The Effectiveness of Dance Interventions on Psychological and Cognitive Health Outcomes Compared with Other Forms of Physical Activity: A Systematic Review with Meta-analysis.

BACKGROUND: Physical activity is known to improve psychological and cognitive outcomes. Learning dance sequences may challenge cognition, partnered or group dance may benefit social interactions, and the artistic aspect may improve psychological wellbeing. Dance is an equally effective form of physical activity compared with other structured physical activities to improve physical health, but it is unclear how effective dance could be for psychological and cognitive outcome measures. OBJECTIVE: To systematically review the literature on the effectiveness of structured dance interventions, compared with structured exercise programmes, on psychological and cognitive outcomes across the lifespan. METHODS: Eight databases were searched from earliest records to July 2022. Studies investigating a dance intervention lasting ≥ 4 weeks, including psychological and/or cognitive health outcomes, and having a structured exercise comparison group were included. Screening and data extraction were performed by two independent reviewers at all stages. All reviewer disagreements were resolved by the primary author. Where appropriate, meta-analysis was performed, or an effect size estimate generated. RESULTS: Of 21,737 records identified, 27 studies met the inclusion criteria. Total sample size of included studies was 1392 (944 females, 418 males, 30 unreported). Dance was equally as effective as other physical activity interventions in improving quality of life for people with Parkinson's disease [mean difference 3.09; 95% confidence interval (CI) - 2.13 to 8.30; p = 0.25], reducing anxiety (standardised mean difference 2.26; 95% CI - 2.37 to 6.90; p = 0.34), and improving depressive symptoms (standardised mean difference 0.78; 95% CI - 0.92 to 2.48; p = 0.37). Preliminary evidence found dance to be superior to other physical activity interventions to improve motivation, aspects of memory, and social cognition and to reduce distress. Preliminary evidence found dance to be inferior to other physical activity interventions to improve stress, self-efficacy and language fluency. CONCLUSION: Undertaking structured dance of any genre is generally equally and occasionally more effective than other types of structured exercise for improving a range of psychological and cognitive outcomes. TRIAL REGISTRATION: PROSPERO: CRD42018099637.

Understanding mental toughness at a Women's Australian rules football club.

Scholars have argued that mental toughness is a term that represents hypermasculine ideals. This hypermasculinity ideal could be considered relevant in the sport of Australian rules football, which has been played, at the professional level, by male athletes for the majority of its existence. Given the rising popularity of the Australian Football League Women's (AFLW), the present research sought to explore how the term mental toughness was understood at an AFLW club through a cultural sport psychology lens. Interviews were conducted with players (n = 4) and coaches (n = 6) from an AFLW club over the course of a competitive season. Data were transcribed verbatim and thematically analysed, with themes constructed to correspond with different levels of contextual influence. From this analysis, the club values and underlying assumptions, the social truths, and the role models/archetypes that provided a collective understanding of the term were identified. Mental toughness was defined by high-performance values of the men's game, which had implications for female athletes in this environment who are not afforded the same opportunities to fully embody these values. Mental toughness is positioned, in this environment, as an ideal with different meanings for female athletes due to structural factors associated with elite-level competition (e.g., full-time versus part-time professionalism).

The influence of an esports-adapted coping effectiveness training (E-CET) on resilience, mental health, and subjective performance among elite league of Legends players: A pilot study.

OBJECTIVE: This study aimed to develop, and pilot esports-adapted coping effectiveness training (E-CET) and measure its influence on coping effectiveness (global and specific), subjective performance, mental health (psychological distress and wellbeing), and resilience. DESIGN: Five elite male League of Legends players competing in the League of Legends Circuit Oceania participated in a mixed methods research design. The effects of E-CET were measured using a within-subjects quasi-experimental design (i.e., pre-to-post, no control group). To measure the effects of E-CET on specific stressors, a longitudinal diary design was used. METHOD: Players participated in a 2-h session of E-CET and a 45-min follow-up workshop. The 2-h workshop delivered content on two conceptual areas: (1) developing awareness of the stress and coping process; and (2) how to cope with stress. Players completed pre-intervention, post-intervention, and follow-up measures and twice-weekly stress journals. RESULTS: E-CET led to increases in players' perceived coping effectiveness and subjective performance, but there were no changes in psychological distress, psychological wellbeing, and resilience. However, the results indicate some positive signs for future coping interventions with League of Legends players and iterations of E-CET. CONCLUSION: The E-CET program appears to provide an opportunity to improve performance and mental health for esports players.

