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Dance and health

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Dance is a healthy physical activity, with many far reaching physical, and psychological benefits. Dancing can be enjoyed in many forms, and is for every age and ability. This physical activity appeals to some who may not typically be active and therefore may be another alternative of exercise.[1] Dance for health has become an important factor in the prevention, treatment and management in several health circumstances. It can benefit both physical and mental health and subsidizes social communication[2] Dance is an art which is learned in and shared between many cultures. Types of dance can entail body movements, expression and collaboration.[1] The correlation between dance and health has been subject of a number of research studies that show dance to be a largely healthy exercise. However, there are a number of health risks that require attention.[2]

Dancing is a healthy exercise for all ages

Uses of dance

Physical health and fitness

Ellsworth Zumba demo.

Dancing can be a way to stay fit for people of all ages, shapes and sizes, having a wide range of physical, and mental benefits including improved condition of the heart and lungs, increased muscular strength, endurance and motor fitness, increased aerobic fitness, improved muscle tone and strength, weight management, stronger bones and reduced risk of osteoporosis, better coordination, agility and flexibility, improved balance and spatial awareness, increased physical confidence, improved mental functioning, improved general and psychological well being, greater self-confidence and self-esteem, and better social skills.[3] Most forms of dance may be considered aerobic exercise and as such can also reduce the risk of cardiovascular disease, help weight control, stress reduction, and bring about other benefits commonly associated with physical fitness. In addition, studies have demonstrated a considerable correlation between dancing and psychological well-being. A large amount of governmental, health, and educational information is available extolling the benefits of dance for health.[4]

Benefits of Cultural dance Physical activity has many physical and mental health outcomes; however, physical inactivity continues to be common. Dance, specifically cultural dance, is a type of physical activity that may appeal to some who are not otherwise active and can be a form of activity that is more acceptable than others in certain cultures.[5]

Dance pads have proven useful in tackling obesity in young people and are welcomed in many schools for that reason.[6]

A 2008 report by Professor Tim Watson and Dr Andrew Garrett of the University of Hertfordshire compared members of the Royal Ballet with a squad of British national and international swimmers. The dancers scored higher than the swimmers in seven out of ten areas of fitness.[7] An Italian study in 2006 showed that dance has a higher rate of positive outcomes for those suffering with cardiac failure compared to other aerobic exercises like cycling. Speculative reasons for this include dance being a more enjoyable (and therefore more sustainable) exercise.[8][9]

A study at the Washington University in St. Louis School of Medicine in 2007 showed Argentine tango was better at improving the mobility of Parkinson's disease sufferers than an exercise class;[10] a later study showed similar benefits from Tai chi).[11] A study by Dr Paul Dougall at Strathclyde University in 2010 concentrating on older women found that Scottish country dancers were more agile, have stronger legs and can walk more briskly than people of the same age who took part in exercises such as swimming, walking, golf and keep-fit classes.[12]

For those with hypercholesterolaemia, dancing - in conjunction with diet and medication such as statins - can provide positive health benefits. As an aerobic exercise abridged levels of total blood cholesterol, especially in LDL cholesterol, acknowledged as bad and helps boost levels of HDL or good cholesterol.[13] Dancing in general increases muscle strength and flexibility, which in turn, improves overall range of motion. Dance also increases core strength which can improve balance, coordination, and posture (which can, in turn, reduce mechanical back pain).[14]

Mental health

Dance has been repeatedly shown to positively impact a person's mental health. A 2013 randomised control trial focusing on whether dance intervention influenced self-rated health for adolescent girls with internalizing problems found that "... despite problems such as stress and other potential challenges in being an adolescent girl, dance can result in high adherence and a positive experience for the participants".[15] The girls who took the dance classes were more likely to report improved mental health and a boost in mood than those who did not, and positive effects lasted up to eight months after the classes ended.

