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Introduction: Lower-extremity external rotation, commonly known as turnout, is a fundamental skill in dance. Limited data exist regarding joint range of motion and strength in pre-professional young dancers and non-dancers. This study aimed to evaluate the differences in hip range of motion and hip strength between pre-professional ballet dancers and non-dancers. Additionally, the study assessed the variations between the left and right sides within each group. Methods: This observational study assessed 60 pre-professional ballet dancers and 31 non-dancers with an average age of 11.91 ± 1.49. Evaluation included passive hip rotation, tibial torsion, total passive turnout measured with digital goniometers, and total active turnout (both static and dynamic) through standing on paper and rotational discs. Hip rotation strength was measured using a force sensor device. Statistical analyses encompassed student t-tests, Pearson's correlations, and ANCOVA with age and body weight as covariates, applying the Bonferroni correction for multiple comparisons. Results: Ballet dancers exhibited greater passive hip external rotation and lower passive hip internal rotation compared to non-dancers. They also demonstrated superior total active turnout (static and dynamic). After adjusting for age and weight, dancers demonstrated significantly higher hip external rotation strength than non-dancers. Hip internal rotation strength did not differ significantly between the groups. Ballet dancers displayed inherent asymmetry, with the left side showing greater tibial torsion and standing active turnout, while the right side exhibited greater hip external rotation during dynamic active turnout. Non-dancers did not show significant side differences. Conclusions: Young pre-professional ballet dancers exhibited significant hip rotation differences compared to non-dancers, including notable right-left asymmetry. These findings should be considered when planning training, aiming to optimize musculoskeletal attributes and promote balanced hip rotation. Recognizing these asymmetries and addressing muscular imbalances is vital for injury prevention and performance enhancement.

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Background: Mindfulness and acceptance-based approaches have been trialled in professional sport. The present pilot study was a randomized controlled trial with professional ballet dancers investigating the effectiveness of the Mindfulness-Acceptance-Commitment (MAC) approach, developed for athletes, compared to an education program which included topics relevant to ballet and performance. Methods: Participants included 16 professional ballet dancers (2 men and 14 women) who were randomly assigned into either the MAC or education group for 1 session per week, for 6 weeks. Participants were assessed pre-and post-intervention using the Mindfulness Inventory for Sport (MIS) and the Acceptance Action Questionnaire (AAQ-II). Within 2 weeks of the final mindfulness session, all participants completed a semi-structured interview. Results: No differences were found when comparing the questionnaire responses between pre- and post- intervention, nor between the MAC group and the control group at post intervention for all subscales. Although dancers reported in the interviews that the sessions were valuable, they advised their ability to dedicate time to mindfulness ongoing would be challenging. Conclusions: Mindfulness interventions, as explored in this study, show promise to promote the well-being of professional ballet dancers. For consistent and ongoing mindfulness practice, future designs should seek to embed mindfulness practice into dancer and company schedules.

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Introduction: Physical literacy (PL) is a multidimensional concept that includes the domains of movement competence, positive affect, social participation, and the confidence, motivation, and knowledge and understanding necessary for regular engagement in physical activity. The Sharing Dance Public School Program was created by Canada's National Ballet School specifically designed to promote PL through dance. The objective of this study was to evaluate the effectiveness of the program to improve PL in grade 4 to 6 children over the course of a school year. Methods: Children were initially recruited from two schools including an intervention and a control school. However, due to the COVID-19 pandemic, data collection was prematurely terminated which resulted in baseline and mid-point data from the intervention group only. As such, participants included 57 children (n = 28 females, Mage = 10.34 ± 0.85 years) that engaged in the dance program once per week for 50 minutes. Assessments of PL included a direct measure of movement competence (PLAYfun) and a self-report measure (survey) to assess the other domains of PL. Results: Significant improvements were found in movement competence. However, significant decreases were found for fun and enjoyment, confidence, and social participation. No changes were observed for knowledge and understanding or overall PL. Conclusions: Findings from the present study are encouraging as they provide initial evidence for the support of community-based PL programs, such as the Sharing Dance Public School Program, to help children develop their movement competence. Future research is needed to further evaluate the effectiveness of the Sharing Dance Public School Program over a school year, and when compared to a control group, as was initially intended.