Effects of dance on gait and dual-task gait in Parkinson's disease.

BACKGROUND: Gait impairments in Parkinson's disease (PD) limit independence and quality of life. While dance-based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to assess the effects of a dance intervention, based on the Dance for PD® (DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted. METHODS: A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke's score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III). The DG undertook a one-hour DfPD®-based class, twice weekly for 12 weeks. The CG had treatment as usual. The spatiotemporal variables of gait were assessed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions: regular walking; dual-task: verbal-fluency (DTVERB), and serial-subtraction (DTSUBT). The data were analysed by means of a linear mixed model. RESULTS: At baseline, there was no significant group difference for any spatiotemporal gait variable. The DG improved significantly compared to the CG with and without a dual task when walking on even surface. During regular walking, DG improved in gait velocity (p = 0.017), cadence (p = 0.039), step length (p = 0.040) and stride length (p = 0.041). During DTVERB significant improvements were noted in gait velocity (p = 0.035), cadence (p = 0.034) and step length (p = 0.039). The DG also exhibited significant improvement compared to the CG during DTSUBT in the measures of gait velocity (p = 0.012), cadence (p = 0.021), step length (p = 0.018), and stride length (p = 0.151). On the uneven surface, improvements were noted when walking while performing serial subtractions only. During regular walking, improvements were noted for the CG but not for the DG. CG has spent less time in double support following the intervention than DG. While DTVERB condition had no significant group differences for any gait parameter (p's >0.05), in the DTSUBT condition, the DG improved significantly compared to the controls on gait velocity (p = 0.048), cadence (p = 0.026), and step length (p = 0.051). CONCLUSIONS: DfPD®-based classes produced clinically significant improvement in spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted. TRIAL REGISTRATION: A protocol for this study has been registered retrospectively at the Australian New Zealand Clinical Trials Registry. Identifier: ACTRN12618001834246.

Artistic and Health Professionals' Perceptions of Training Load Practices in Pre-Professional and Professional Ballet and Contemporary Dance: A Cross-Sectional Survey.

This study aimed to investigate the perceptions of training load practices of dance artistic and health professionals. Artistic staff and health professionals with experience in dance were invited to participate in a cross-sectional survey study relating to training load practices in pre-professional and professional, ballet and contemporary dance. The survey was developed from previous investigations in soccer and consisted of multiple-choice, Likert scale, and free-text responses. Responses to closed questions were reported by percentage and 95% confidence intervals (95% CI). Thematic analysis was performed by two independent assessors of free-text responses. There were six artistic staff and 18 health professional participants. Artistic staff were perceived to be "mostly/completely responsible" for planning training (artistic staff: 100%, 95% CI: 61%, 100%; health professionals: 94%, 95% CI: 76%, 100%), with health professionals "mostly/completely responsible" at times of injury (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). Both groups reported using individual modification to manage training loads and recognized the benefits of rest. Artistic staff recognized the need to modify training when injured, in line with experience levels, workload, age, and general health. Both groups "agree/strongly agree" that monitoring would be or is useful (artistic staff: 83%, 95% CI: 41%, 99%; health professionals: 95% CI: 61%, 96%). This investigation provides insight into the perceptions of artistic staff and health professionals with experience in dance toward training practices. Artistic staff and health professionals need to work together and adapt monitoring practices to their context to support artistic staff in planning training. The findings guide the implementation of these interventions by understanding potential barriers to their effectiveness that may potentially reduce injury.

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study.

Introduction: The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. Methods: International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Results: Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting. Discussion: Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.

Competitive Situations Requiring Mental Toughness in Women's Australian Rules Football.

