Ballet after breast cancer: Investigating the feasibility, acceptability, and participant experiences of a novel 16-week classical ballet intervention for breast cancer survivors

ABSTRACT

Aim: The 'Ballet after breast cancer' study sought to investigate the feasibility, acceptability, and participant experiences of a 16-week classical ballet intervention for breast cancer survivors, delivered face-to-face and/or online. Method(s) Breast cancer survivors attended 2 x 1-h weekly ballet classes for 16 weeks. Primary outcomes of feasibility and acceptability were assessed according to rates of enrolment and attendance, and feedback questionnaire. Secondary outcomes included quality of life (QOL), upper-body disability, shoulder range of motion (ROM), muscular strength, aerobic capacity, and physical activity levels. Participants were invited to attend study focus groups. Semi-structured discussions regarding perceived changes following ballet participation, program design and delivery, and recommendations for future implementation were subject to thematic analysis. Result(s) Thirty-one participants (77.5% of target) enrolled in the program. Classes commenced face-to-face and moved online due to COVID-19 restrictions. Twenty-nine commenced the intervention [Female, 53.3 +/- 10.8 yrs (Mean +/- SD)] attending 77.6% [67.6, 87.5] (Mean [95%CI]) of sessions. Seventeen participants (54.4 +/- 11.9yrs;54.2 +/- 43 mnths post-diagnosis [Mean +/- SD]) attended focus groups. Based on rates of enrolment and attendance, and participant feedback, the program was deemed feasible and acceptable. Significant improvements in shoulder ROM and reductions in sedentarity were achieved. Participants reported improved physical capacity and psychological, social, and cognitive wellbeing. In discussing experiences, five themes emerged Embracing normal;Connection to others;Acceptance without judgement;Engagement;Learning and progress. The characteristics of the ballet instructor emerged as key determinants of program engagement/enjoyment. Recommendations to improve future programs included a hybrid delivery model, facilitated socialisation, and the provision of learning resources. Conclusion(s) Classical ballet delivered face-to-face and/or online is a feasible and acceptable activity after breast cancer, leading to perceived improvements in physical, psychological, social and cognitive wellbeing. The study provided preliminary evidence showing ballet can improve shoulder ROM and reduce sedentarity. Findings invite future research investigating the comparative effectiveness of ballet and honing its implementation after breast cancer.