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BACKGROUND: Through pressure from funding and governing bodies, an audit culture invades the rhetoric of the dance medicine and science research community, leading to undue focus on justifying and legitimizing the holistic benefits of dancing. This paper critiques this hierarchical value system which disproportionately favors objective, generalizable, and quantitative research approaches still dominant in dance medicine and science, existing since the founding of the International Association for Dance Medicine and Science (IADMS) in 1990. PURPOSE: Whilst this may mean studies are generalizable when applied to broader contexts, objective outcomes lack granularity and do not automatically lead to appropriate, meaningful, inclusive, or accessible dance experiences for everyone. Subjective, idiographic, ethnographic, embodied, phenomenological, and transdisciplinary approaches to dance medicine and science research have great potential to broaden, deepen, and enrich the field. CONCLUSIONS: This paper highlights the tensions between qualitative and quantitative methodologies, advocating that researchers can rigorously embrace their positionality to contribute toward ontological and epistemological clarity with any researcher bias, assumption, or expectation transparently disclosed. The writing draws on research examples from Dance for Health (DfH) as a part of dance science and medicine field of study, including but not limited to Dance for Parkinson's. This paper provides resourceful recommendations, encouraging researchers to remain imaginative and curious through application of arts-based, person-centered, collaborative mixed methods within their own studies.

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BACKGROUND: Evidence of the benefits of dance for people with Parkinson disease is well established, but only recently has dance been investigated for people with multiple sclerosis (MS). The purpose of this review was to identify and evaluate the feasibility and effectiveness of dance interventions to improve functional, psychosocial, and participation outcomes in people with MS. METHODS: Eight databases and gray literature sources were searched from inception to March 2022. Quantitative, mixed-methods, and qualitative studies evaluating dance interventions for adults with MS were included. Included studies were critically appraised using the Mixed Methods Appraisal Tool, and results were analyzed through a parallel-results convergent synthesis. RESULTS: Thirteen studies were included, with a total of 174 participants. Various dance genres were investigated, and only 1 mild adverse event was reported. Four to 12 weeks of twice-weekly, 60-minute dance sessions were feasible in those with mild to moderate relapsing-remitting MS. Positive effects were identified mainly in motor outcomes, with qualitative themes indicating psychological and social benefits. CONCLUSIONS: A variety of dance interventions are likely feasible and potentially beneficial for people with mild to moderate relapsing-remitting MS, but studies were generally of low-moderate quality. High-quality studies are needed to determine the effectiveness of dance interventions for people with MS, including those with progressive forms of MS and higher levels of disability.

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BACKGROUND: While the content of health-related dance interventions is still relatively undocumented in the literature, the processes of adapting dance to specific situations are even less so, and rarely seem to be based on theoretical or practical guidelines. Yet the description of these processes could guide the adaptation of other interventions. PURPOSE: This study aimed to document the process of adapting a dance intervention in a complex clinical setting, in order to propose a methodology that could inspire the development of other interventions in specific clinical contexts. METHODS: The adaptation methodology described in this article is part of an embedded single-case study, where the case unit was the adaptation process of a dance group intervention and the subunits of analysis were the intervention's clinical and theoretical premises, content, and pedagogy. Participants were rehabilitation therapists (n=21), patients (n=6), relatives (n=4), and rehabilitation assistants (n=4). Data were collected through various techniques (focus groups, situational observation, pilot dance sessions, interviews, critical incidents, research journals, template for intervention description and replication/TIDieR checklist, and video recordings) to allow an iterative adaptation process. Data were analyzed using inductive qualitative analysis. RESULTS: Adaptations were made prior to and throughout the intervention, taking into account relevant scientific and disciplinary knowledge, as well as the different actors' implicit and explicit experiences. The intervention pedagogy focused on adapting the dance content to meet the participants' needs while inviting them to self-adapt this content. The resulting methodology model includes four stages: preliminary design, validation with rehabilitation therapists, specific tailoring, and ongoing tailoring. Conclusion: Optimizing the adaptation of dance and ensuring its complementarity within a complex clinical context requires collaboration with the different disciplinary clinicians in order to offer synergistic coherence and ensure dance's contribution to therapeutic objectives.

