Funny Senior Citizen Discount Sign Elderly People Dancing
Altern Ther Health Med. Author manuscript; bachelor in PMC 2017 Jun 29.
Published in final edited form every bit:
Altern Ther Wellness Med. 2015 Sep-October; 21(5): 64–70.
PMCID: PMC5491389
NIHMSID: NIHMS869827
The Effectiveness of Trip the light fantastic toe Interventions to Improve Older Adults' Health: A Systematic Literature Review
Phoebe Woei-Ni Hwang
DrPH candidate, University of Hawai'i at Manoa in Honolulu
Kathryn Fifty. Braun
professor and chair of the Function of Public Health Studies, University of Hawai'i at Manoa in Honolulu
Abstract
Background
Concrete inactivity is commonly observed among individuals aged ≥60 y. Identified barriers to sedentary older adults starting time activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an bonny concrete activeness that can be adjusted to fit a target populations age, concrete limitations, and civilization.
Objectives
This review examined the benefits to concrete health of dance interventions among older adults.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the report'south design, participants' demographics, and outcomes, including compunction.
Results
The 18 articles reported on studies conducted in N America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, iv used cultural, ane used pop, and 2 used jazz. 2 studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52–87 y. Researchers used a variety of measures to assess effectiveness; (1) 3 of 5 (sixty%) that used measures to appraise flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of ix (89%) that used measures of balance showed significant positive changes; (4) viii of x (80%) that used measures of cognitive power showed meaning positive changes; and (5) the ane that measured cardiovascular endurance showed meaning positive changes. Merely 6 studies reported participation, and they institute low attrition.
Conclusions
The findings suggest that dance, regardless of its style, tin significantly improve muscular strength and endurance, residue, and other aspects of functional fitness in older adults. Future researchers may want to analyze the effects of dance on mental wellness and explore ways to make this intervention attractive to both genders. Standardizing outcome measures for dance would facilitate meta-analysis.
Physical inactivity contributes to many health weather, including obesity,one cancer, coronary centre disease,2 sarcopenia,3 cerebrovascular disorders,four circulatory diseases,five and frailty.6 Fortunately, adding physical activity to i's life is an effective method of preventing, controlling, and alleviating some health weather condition. Studies accept demonstrated that physical action has positive effects on low, anxiety,7 dementia,8 eye failure,nine stroke,10 noesis,11 and sleep.12,xiii The harmful furnishings resulting from physical inactivity and the positive furnishings of physical activity suggest that farther efforts are needed to encourage physical activeness, with an emphasis on populations at high adventure for inactivity.14
Physical inactivity is usually observed amidst individuals anile 60 y and older.15 Although many older adults take positive attitudes toward physical activity and its benefits, factors such equally the person who is recommending physical activity, the older adult's environment, costs of activities, and safety concerns bear on their behaviors regarding physical activity.16 Identified barriers to sedentary older adults starting time activity include low cocky-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture.17
The Usa' older adult population has been steadily increasing since the 1900s. Information technology is predicted that 92 meg older adults will alive in the United States in 2060, compared with 30 one thousand thousand in 2000.eighteen Therefore, creative, appealing, and effective methods of physical activity demand to exist investigated to conform this growing population.
Trip the light fantastic therapy is a creative arts therapy that has been defined by the American Trip the light fantastic toe Therapy Clan as "the psychotherapeutic utilise of movement to further the emotional, cognitive, physical, and social integration of the individual."19 Cross-exclusive studies have shown that older adults who dance on a regular basis have greater flexibility, postural stability, balance, physical reaction fourth dimension, and cognitive performance than older adults who do non dance on a regular basis.twenty
Unlike other holistic approaches used to increase physical activity, dance includes an artful form of artistic expression.21 Dancing can produce physical results comparable with those of formal practice preparation, and it also has been establish to improve social and behavioral factors, such equally cocky-motivation.22 In addition, it can improve the emotional, psychological, and physical well-being of individuals.
Qualitative studies take shown that aesthetic forms of expression build passion and can contribute to older adults' concrete, intellectual, and social development.23,24 Dancing has the potential to be a versatile activity that can be adjusted to fit a target population's age, concrete limitations, and civilization.
