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“Dancing” our way to fewer falls and better physical function?

The Bottom Line

  • Annually, more than 37 million falls result in medical treatment, and approximately 700,000 people die from falls.  
  • Dance-based mind-motor activity is a form of exercise that engages our sensory and cognitive functions. It involves structure, mind-motor movements, and social interaction, with ballroom dancing and Tai Chi as two examples.     
  • In healthy older adults, dance-based mind-motor activity may reduce the risk of falling and rate of falls, as well as enhance balance, mobility, and lower body strength. 
  • Consider incorporating a dance-based mind-motor activity into your exercise routine, but first, speak with your health care provider about what specific sub-types are beneficial and safe for you.

Throughout our lifetime, there are many instances that sweep us right off of our feet, quite literally. However, unlike in the movies, slipping on a banana peel or tripping on an untied shoelace is no laughing matter. Falls are a real problem that can lead to serious consequences such as injury and death. Annually, over 37 million falls worldwide end up needing medical intervention, while nearly 700,000 people die as a result of a fall. Age increases our risk of experiencing a fall, as well as injuring ourselves from a fall (1)—think osteoporosis, declining vision, reduced walking speed, etc. In fact, when it comes to falls that lead to death, the majority occur in older adults (1).


Maintaining foot health through podiatry care, regularly reviewing medications, balance-recovery training, and exercise alone or coupled with other strategies—such as environmental assessment and modification—have shown the potential to help reduce the risk of falls (2-6). Exercise, in particular, seems to be a hot topic when it comes to falls prevention.


A recent systematic review placed a type of exercise known as dance-based mind-motor activity and its impact on falls risk at centre-stage. Here, dance-based mind-motor activities involved the following components: mind-motor movements done in the upright position; choreography or instructions; structuring of the exercise using external or internal rhythms, such as music or breathing; a focus on dynamic balance (i.e., staying balanced while moving around or changing positions); and interaction with others (7). Tai Chi and non-Tai Chi activities like ballroom dancing and folk dancing are examples of this form of exercise, which engages both our sensory and cognitive functions (7-9).


To those of us who find it difficult to engage in more traditional forms of exercise or would like to diversify our exercise routine, dance-based mind-motor activities surely sound like an exciting addition to our fall prevention plan. But before we make our way to the "dance floor," let’s see what the evidence has to say.


What the research tells us

The review found dance-based mind-motor activities may hold benefits for fall prevention and physical function in healthy older adults, compared to other types of exercise, no exercise, or usual care.


First, dance-based mind-motor activities may reduce the risk of falling (a.k.a. the number of people who have a fall) by 37% and the rate of falls (a.k.a. the number of falls) by 31%. In terms of specific dance-based mind-motor activities, Tai Chi was found to be effective in improving these falls outcomes, while a small number of studies found that non-Tai Chi activities were not effective.


Second, dance-based mind-motor activities may moderately improve measures of physical function such as balance, mobility, and lower body strength, but not upper body strength. For balance and mobility outcomes, both Tai Chi and non-Tai Chi activities were effective, but the latter was especially beneficial. For lower body strength, only non-Tai Chi activities were effective.


Third, engaging in these activities 3 or more times a week for a period of 12 to 24 weeks may result in greater benefits. With that said, future research that focuses on non-Tai Chi activities and provides further evidence on the most ideal frequency and duration of dance-based mind-motor exercises is needed (7). In the meantime, speak with your health care provider about the benefits of adding these exercises to your routine. They may be able to help you choose the best activity for you, taking into consideration your individual health needs, physical capabilities, and safety. In the absence of in-person dance classes, Tai Chi programs, and other similar services, try accessing online classes or programming.


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References

  1. World Health Organization. Falls. [Internet] 2021. [cited April 2021]. Available from https://www.who.int/news-room/fact-sheets/detail/falls 
  2. Wylie G, Torrens C, Campbell P, et al. Podiatry interventions to prevent falls in older people: A systematic review and meta-analysis. Age Ageing. 2019; 48(3):327-336. doi: 10.1093/ageing/afy189. 
  3. van der Cammen TJ, Rajkumar C, Onder G, et al. Drug cessation in complex older adults: Time for action. Age Aging. 2014; 43:20-25.
  4. Mansfield A, Wong JS, Bryce J, et al. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials. Phys Ther. 2015; 95:700-709. doi: 10.2522/ptj.20140090.  
  5. Grossman DC, Curry SJ, Owens DK, et al. Interventions to prevent falls in community-dwelling older adults: US preventive services task force recommendation statement. JAMA. 2018; 319:1696-1704. doi: 10.1001/jama.2018.3097.  
  6. Tricco AC, Thomas SM, Veroniki AA, et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. JAMA. 2017; 318(17):1687-1699. doi: 10.1001/jama.2017.15006.
  7. Mattle M, Chocano-Bedoya PO, Fischbacher M, et al. Association of dance-based mind-motor activities with falls and physical function among healthy older adults: A systematic review and meta-analysis. JAMA Netw Open. 2020; 3:e2017688.
  8. Ballesteros S, Kraft E, Santana S, et al. Maintaining older brain functionality: A targeted review. Neurosci Biobehav Rev. 2015; 55:453-477. doi:10.1016/j.neubiorev.2015.06.008.
  9. Rehfeld K, Lüders  A, Hökelmann  A, et al. Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One. 2018; 13(7):e0196636. doi:10.1371/journal.pone.0196636.  

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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