Additionally, a 2009 study explored the use of Wu Tao Dance as a therapy for people with dementia. It was shown that Wu Tao dance helped to reduce symptoms of agitation in people with dementia.[16] The complex mental coordination involved with dancing activates both sensory and motor circuits. Therefore, when one dances, one's brain is both stimulated by the sound of the music and by the dance movements themselves. PET imaging has shown brain regions that become activated during dance learning and performance, including the motor cortex, somatosensory cortex, basal ganglia, and cerebellum.[17][better source needed] The benefits of dancing on the brain includes memory improvement and strengthened neural connections. Consequently, not only can dance help to reduce symptoms experienced by those with dementia, but it can also reduce the risk of developing dementia in the first place, as shown in a 2003 study in the New England Journal of Medicine by researchers at the Albert Einstein College of Medicine.

[18]

A 2017 study, which focused on two groups of health seniors: one that participated in regular physical activities, and the other that participated in dance, found that he seniors that participated in dance showed a dramatic increase in grey-matter volume (which is the area of the brain that is responsible for controlling motor functions) after only 6 months of participation. The study concluded that, "dance is highly promising in its potential to counter act age-related grey matter decline" (Muller et al. 2017)[19]

In addition to improving symptoms of dementia and preventing dementia, frequent dancing can even lead to increased cognitive acuity for individuals of all ages. However, not all kinds of dancing has this power. Those dance styles that allow for the most split-second decisions are the most beneficial; those dance styles with the same, memorized patterns are the least beneficial.[20] For the same reason, those who take the Follow role have a higher opportunity for improving their cognitive acuity since they must make constant split-second decisions as they follow their partner's lead. The key for improving cognitive acuity is to create new neural connections to increase the complexity of our neuronal synapses. Another important consideration is that the frequency of dancing matters. The more frequent an individual dances, the greater the cognitive improvement.

Furthermore, many cultures agree that there is a mind and body connection, and many cultures use dance to heal this often damaged connection. During the African diaspora, individuals used dance therapy to treat the trauma that resided from their situations.[21] Dance therapy is suggested for patients today as treatment for emotional and therapeutic support, as dance allows individuals to connect with their inner-self.[22]

Damage of dance

As with any physical activity, there is always a risk of injury. Dancers are athletes, and require many hours of training - which can put strain on the body. As a result, sports injuries, repetitive strain injury, and chronic workplace stress can be common.

Dancers risk injury within the course of their career, many retiring from active performance in their mid to late 30s. Since dance is a performance art with emphasis on aesthetics, dancers are also at a higher risk of body image problems and eating disorders such as anorexia nervosa or bulimia.[23] Some dances, such as ballet, are very strenuous on the body. Research shows that dancers in elite pre-professional companies have 1.38 injuries per 1000 hours of dancing, with dancers averaging about 30.3 hours per week. The most common injury was to the lower extremities, with ankle being the most common. The injuries on average took about 7 days to heal with foot injuries taking the longest at 14 days and thigh injuries being the lowest at 2 days.[24] Another risk dancers face are eating disorders. They are constantly judged based on their looks and expected to have toned, slim bodies. This can lead to a lot of health risks.[25]

Injuries

...compared to the 61 common sports, only professional [American] football is more physically demanding than ballet.[26]

Many dance movements, and particularly ballet techniques, such as the turnout of the hips and rising on the toes (en pointe), test the limits of the range of movement of the human body. Dance movements can place stress on the body when not performed correctly; even if perfect form is used, over-repetition can cause repetitive strain injury. The most common injuries for ballet dancers is snapping hip syndrome and foot and ankle injuries.[27] Foot and ankle injuries are vulnerable to a wide range of injuries including, stress fractures, tendon injuries, sprains and strains. Much of this is due to not only the emphasis of footwork in dance but also the foot wear. Dancers either wear pointe shoes, bare feet, a soft shoe of some kind or heels, all of which offer no support. Shoulder injuries can be common in male dancers due to lifting, partnering and floor work that is commonly seen in modern dance. The periscapular muscles assist in keeping the shoulder still and steady, these muscles are at greater risk for injuries among dancers.[28]