Two previously compiled literature reviews have examined the wellness benefits of dance.25,26 Withal, one review focused on the effectiveness of dance for salubrious people regardless of age. The other specifically examined dance in older adults simply excluded studies with elders who had health conditions besides as studies that did not specify the health condition of the older adult. In addition, those 2 literature reviews focused on the effectiveness of dance as a substitute for concrete activity rather than the feasibility of and adherence to the dance programs. Common reasons for the demise of interventions related to concrete action for older adults are poor adherence and high dropout rates.27 Therefore, boosted research is needed to identify an intervention's power to be individualized and tailored to populations of older adults in ways that maintain participants' involvement in the activity. The current study is meant to further scientific knowledge on this issue.
Given that many of older adults have cognitive and sensory motor impairments28 and that 45.3% of older adults aged 65 years and older have ii or more chronic weather,29 studies of interventions for older adults should not exclude those with chronic weather. Thus, the purpose of the electric current review was to examine the effectiveness of trip the light fantastic toe programs in improving the concrete health of all older adults, both those with health conditions and those considered healthy.
METHODS
Databases
Guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to develop the current systematic review.30 PubMed was searched using the keywords dance, anile, and older adults. In addition, the term trip the light fantastic therapy was used equally a medical subject heading and used in searching as text words. The search was conducted from September 2013 through October 2013. Citation chasing was as well used by searching the reference sections of other papers that pertain to the topic.
Inclusion and Exclusion Criteria
To be included in the current review, a written report had to evaluate the benefits of a dance intervention to the physical health of older adults lacking prior dance experience, within the age limits defined past a reviewed study'south authors. Studies had to nowadays results in a quantitative format. Dance was defined as a form of artistic expression through rhythmic move to music, which does not include aerobic fettle classes taught to music, such as Zumba and step-aerobics. The authors placed no limitations on the location of the research, intervention, or year the study was published. However, publications reviewed had to be peer reviewed and written in English language.
Data Extraction and Coding
Upon availability, the post-obit information on each intervention and study was abstracted from each publication: (1) the mean age and gender of participants, (2) the trip the light fantastic toe way studied, (three) the program's implementation strategy, (4) the study's results, (5) the researchers' decision about the effectiveness of the intervention, (6) the written report's attrition rates, and (seven) the researchers' conclusions. Effectiveness decisions were coded in the following fashion: A plus (+) was used for significant results in positive health improvement, a 0 for goose egg results, and a minus (−) for significance results in the negative direction.
Quality Analysis
The scientific rigor of each study was evaluated using 6 criteria adapted from Sackett31 and Megens and Harris.32 Specifically, studies were assessed for the presence of (i) clearly stated inclusion and exclusion criteria for participants, (2) an adequate clarification of the dance program, (3) reliable consequence measures, (four) valid event measures, (five) assessors who were blinded to the participants' groups, and (6) participants' omnipresence, retention, and dropout rates.
RESULTS
The article option process is illustrated in Figure 1. Specifically, 268 articles were identified based on search terms. Of those manufactures, 173 were excluded by championship; 28 duplicates were removed; 51 were excluded based on the commodity's content; and 2 were included from citation chasing. Remaining were 18 articles published from 2004 to 2013.33–50
Commodity selection procedure.
Intervention Designs
Regarding styles of dancing, of the 18 interventions examined, 6 used ballroom, v used gimmicky, 5 used cultural, and 2 used jazz (Table ane). Ballroom interventions included foxtrot, salsa, tango, bolero, swing, polka, cha-cha, waltz, and merengue. Two of the studies that used ballroom interventions used more than than 1 mode of ballroom dance in the programme. Contemporary interventions included improvisation and the Lebed method. Cultural dance interventions included Greek, Turkish, Korean, Cantonese, and line dancing.