In the last decade, mental toughness (MT) researchers have been interested in the behaviours exemplifying MT. Despite this interest, little attention has been paid to the competitive situations these behaviours occur in. Hence, the aim of the current study was to start addressing this gap by comprehensively focusing on the situations requiring MT in sport - specifically, the contextual demands linked to MT in women's Australian rules football. Focus groups and individual semi-structured interviews were conducted at two Australian rules football clubs after each competitive round of the 2020 season. Following analysis of participant responses, three broad situational categories were created, representing the psychological demands required by the player or team to successfully overcome in-game challenges. These categories were: context intelligence, attentional regulation, and emotional regulation. This study identified that situations requiring MT also required a degree of acceptance and commitment - alluding to a potential link between acceptance-commitment therapy (ACT) and MT. Conceptually, this view offers a new perspective on the psychological process of being mentally tough in competition. The link between ACT and MT also offers an avenue for MT development. Recommendations are made for incorporating these identified situations into regular training sessions following affective learning design principles.

Remediation Strategies for Performance Anxiety across Sex, Sport and Stage: Identifying Common Approaches and a Unified Cognitive Model.

Strategies for addressing anxiety-related decrements in performance have been implemented across a variety of domains, including Sex, Sport, and Stage. In this review, we (1) iterate the dominant anxiety-related remediation strategies within each of these domains; (2) identify over-lapping and domain-specific strategies; and (3) attempt to unify the conceptualization of performance-related anxiety across these three areas under the information-processing framework of the Reflective/deliberative-Impulsive/automatic Model (RIM). Despite both diversity and similarity in remediation approaches across domains, we found that many strategies appear to share the common goal of maintaining a dominant automatic style of information processing in high performance demand situations. We then describe how various remediation strategies might hypothetically fit within the RIM framework and its subcomponents, identifying each intervention as falling into one or more broad categories related to achieving and/or maintaining dominance in automatic information processing. We conclude by affirming the benefit of adopting a unifying information-processing framework for the conceptualization of performance-related anxiety, as a way of both guiding future cross- and inter- disciplinary research and elucidating effective remediation models that share common pathways/mechanisms to improved performance.

Dance improves symptoms, functional mobility and fine manual dexterity in people with Parkinson disease: a quasi-experimental controlled efficacy study.

BACKGROUND: Clinically, individuals diagnosed with Parkinson disease (PD) present several symptoms that impact on their functional independence and quality of life. While there is accumulating evidence supporting dance as an effective symptom management option, few studies have objectively assessed these benefits, particularly related to the Dance for Parkinson's Disease® (DfPD®) program. AIM: The aim of this study was to explore the effects of DfPD®-based dance classes on disease-related symptoms, fine-manual dexterity and functional mobility in people with PD. DESIGN: A quasi-experimental controlled efficacy study, with pre and post testing of two parallel groups (dance versus control). SETTING: Community. POPULATION: Thirty-three participants with PD allocated to one of two groups: dance group (DG; N.=17; age=65.8±11.7 years) or control group (CG: N.=16; age=67.0±7.7 years). They were cognitively intact (Addenbrooke's Score: DG=93.2±3.6, CG=92.6±4.3) and in early-stage of disease (Hoehn & Yahr: DG=1.6±0.7, CG=1.5±0.8). METHODS: The DG undertook a one-hour DfPD®-based class, twice weekly for 12 weeks. The CG had treatment as usual. Both groups were assessed at baseline and after 12 weeks on disease-related symptom severity (MDS-Unified Parkinson Disease Rating Scale: MDS-UPDRS), fine-manual dexterity (Perdue Peg Board), measures of functional mobility (Timed Up & Go: single & dual task, Tinetti, Berg, Mini-BESTest) and self-rated balance and gait questionnaires (Activities Balance Confidence Scale: ABC-S; Gait and Falls: G&F-Q; Freezing of Gait: FOG). RESULTS: Compared to the CG, there was significantly greater improvement in the DG pre-post change scores on measures of symptom severity MDS-UPDRS, dexterity, six measures of functional mobility, and the ABC-S, G&F-Q, FOG questionnaires. CONCLUSIONS: DfPD®-based dance classes improved disease-related symptom severity, fine-manual dexterity, and functional mobility. Feasibility of the approach for a large scale RCT was also confirmed. CLINICAL REHABILITATION IMPACT: DfPD® could be an effective supportive therapy for the management of symptoms and functional abilities in PD.