Examined in the Journal of Dance Medicine and Science, dancers often put off consultation from doctors or physical therapists in the effort to stay employed by a dance company or to stay in rehearsals. When in fact those dancers that "work through" their pain more often than not end up worsening their symptoms and prolonging their recovery. Eighty percent of professional dancers will be injured in some way during their careers; 50 percent of dancers from large ballet companies and 40 percent from small companies will miss performances due to injury.[29]

Overwork and poor occupational health and safety conditions, a (non-sprung) hard floor, a cold studio or theater, or dancing without sufficient warm up also increases risk of injury. To minimize injury, dance training emphasizes strength building and forming appropriate habits. Choreographers and dance instructors will often put certain demands on their students and dancers without taking into consideration that each dancer is faced with different anatomical limitations. Dancers will strive to achieve the ideal aesthetic in their respective dance technique by over compensating for their limitations and thus presenting themselves with a higher risk for injury. Damage may also result from having a student perform movements for which they are not prepared, care must be taken that the student is not "pushed" inappropriately.[30]

A dancer put en pointe at an age where his or her bones have not completely ossified may develop permanent damage; even past the point of ossification, ankle injuries can result if a dancer goes en pointe without sufficient strength. According to a study conducted by Rachele Quested and Anna Brodrick, the lower extremities are the most vulnerable to injury. The most common injury is to the ankle, then leg, foot, knee, hip and finally the thigh. Dancers are trained from a very young age to avoid injury by using plie, turn out, and other means to protect their bodies.[31]

Avoiding injury

[32]

Keeping dancers free of injury is a crucial aspect and will help a lifetime of healthy physical activity and can prevent injuries in the future. By being taught a few simple techniques by parents, teachers, and medical professionals can avert injuries from occurring. Following are a few advice's on preventing injuries.[33] Wearing properly fitting clothing and shoes, drink plenty of fluids to stay hydrated, don't dance through pain, rest and then start back up again and listen to your teachers for correct technique.[33] For social dance the use of a sprung floor is highly recommended.[34] Because a dance injury can ruin a career professional dancers are increasingly refusing to dance on anything else. In ballet, good pliés (bending the knees) on landing helps protect against knee injuries and shin splints. Many types of dance, especially folk dances, have hops in the steps where the impact of landing can be reduced by slightly bending the knee. Warming up and cooling down exercises are recommended before and after exercises to avoid strain, muscle pains, and possible injury.[35] Conditioning is a good way to prevent dance injuries.[36]

Treatment of injuries

[32]
Main article: Sports injury

RICE (Rest, Ice, Compression, Elevation) is generally regarded as a good first aid therapy for most dance injuries before the ambulance comes, or even for what may be thought of as minor injuries.[37] Pain and inflammation can be reduced using a non-steroidal anti-inflammatory drug (NSAID) in a gel applied to the affected area (not on broken skin). Note, however, that masking pain to continue dancing is dangerous as it can easily make an injury worse.[34]

Stress

Professional dancers may experience chronic workplace stress due to uncertain work security and shifting work environments. The average income for a ballet dancer is low,[38] and competition for jobs is very high. The median hourly wage for dancers was estimated at $17.49 in May 2019.[39] In addition to the stress that may be caused by this, dancers also may experience the psychological distress from technical and physical perfectionism.[40] In a survey of 300 professional dancers, 40% were tobacco smokers in contrast with the Center for Disease Control average of 24% of American women and 29% of American men aged 18–34.[41]