Table 1
Intervention Design and Physical Outcomes
| Intervention Design | Physical Outcomesa | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study | Location | Style of Dance | Dosage—Frequency of Session, Elapsing of Program, and Session | Flexibility | Muscular Force/ Endurance | Balance | Cardiovascular Endurance | Cognition | Trunk Composition |
| Hackney et al33 | Atlanta, GA, Us | Ballroom (tango) | 2/wk, 11 wk, 1.five h | 0 + | + | ||||
| Granacher et al34 | Switzerland | Ballroom (salsa) | 2/wk, viii wk, ane h | + + + 0 0 | |||||
| Ferrufino et al35 | France | Gimmicky (improvisation) | 1/wk, iv.4 mo, one h | + 0 | |||||
| Krampe et al36 | – | Gimmicky | 3/wk, 6 wk, 45 min | 0 | 0 | 0 | |||
| Coubard et al37 | Paris, France | Contemporary (improvisation) | 1/wk, v mo, ane h | + 00 | |||||
| Krampe et al38 | – | Gimmicky (Lebed method) | 3/wk, six wk, 45 min | + | + | ||||
| Marmeleira et al39 | Evora, Portugal | Contemporary | 3/wk, 12 wk, i.v h | + + + | |||||
| Sofianidis et alforty | Finland | Cultural (Greek) | two/wk, 10 wk, 2 h | + | + + + | ||||
| Alpert et al41 | Las Vegas, Nevada, U.s. | Jazz | xv wk | + | |||||
| McKinley et al42 | – | Ballroom (Argentine tango) | 2/wk, 10 wk, 2 h | + + | + | ||||
| Hui et al43 | – | Cultural (Cantonese pop) | ii/wk, 12 wk, 50 min | + + + | + | ||||
| Eyigor et al44 | – | Cultural (Turkish sociology) | three/wk, 8 wk, 1 h | + + + 0 | + | ||||
| Wallman et al45 | – | Jazz | 1/wk, xv wk, i.five h | + | |||||
| Borges et al46 | Brazil | Ballroom (foxtrot, bolero, swing, waltz, rumba) | three/wk, viii mo, l min | + | + | ||||
| Holmerova et al47 | Czech republic | Ballroom (polka, foxtrot, flit, cha-cha) | 1/wk, three mo, 75 min | + | + + + | ||||
| Kim et al48 | Korea | Ballroom (cha-cha) | two/wk, 2 mo, 1 h | + + + | 0 0 00 | ||||
| Song et al49 | Korea | Cultural (Korean) | iv/wk, 6 mo, 50 min | + + + | |||||
| Young et al50 | – | Cultural (line) | i/wk | + + | 00 | ||||
Eleven studies reported on the location of interventions. Two were implemented in the U.s.; half-dozen were in Europe; 2 were in Asia; and 1 was in South America. The frequency of the interventions ranged from 1 to 4 times per week. The duration of the interventions ranged from 6 weeks to 8 months. The length of each session ranged from 45 minutes to two hours.
Participants
Two of the xviii studies examined the effectiveness of dance interventions for older adults who had been diagnosed with specific health conditions (Table 2). Those weather included visual impairment33 and metabolic syndrome.48 The remaining xvi studies targeted the general population of older adults. Groups ranged in size from 13 to 97 participants. In eight studies, more than one-half of the participants were females, and in 5 studies, all the participants were females. The remaining three studies did non specify the gender of their participants. The average age of participants ranged from 52 to 87 years.