Ballet and Contemporary Dance Injuries When Transitioning to Full-Time Training or Professional Level Dance: A Systematic Review.

This systematic review examines the relationship between injury and two stages of a dancer's career development: when transitioning to full-time training and to a professional dance company. The findings are discussed in relation to managing transitioning loads with regard to injury prevention. Six electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, Scopus, and Performing Arts Periodicals Database) were searched from inception to July 2018, inclusive of English language peer reviewed studies investigating injury in pre-professional and professional ballet and contemporary dancers. Seventeen studies met the inclusion criteria. "Limited" evidence revealed that dancers transitioning to professional ballet had a significantly higher rate of time-loss injuries per exposure hour relative to established professionals, whereas transitioning professional contemporary dancers had a significantly lower rate of both medical-attention and time-loss injuries. "Limited" evidence also showed a decreased rate and trend toward lower prevalence rates for time-loss injuries per exposure hour for transitioning ballet students and an increased rate of medical-attention injury in a combined cohort of transitioning ballet and contemporary dance students. Thus, this review provides some evidence that injuries tend to occur as dancers are transitioning to full-time ballet or contemporary dance training or to professional careers.

Effects of Dance on Gait, Cognition, and Dual-Tasking in Parkinson's Disease: A Systematic Review and Meta-Analysis.

Dance-based interventions have been proposed for the management of Parkinson's disease (PD) symptoms. This review critically appraises and synthesises the research on the effects of dance interventions on gait, cognition and dual-tasking in PD, through a meta-analysis of peer-reviewed literature from seven databases. Eligible studies included people with PD, used a parallel-group or cohort design with a dance-based intervention, reported outcome measures of gait, cognition or dual-tasking, and were published in English up until September 2017. Of the initial 1079 articles, 677 articles were reviewed for eligibility, and 25 articles were retained. Only 12 articles had sufficient common assessment items for meta-analysis. Two independent reviewers extracted the data and assessed the risk of bias of each study using the Cochrane risk-of-bias tool. Based on pre-post change scores, gait speed, Timed Up and Go (TUG) test performance, freezing of gait questionnaire, and six-minute walk test times significantly improved after a dance intervention compared to controls. Global cognition assessed with Montreal Cognitive Assessment, and cognitive dual-tasking measured using dual-task TUG, also exhibited greater improvement in dance groups. There was limited evidence to determine the most effective intensity, frequency, duration of dance interventions or the most beneficial music. Findings must be interpreted cautiously because of the lack of randomised control trials, and the moderate to high risk of bias of studies. However, the results of papers with level-I and level-II.1 evidence suggest that dance may have the potential to ameliorate PD symptoms, particularly gait, global cognition and cognitive dual-tasking.

Using technology to enhance and encourage dance-based exercise.

This study investigated the role of Self-Service Technologies (SSTs) in dance-based exercise in order to begin exploring the motivations behind the use (or not) of SSTs by ordinary men and women in this context. The research approach employed interviews to gain insights into participants' use of SSTs and their exercise practices, in order to start establishing ways in which dance can be re/incorporated into people's lives through the design of appropriate SSTs. Findings from this study highlight the significant opportunity to further explore how the properties of music and dance can be integrated into the design of new SSTs. Literature suggests dance could be a beneficial exercise format for many people and self-service technology abounds for exercise but is often not used consistently. Our interviews asked participants about dance-based exercise and SSTs for exercise and showed that there is an opportunity to design SSTs to help people access dance-based exercise. SSTs should help people learn dance, build confidence, and dance alone or with others. SSTs could facilitate movement and increase engagement with physical activity whilst addressing issues around logistics, confidence and dance knowledge and experience.