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PURPOSE: The "Ballet after breast cancer" study sought to investigate the feasibility and acceptability of a 16-week classical ballet intervention for breast cancer survivors, delivered face-to-face and/or online. METHODS: Breast cancer survivors were recruited to take part in 2 × 1-h ballet classes per week for 16 weeks. Primary outcomes of feasibility and acceptability were assessed according to rates of enrolment and attendance and participant feedback via questionnaire. Secondary outcomes included quality of life (QOL), upper-body disability, shoulder range of motion (ROM), muscular strength, aerobic capacity, and physical activity levels. Associations between rate of attendance and changes in secondary measures were explored. RESULTS: Thirty-one participants (62% of eligible individuals) enrolled in the program. Twenty-nine women commenced the intervention [53.3 ± 10.8 years (Mean ± SD)], attending 77.6% [67.6, 87.5] (Mean [95% CI]) of sessions. Based on these rates of enrolment and attendance, and participant feedback, the program was deemed feasible and acceptable to participants. Significant improvements in shoulder ROM and reductions in sedentary behaviour were achieved. Participants also reported improvements in physical capacity and psychological, social, and cognitive wellbeing. CONCLUSIONS: The "Ballet after breast cancer" program, delivered face-to-face and/or online, was feasible and acceptable to breast cancer survivors. Improvements in shoulder ROM achieved doing ballet were pertinent given the adverse effects of upper-body morbidity on breast cancer survivor QOL. Improvements in physical activity behaviour and perceived benefits to wellbeing also support the use of ballet to mitigate QOL impairment after treatment. IMPLICATIONS FOR CANCER SURVIVORS: The physical demands and the fun, creative, and social characteristics of ballet promote improvement across multiple domains of health and wellbeing. Ballet shows promise as an activity to improve QOL and increase long-term engagement in health-promoting physical activity after breast cancer.

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OBJECTIVES: Globally, 20-25% of people will experience chronic pain in their lifetimes. Dance is a physical activity with psychosocial benefits that might positively impact pain. This review aimed to investigate the effect of dance interventions on the experience of pain by quantitative measures and qualitative themes. METHODS: Seven major databases were searched from inception to January 2021. Two independent reviewers screened articles at each stage. Qualitative and quantitative studies were included if the dance interventions lasted more than 6 weeks, participants reported pain of duration longer than 3 months, and pain was an outcome of the study. All articles were critically appraised with appropriate Joanna Briggs Institute tools, and data were collated through the use of results-based convergent synthesis. RESULTS: From 23,628 articles, 34 full papers were included, with a total of 1,254 participants (75.2% female). Studies predominantly investigated individuals with fibromyalgia (26%) and generalized chronic pain (14%), with aerobic dance (20.7%) and Biodanza (20.7%) being the most common dance genres investigated. Overall, 74% of studies noted either reduced pain through quantitative pain measures or qualitative themes of improved pain experience (88% for chronic primary pain and 80% for chronic secondary musculoskeletal pain). DISCUSSION: There were positive effects of dance on chronic primary and secondary musculoskeletal pain across diverse populations. A variety of study designs and interventions noted improved pain measures and themes around pain coping and acceptance, with all dance therapies showing improvements, particularly when performed for 60-150 minutes' duration weekly. Dance should be considered as an effective adjunct in the management of chronic pain.

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PURPOSE: This review articulates current understanding of the aesthetic, artistic and creative contributions that Dance makes to Health and Wellbeing across the lifecourse within publications 2000-2019, an under-researched area. METHODS: Review Questions: What are the aesthetic, artistic and creative contributions that Dance makes to Health and Wellbeing across the lifecourse? And what methodologies are appropriate for investigating these contributions? A database keyword search identified 769 articles and 91 evaluations. 109 documents were identified for further in-depth analysis and rating, resulting in 24 papers (11 articles, 3 PhD studies, 10 evaluation reports), which were thematically analysed. RESULTS: Findings offer seven interrelated contributions that Dance makes to Health and Wellbeing: embodiment, identity, belonging, self-worth, aesthetics, affective responses and creativity. There was less insight regarding different methodologies, and discussions focused on quantitative data's limitations. There were insights into inclusion of embodied voices, subjective accounts, and lived experiences. CONCLUSION: Whilst acknowledging challenges, this paper illuminates the key contributions of dance to arts and health. It provides a future conceptual research agenda (prioritizing identity and creativity) and associated methodological developments. It recommends expanding geographical/lifecourse research, better defining terms, fuller epistemological critiques to open space for new methodologies, and continued attendance to appropriate rigour criteria.

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