Table 2
Studies' Designs and Participants' Demographicsa
| Study | Study Design | Experimental Participants | Control Participants | Diagnosed Health Condition |
|---|---|---|---|---|
| Granacher et al34 | RCT | N = xiv (y = 71) | N = 14 (y = 68.ix) | – |
| Ferrufino et al35 | RCT | N = 16 (f= 16, y = 73) | Fall prevention: N = 23 (f = 23, y = 72) | – |
| Krampe et al36 | RCT | N = fifteen (f= xi, y = 85) | Northward = 12 (f= six, y = 85) | – |
| Marmeleira et al39 | RCT | N = 19 (f= 15, y = 64) | North = fifteen (f= x, y = 66) | – |
| Sofianidis et al40 | RCT | N = fourteen (f= 13, y = 69) | North= 12 (f= 7, y = 72) | – |
| McKinley et al42 | RCT | N = 14 (f= 11, y = 78) | Walking: N = 11 (f = viii, y = 74.6) | – |
| Eyigor et al44 | RCT | N= 19 (f= 19, y=73) | N = 18 (f = 18, y= 71.two) | – |
| Borges et al46 | RCT | Due north = 39 (y=67) | N = 36 (y = 67) | – |
| Holmerova et al47 | RCT | Due north = 27 (f= 25, y = 81) | N = 25 (f= 21, y = 82) | – |
| Kim et al48 | RCT | N = 26 (f= xix, y = 68) | N = 12 (f= 10, y = 68) | Metabolic syndrome |
| Coubard et al37 | Quasiexperimental | N = 16 (f = 16, y = 74) | Autumn prevention: N = 67 (f = 64, y = 75), Ta'i chi chuan: Due north = 27 (f = 24, y = 72) | – |
| Hui et al43 | Quasiexperimental | N = 52 (f= 50, y = 52) | Due north = 45 (f= 44, y = 69) | – |
| Song et al49 | Quasiexperimental | N = 46 (f=43, y = 76) | N = 27 (f = 21, y = 74)b | 65% diagnosed with chronic diseasec |
| Young et al50 | Quasiexperimental | Line trip the light fantastic toe only: North = 15 (f= 15, y = 61) Line dance + squats: N= xv (f= 15, y=61) Line trip the light fantastic toe + squats + stomping: N = 15 (f = 15, y = 64) | – | Postmenopause |
| Hackney et al33 | 1 grouping, pre- and posttest | North = 13 (f=7, y = 87) | – | Visual impairment |
| Krampe et al38 | 1 group, pre- and posttest | N = 11 (f = 7) | – | – |
| Alpert et al41 | 1 group, pre- and posttest | North= 13 (y = 68) | – | – |
| Wallman et al45 | ane grouping, pre- and posttest | N = 12 (f= 12) | – | – |
Written report Designs
Of the 18 interventions, 10 were randomized controlled trials (RCTs),34–36,39,40,42,44,46–48 4 used a quasiexperimental pattern,37,43,49,l and iv included merely 1 group using pre- and posttest designs33,38,41,45 (Table ii). Of the 14 RCTs and quasiexperimental designs combined, 4 had control groups that engaged in another activity, such as walking,42 line dancing,fifty t'ai chi,37 and a autumn prevention program.35,37 The other ten did not provide their control groups with alternate activities.
Quality Assay
Scientific rigor was assessed by the 6 criteria provided by Sackett31 and Megens and Harris.32 As shown in Table iii, none met all 6 criteria; ten met 5 criteria34,36,38,xl,42,44,47–49; 6 met iv criteria33,35,43,45,46,50; and ii met 3 criteria.37,39 All 18 studies specified the inclusion and exclusion criteria for participants and employed valid and reliable result measures in their evaluations. Fifteen studies adequately described the intervention. Nonetheless, only 6 used blinded assessors, and but half dozen provided information on participants' compunction.
Table 3
Evaluative Criteria for Studies
| Study | Inclusion and Exclusion Criteria | Intervention Adequately Described | Reliable Upshot Measures | Valid Outcome Measures | Bullheaded Cess of Outcome Measures | Accounted for Attrition | Total No. Criteria Met |
|---|---|---|---|---|---|---|---|
| Granacher et al34 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| Krarape et al36 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| Krampe et al38 | ✓ | ✓ | ✓ | ✓ | ✓ | five | |
| Sofianidis et al40 | ✓ | ✓ | ✓ | ✓ | ✓ | five | |
| Alpert et al41 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| McKinley et al42 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| Eyigor et al44 | ✓ | ✓ | ✓ | ✓ | ✓ | five | |
| Holmerova et al47 | ✓ | ✓ | ✓ | ✓ | ✓ | five | |
| Kim et al48 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| Song et al49 | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | |
| Hackney et al33 | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Ferrufino et al35 | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Hui et al43 | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Wallman et al45 | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Borges et al46 | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Young et all | ✓ | ✓ | ✓ | ✓ | 4 | ||
| Coubard et al37 | ✓ | ✓ | ✓ | iii | |||
| Marmeleira et al39 | ✓ | ✓ | ✓ | three |
Outcomes
The studies' authors used a diverseness of measures of wellness outcomes. For the current review, each physical health outcome of dance measured by studies' investigators was grouped into 1 of the 6 measurement categories: (1) flexibility—the flexibility of an older adult's upper and lower trunk; (ii) muscular forcefulness and endurance measures— the general functional fitness of an older adult using tests such as get upward and become, chair squats, or gait speed; (3) balance—the ability of an older adult to stand on 1 or ii legs without swaying or with no center-of-pressure level deportation; (4) cardiovascular endurance—the maximum book of oxygen intake; (v) cognitive role—the older adult's retentiveness and organizational ability; and (6) body composition—the older adult'due south torso mass alphabetize and body fat percentage.