Body image and disordered eating

As with other activities (such as horse jockeying) where weight is a factor, dancers are at a higher risk for developing eating disorders such as anorexia and bulimia.[42] According to research, about 12% of dancers have eating disorders and 16.4% of ballet dancers have eating disorders.[43] Many young dancers, believing that the ideal dancer must be thin, may begin controlling their diets, sometimes obsessively.[44]Because of this, dancers are three times as likely to risk suffering from eating disorders, more particularly anorexia nervosa and EDNOS.[43] Such dancers may be unaware of or may choose to ignore the fact that an emaciated dancer will not have the strength required for ballet. Inadequate nutrition in adolescent females has been linked to development of scoliosis, due to decreased oestrogen production and subsequent reduced bone density. A dancer with poor nutrition is at a higher risk for injuries and long-term health problems. A malnourished dancer's performance will be altered and weaken as his or her body starts to break down muscle and bone in order to fuel itself. This puts the dancer at risk for injury and slows healing.[45]

Scientific study of dance

Dance science is the scientific study of dance and dancers, as well as the practical application of scientific principles to dance. Its aims are the enhancement of performance, the reduction of injury, and the improvement of well-being and health. Dance requires a high degree of interpersonal and motor skills, and yet seems built into humans. It has therefore increasingly become the subject of neurological studies. The July 2008 edition of Scientific American contains a summary of recent studies and further questions.[46]

An article in Nature 'Dance reveals symmetry especially in young men' shows that dance in Jamaica seems to show evidence of sexual selection and to reveal important information about the dancer.[47][48] Professor Lee Cronk at Rutgers: "More symmetrical men put on a better show, and women notice." Symmetry is a strong indicator of fitness as it shows developmental stability.

Dance therapy or dance movement therapy is a form of expressive therapy, the psychotherapeutic use of movement (and dance) for treating emotional, cognitive, social, behavioral and physical conditions. Many professionals specialize in dancer's health such as in providing complementary or remedial training or improving mental discipline.[49]

References

  1. ^ a b Ravelin, Teija; Kylmä, Jari; Korhonen, Teija (2006). "Dance in mental health nursing: a hybrid concept analysis". Issues in Mental Health Nursing. 27 (3): 307–317. doi:10.1080/01612840500502940. PMID 16484172.
  2. ^ a b Ward, Sheila A. (1 April 2008). "Health and the Power of Dance". Journal of Physical Education, Recreation & Dance. 79 (4): 33–36. doi:10.1080/07303084.2008.10598161. ISSN 0730-3084.
  3. ^ Services, Department of Health & Human. "Dance - health benefits".
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  8. ^ America Heart Association Archived 16 July 2009 at the Wayback Machine Heart failure patients can waltz their way to healthier hearts
  9. ^ Heart Care -February 2007 Waltzing Your Way to a Stronger Heart
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  16. ^ "Exploring dance as a therapy for symptoms and social interaction in a dementia care unit". nursingtimes.net. 30 July 2009.
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  37. ^ Dance Magazine April, 2005 by Linda Hamilton Ouch! Five common dance injuries & how to treat them
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  45. ^ "Dance". Children's Hospital of Colorado: Orthopedics Institute. Archived from the original on 9 February 2013. Retrieved 13 June 2013.
  46. ^ [1] So You Think You Can Dance?: PET Scans Reveal Your Brain's Inner Choreography. Stephen Brown and Lawrence M. Parsons Scientific American July 2008 vol 299 No. 1 58-63
  47. ^ http://grail.cs.washington.edu/projects/dance-symmetry/ Dance Symmetry Project
  48. ^ Dance reveals symmetry especially in young men. Brown, William M., Lee Cronk, Amy Jacobson, Keith Grochow, C. Karen Liu, Zoran Popovic, and Robert Trivers. 2005. Nature 438: 1148-1150
  49. ^ "Archived copy". Archived from the original on 14 June 2008. Retrieved 9 July 2008.{{cite web}}: CS1 maint: archived copy as title (link) Londondance.com: Dancers Health

Further reading

  • Quin, Edel; Rafferty, Sonia; Tomlinson, Charlotte (2015). Safe Dance Practice. Human Kinetics. ISBN 978-1-4925-1347-6.
  • Vicky Karkou; Sue Oliver; Sophia Lycouris, eds. (2017). The Oxford Handbook of Dance and Wellbeing. Oxford University Press. ISBN 978-0199949298.
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