reported fewer depressive symptoms from pre- to posttest.

La disponibilidad emocional (EA) es una construcción que describe la observada conexión emocional en las relaciones entre progenitor y niño. Durante el embarazo, EA se evalúa solamente usando la sensibilidad y el nivel de no hostilidad de quien presta el cuidado. Usamos los aspectos no verbales de estas cualidades para crear una nueva intervención de baile/movimiento ("Intervención de Baile con Base en la Disponibilidad Emocional"). Dada la escasez de intervenciones de embarazo, les ofrecimos entrenamiento a las participantes en cuanto a cómo interactuar emocionalmente con sus bebés no nacidos por medio del baile/movimiento. La Intervención de Baile con Base en la Disponibilidad Emocional abarca por sí sola el primer grupo o brazo de la intervención (n = 12). Un segundo grupo o brazo de intervención incluyó la combinación de la Intervención de Baile con Base en la Disponibilidad Emocional con psicoeducación breve (n = 10). El tercer grupo o brazo de intervención fue un grupo de control, el cual sólo recibió las evaluaciones (n = 7). Anterior y posteriormente a la prueba, se usaron medidas de auto reportados síntomas de depresión y ansiedad, de expresividad emocional, de mejorar y salir adelante, y la (recién desarrollada) EA prenatal auto reportada. La medida de EA prenatal observada se usó para comparar los grupos de intervención vs. de control sólo con posterioridad a la prueba. En este estudio piloto, encontramos que las participantes que recibían la Intervención de Baile con Base en la Disponibilidad Emocional solamente o combinada con psicoeducación, auto reportaron mejoras en los síntomas de ansiedad y auto reportaron una EA prenatal más alta. Cuando se les comparó con el grupo de control, quienes experimentaban la Intervención de Baile con Base en la Disponibilidad Emocional reportaron menos síntomas depresivos desde antes hasta después de la prueba.

Lower-Extremity Energetic Distribution During Rate-Controlled Ballet Jumps (Sautés) in Healthy Dancers.

Dancers frequently perform jumps in the context of a prolonged, continuous dance piece. The purpose of this study is to explore the lower-extremity energetics in healthy dancers performing repetitive dance jumps (sautés) before and after typical dance-specific choreography. Lower-extremity kinetic data were collected from 14 healthy female dancers during a series of sautés performed before and after 3 minutes of dance. Percent contributions of the lower-extremity joints to the whole-limb mechanical energy expenditure during ground contact were calculated. The jumps performed at the beginning were compared with the jumps at the end of the dance choreography. Dancers maintained the jump rate and consistent whole-limb mechanical energy expenditure between the jump series. As expected, for both jump series, the sautés had greater relative energetic contribution from the ankle and knee as compared with lesser contribution from the hip and toe. However, we observed lesser contribution from the knee and greater contribution from the hip after a 3-minute dance. After performing typical dance choreography, the dancers demonstrated a distal to proximal redistribution of individual joints' contribution to whole-limb mechanical energy expenditure.

Impact of Attentional Focus on Dance Performance: A Critically Appraised Topic.

CLINICAL SCENARIO: Dancing is a demanding esthetic activity with dancers having an 85% annual injury incident rate when performing complex dance motor skills. Teachers and clinicians use a combination of external and internal attentional cues when teaching dancers motor skills and when working on rehabilitation programs with injured dancers, respectively. External attentional focus (ie, focusing on movement outcome) reportedly results in superior performance than internal attentional focus (ie, focus on body movements). Interestingly, dancers reportedly often adopt an internal focus when dancing. Still, limited literature exists examining the effects of attentional focus on dancers' performance. CLINICAL QUESTION: How does attentional focus (external or internal) impact performance in dancers? SUMMARY OF KEY FINDINGS: Four original quasi-experimental studies met inclusion criteria. In the current examination, we found mixed results about the impact of attentional focus in dancers. Specifically, using an external attentional focus resulted in better performance in 2 studies, but these findings were limited to lesser experienced dancers. Experienced dancers did not have any physical performance differences when using external or internal focus. Internal focus also did not negatively affect dancers' performance in 2 studies. Some authors noted positive motivational effects (eg, increased perceived competence) when dancers used external focus. CLINICAL BOTTOM LINE: Low-quality evidence exists supporting the notion that in less experienced dance students, external focus improves performance. In experienced dancers, the type of attentional focus did not impact performance. External focus provides positive mental effects. Thus, clinicians working with dancers can integrate individualized feedback according to dancer level, with a preference toward external focus due to positive mental effects, to design optimal training and rehabilitation programs. STRENGTH OF RECOMMENDATION: Grade B evidence exists supporting the notion that an external attentional focus improves performance in less experienced dance students and also has positive mental effects. Internal attentional focus does not impede experienced dancers' performance.

The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial.

This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.

Incidence, Prevalence, and Characteristics of Injuries in Pole Dancers: A Systematic Review.