Beyond the 18 studies, 59 measurements were reported (Tabular array 1). These measurements include 5 measurements of flexibility, 28 of muscular strength and endurance, ix of balance, 1 of cardiovascular endurance, x of cognitive ability, and six of body composition. Studies employed approximately iii measures on average. Of the 18 studies, vi used measurements from 1 category.35,37,39,41,45,49 All other studies used measurements from multiple categories.
All just 1 study showed significant improvement in at least i of their measures of physical health, and no modify in measurement was significant in the negative direction. Specifically, 3 of v (threescore%) measurements of flexibility showed pregnant positive results, and ii showed no pregnant changes. Twenty-3 of the 28 (82%) measurements of muscular strength and endurance showed significant positive changes, and 5 showed no significant changes. Eight of the nine (89%) measurements of residuum showed significant positive changes, and 1 showed no meaning change. One report measured cardiovascular endurance, showing meaning positive change. Eight of the 10 (fourscore%) measurements of cerebral power showed significant positive changes, and 2 showed no pregnant changes. Finally, for the 2 studies that used a mensurate of trunk composition, neither showed a significant change.
Attrition
Only 6 of the 18 studies examined rates of compunction from their interventions (Table three). 3 reported completion rates of 100%34,38,40; one reported a completion charge per unit of 81%48; i reported a completion rate of 93%41; and 1 reported a completion charge per unit of 86%.36 The programs' lengths for these 6 studies ranged from 6 weeks to two months. No correlation existed betwixt a programs length and the attrition rate.
Older Adults With Wellness Weather condition
Although virtually the 18 studies focused on improving health among older adults in general, ii studies limited their interventions to older adults with specific health atmospheric condition or statuses (Table 2). Conditions examined were visual impairment33 and metabolic syndrome.48 Both studies demonstrated an improvement in the constructs measured. For example, the dance program for visually impaired older adults used a self-reported visual function test, covering measures of muscular endurance, force, and balance. Pregnant positive increases were observed in all iii tests. The study that examined older adults with metabolic syndrome found a significant positive increase in older adults' cognitive performance, although no alter in body composition occurred.
Word
Eighteen studies that fit the search criteria were assessed on each written report'southward quality, its design, the intervention design, physical health outcomes, and attrition. The results for the current review accept shown that trip the light fantastic is a promising method for improving older adults' physical health. In addition, studies show that dance interventions may address older adult barriers to being physically active such every bit cultural preferences, pre-existing medical conditions, and physical limitations.
Dancing to Improve Overall Physical Health
Every study except for 1 showed an comeback in a measure out of physical health among older adults. With the exception of body composition, improvements were seen for 60% to ninety% of measurements in the other categories of physical wellness measurement—flexibility, muscular strength and endurance, balance, cardiovascular endurance, and cognitive function. Lack of comeback in body limerick is perchance not surprising. Older adults on average increment 7.v% of their body fat mass and decrease 2% of the fat-free body mass per decade, even with moderate sports or recreational activity.51 In addition, dietary intake affects the lean mass of older adults and should exist considered as a misreckoning factor when measuring body composition.52 However, because no significant negative changes were observed, perhaps trip the light fantastic can exist seen every bit a method to maintain body limerick. Body composition may not be a realistic evaluation measure for trip the light fantastic toe, because many variables contribute to body composition.
A majority of the studies tested muscular strength and endurance and balance, showing a significant positive event for dance on older adults' functional fitness. These measures are meaning when identifying the physiological parameters that support physical mobility and independence in older adults53 and are also commonly used in basic tests of functional fitness for older adults. Therefore, dance interventions increase the functional fitness of older adults, which strengthens their bodies, assuasive them to perform day-to-day tasks independently.
Intervention Design
All types of trip the light fantastic toe reviewed in this article showed significant positive changes. Because the effectiveness of dance every bit an intervention was observed across a wide range of dosages, the dosage may be modifiable for participants as long as dance occurs at least once per week, for at least vi weeks, with a minimum of 45-minute sessions.
The current review included a focus on attrition considering a common downfall of concrete activity interventions for older adults is poor adherence and high dropout rates.27 Unfortunately, merely half-dozen of the 18 interventions reported program completion rates. Withal, these 6 reported depression attrition rates.
Dancing to Better Wellness Conditions
Two studies specifically examined the furnishings of dance interventions on populations of older adults with health atmospheric condition. This preliminary evidence suggests that dance interventions should non automatically exclude older adults with pre-existing medical conditions from participating. Rather, dance interventions can be offered to older adults with a multifariousness of atmospheric condition. Additional research is needed to ostend the efficacy of trip the light fantastic to meliorate specific health conditions.
Limitations
Limitations of this review of inquiry studies include imbalanced demographics for participants, inconsistent event measures, and lack of process evaluations. More specifically, all examined studies reported samples with more than 50% female. In fact, several studies had merely female participants. Futurity investigations should place gender-related barriers in recruitment, retentiveness, program pattern, and report objectives. Further, enquiry should explore if trip the light fantastic is a gender-oriented activity or tin be used across all demographics. The wide variety of measures used to exam outcomes limited comparisons across studies and precluded a meta-analysis. Finally, only 6 studies reported attrition data.
The review was express in that the just database searched was PubMed. This pick was made because of the review'due south focus on physical health outcomes. Researchers who desire to examine mental health outcomes of trip the light fantastic toe should expand the search to databases such as PsycNET.
Recommendations
After reviewing the eighteen studies that met the search criteria, the authors propose the following recommendations. Offset, trip the light fantastic toe interventions that aim to affect torso composition should either incorporate a nutritional component into the intervention or document the participants' dietary intakes. 2nd, the research customs should augment study parameters to include dance styles other than the popularly used contemporary and ballroom styles. Third, dancing should be used as a medium to promote older adults' physical health. Dance programs should provide a minimum of i 45-minute session per week for a full duration of half dozen weeks. Plan completion and reasons for attritions should be tracked.
Concluding, a bulk of the studies in the current review tested muscular strength and endurance and remainder. Those measures are useful in measuring physiological parameters that support physical mobility and independence in older adults.53 The measures are too commonly used in basic tests of functional fitness for older adults. Therefore, hereafter studies should include measures that examine the functional fitness of older adults. Standardizing effect measures for trip the light fantastic toe would facilitate time to come meta-analyses.
CONCLUSIONS
To the authors' knowledge, no systematic literature reviews take occurred that certificate how dance affects the physical health of older adults. Stiff bear witness suggests that trip the light fantastic toe, regardless of fashion and dosage, significantly improves older adults' functional fitness. However, dance may not be sufficient to change torso composition significantly. Although trip the light fantastic toe interventions accept low compunction rates, a bulk of the older adults participating in the dance interventions were female. Additional studies are needed to investigate the concrete effects of dance coupled with nutritional instruction, the psychological impacts of trip the light fantastic, and rates of and reasons for adherence to dance as a physical activity.
Footnotes
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Contributor Information
Phoebe Woei-Ni Hwang, DrPH candidate, University of Hawai'i at Manoa in Honolulu.
Kathryn L. Braun, professor and chair of the Part of Public Health Studies, University of Hawai'i at Manoa in Honolulu.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491389/