OBJECTIVES: Pole dancing is an extreme form of performance physical activity, combining considerable feats of muscular strength, flexibility, dancing and acrobatics on a vertical metal apparatus. Despite rapid growth in the artform, many pole dancers continue to participate without fulfilling physical requirements to withstand the forces and physicality required. The aim of this systematic review was to determine the incidence, prevalence and characteristics of injuries sustained by pole dancing participants reported in published studies. METHODS: Five databases were comprehensively searched in February 2023. Authors independently screened titles and abstracts, with full copies of eligible studies reviewed using specific inclusion/exclusion criteria. Studies were included if they referenced pole dancing, were in English language and Level I-III-3 in accordance with the Australian National Health and Medical Research Council, with case reports considered if included 10 or more participants. The National Institute of Health quality assessment tool for observational cohort and cross-sectional studies was used to review the quality of reporting of selected studies. RESULTS: Eleven articles were retrieved based on searches, with five studies meeting full inclusion/exclusion criteria, published between 2020-2022. In total 787 study participants were identified, with 623 sustaining a total of 1,803 pole dancing injuries. Data from all studies in injury profiles reported 42.4% of injuries sustained to the upper limb, 44.8% lower limb, 10.5% trunk, 0.02% associated with the head and neck, and several injuries affecting multiple regions. Acute injuries comprised 51.6% of reported injuries compared to 48.4% chronic. Injury characteristics were varied due to inconsistencies in reporting across studies. CONCLUSIONS: This systematic review highlights a paucity of knowledge regarding injuries in pole dancing, perhaps expected with a relatively young sport. Improvement in reporting is required to aid in identification of injuries and opportunities for development of injury risk reduction strategies. PROSPERO Registration no. CRD42023401012.

One-Year Injury History and Safe Dance Practices Among Female Highland Dancers in Canada.

AIMS: Over 8,650 Highland dancers registered to compete in Royal Scottish Official Board of Highland Dancing events worldwide in 2019. While the burden of dance-related injuries is high among dancers, there are few studies examining Highland dance. The purpose of this study was to describe the prevalence of self-reported 1-year injury history and safe dance practices among female Highland dancers. METHODS: Sixty-five female Canadian Highland dancers (median age 18; range 14-47) completed an anonymous online survey at the beginning of the 2019 championship season. Demographics (i.e., age, body mass index), exposure (e.g., months/year dancing), safe dance practices (e.g., environmental, physical, psychological), and 1-year injury history (i.e., yes/no) were self-reported. Three definitions of dance-related injury were used: 1) time-loss (missed ≥1 class, practice, performance, and/or competition); 2) medical attention (requiring professional medical care); and 3) any physical complaint that affected full participation. RESULTS: Most participants were training at the elite standard/premier level (86%, 95%CI 75-93) and for ≥8 months/year (83%, 95%CI 75-93). The proportion of dancers reporting at least one physical complaint in the previous 1 year was 71% (95%CI 58-81). Sixty percent (95%CI 47-71) of dancers reported ≥1 medical attention and/or time-loss injury. All participants reported warming up regularly, with 59% (95%CI 46-70) participating in regular cool-downs. CONCLUSION: The prevalence of 1-year injury history among female Highland dancers is high. Education on the benefits of safe dance practice for Highland dancers may be useful. Prospective cohort studies are needed to understand the dynamic nature of dance injuries across a full competitive season.

Laterality in Body Coordination of Professional and Amateur Ballet Dancers While Performing a Single Pirouette with Pointe Shoes.

OBJECTIVE: Imbalances in muscle strength coordination owing to lateral preference may be a risk factor for injury in dancers. Postural control is essential for the basic turn in ballet (pirouette), owing to its lateral asymmetry. Since dance with pointe shoes demands greater range of motion, muscle strength, and balance control compared to dancing with flat shoes, pointe shoes may further add to the risk and cause an imbalance between the preferred and non-preferred legs during pirouette. In this study, we examined lateral differences in professional and experienced amateur ballet dancers during single pirouettes with pointe shoes to understand the multiple elements involved in lateral balance control in pirouettes. METHODS: Eight female professionals and seven female amateur ballet dancers performed single pirouettes in pointe shoes on both the preferred and non-preferred sides. To understand the body coordination laterality in single pirouettes, statistical parametric mapping was performed for the trunk, hip, knee, ankle angle, and center of mass-center of pressure inclination angle timeframe data during the pirouette in three phases: turn with double-leg (Phase 1), single-leg (Phase 2), and finish turning with a single-leg (Phase 3). In addition, the hop-up time was calculated as the percentage when the foot is not in contact with the ground in Phases 2 and 3. RESULTS: There were no lateral differences in trunk and lower limb angles in either group. Professional dancers showed slightly more inclination towards the stance leg during left rotation at the beginning of the movement (Phase 1) with longer hop-up time in Phase 2, whereas amateur dancers tended to tilt forward during the left turn (Phases 1 and 2) with longer hop-up time in Phase 3. CONCLUSION: It is notable that the COP-COM inclination angle was adjusted by hop-up and it caused the lateral differences in both professional and amateur dancers during a single pirouette with pointe shoes. This study highlights elements to consider in laterality when monitoring pirouette performance with pointe shoes.