Ballroom Dance in Promoting Balance and Reducing Falls Incidences - Research Proposal Example

Ballroom Dance in Promoting Balance and Reducing Falls Incidences Ballroom Dance in Promoting Balance and Reducing Falls Incidences Introduction Keogh et al. (2009) defines dancing as a method of engaging people in physical activities to enable them enhances their health, bodily function, and well-being. Dance refers to a practice of physical activity, which permits focus since it encompasses numerous dancing styles and can remain performed in a number of physical settings that do not attract extra costs (Daniel et al. 2013). The process of ageing links to the physiological and physical changes that result into reduced levels of activities in older individuals (Keogh et al., 2012). The situation has led to the initiation of more critical studies to explain how ballroom dance can remain tailored to boost balance and minimize falls incidences in older individuals. Inquiries into the physical activities note that, regular involvement in ballroom dance is vital to maintain one’s physical, emotional, and cognitive health (Bethancourt et al., 2013), besides, it can also be tailored towards the improvement of balance and reduction of falls incidences. Further, despite numerous advantages related to the exercise, many individuals fail to participate in any form of physical activities in sufficient periods (Park et al., 2014). The purpose of this study is to present a detailed report on the importance of engaging older adults in ballroom dance. As a form of physical activity, ballroom dance enhances balance and reduces falls instances among older individuals. Literature Review Early research, epidemiological data, and surveys suggest an arrangement of groups to utilize the ballroom dance as a form of physical activity amid older individuals (Souza et al, 2015, p. 1). Two categories, that is, the conditions and practices related to health and demographic data have remained emphasized in the prediction of exercise among older individuals in the contemporary world. In relation to demography, age is perceivable to be less associated to exercise whilst high education levels show an increased trend of older adults in physical activities, particularly ballroom dance (Medina, Barquera, and Janssen, 2013, p. 21). Further, there is a significant relationship between ballroom dance and marital status. Studies show that ballroom dance serves as a substitution for social support among adult couples. On employment, people tend to be busy with the job demands and forget about exercises. Proposals argue that, after job, the people are too tired to be involved in dynamic physical activities like ballroom dance. The situation enhances negative behaviors in older adults in relation to this kind of dance. When it comes to health behaviors and exercise, studies suggest that, greater participation in physical health exercises results in a reduced burden of health conditions (Bloomfield, 2007, p. 681). For example, research claims that smoking causes a reduction in participation concerning dynamic exercises, ballroom dance being a dynamic exercise, smokers tend to avoid it. The situation may lead to increased health conditions, which in turn reduce balance and increase falls instances. Older adults on a regular basis experience a reduction in linear cognitive functioning that is, memory loss, deprived reasoning, and slowed information processing due to advanced ages (Chang, et al., 2013). Linear reduction in cognitive functioning impairs balance and increases falls incidences. Chang et al. (2013) notes that, active participation in the physical exercises mainly ballroom dancing can increase a person’s mental activity thereby initiating a decline in cognitive functioning, a situation known to boost balance and reduce falls incidences. Recommendations on the engagement in physical activities especially ballroom dance outline that adult persons should on moderate-to-dynamic situations accumulate at least 30 minutes daily. Meeting these recommendations brings about a reduction in the health risks associated with low exercise involvement. For example, there is substantial evidence in the reduction of high blood pressure, metabolic disorder, and heart-related illnesses when individuals are involved in dynamic exercise such as ballroom dance (Park et al., 2014). Moreover, most adult women in the United Kingdom are more prone to chronic diseases due to reduced participation in dynamic physical activities. The strategy to increase participation in ballroom dance is motivated by the desire to moderate sedentary time and curb chronic diseases among women in the United Kingdom (Curry and Tompson, 2014). Souza et al. (2015) identifies physical inactivity as a major cause of health problems in developing countries. He adds that, the associates of inactivity are not recognizable. This situation hinders the establishment of interventions to address issues brought about by physical inactivity. Research estimates that, the total population of older adults is set to increase past 50% in the subsequent four decades. If this is true, there will be more adults than children in the world and the situation will make an entry into the history for the first time. Advanced ageing leads to a declined access to improved health services in most of the developing nations, this elevates the deterioration of the health of the aged (Marques et al., 2011). The World Health Organization (2002) has described the “active ageing” concept to encompass those opportunities that promote health, security, and involvement to boost the quality of life of the aging population. Essentially, there is a rising anxiety to develop more strategies and interventions to eliminate inactivity of the populations regarding physical activity precisely in ballroom dance. Due to deleterious health consequences of physical inactivity, there is a need to determine useful strategies to enhance behavior and mood for the adult persons. It is acknowledged by Garcia et al. (2012), that dance improves mood among the elderly in care homes, and ballroom dance being among the dancing styles it should be enhanced. Documentation has it that, an estimated number of 700,000 older persons in the UK experienced dementia in 2007, 61% of this population secretly existed in the society while 35% received care in their homes, in addition, 120,000 more cases were reported in 2000 (Garcia et al. (2012). There is a perceived fear among the elderly individuals in relation to their involvement in the realm of ballroom dancing (Verderber, 2009). In addition, it is worth to identify a model to elucidate on the efficacy and quality of the interventions needed to enhance involvement in outdoor physical activities among older individuals such as ballroom dancing. Purpose of the study The research aims at examining ballroom dancing by providing a critical review on how to improve balance while effectively decreasing falls incidents in healthy older adults. Research hypotheses H0: There is no significant difference between ballroom dancing and balance improvement among old adults. H0: There is no significant difference between ballroom dancing and the falls incidents among old adults. Specific Aims The study effectively addresses the following specified roles; To determine the feasibility of enrolling, retaining, and observing the procedures among the old adults for ballroom dancing. To provide insight into ballroom balancing and reduction of falls incidents among the old adults. Methodology To address the study aims effectively, the participants in ballroom dance from the local villages will have a maximum of 60 hours of dance lessons over a period of 10 months. The lessons will take place for 45 minutes, two times per week for approximately 32 weeks. The remaining time will account for short breaks for the entire 10-month period. Cognizant that more training enhances efficacy, ballroom dance requires more training to ensure that the older adults are achieving maximal balance and learn on how to avoid falls incidences. The participants can exercise in two major dances, that is, ballroom dance that will encompass dances like Roll, Rock, Rhumba, Salsa, and Foxtrot. In addition, there will be Folk dance to act as a control exercise and will offer dances from France, USA, UK, Greece, and Italy. The major aims of these activities are to demonstrate the efficacy of ballroom dance in promotion of balance and reduce falls incidences (Boyé et al., 2013). A dance coordinator will run the dance activities and teach imperative lessons via diversified complexities as the dance advances (Merom, 2013). During the progression from one dance to another, the degree of flexibility, balance challenge, cognitive demand, cardiovascular demand, and coordination demand challenges will be testable. The program will remain homogenized via guidebooks, workshops, and provision of DVDs tailored to the dances by the dance coordinator. To increase involvement in ballroom dance, a systematic review, plus meta-analysis of works that seek to reduce falls and increase balance among the older adults were conducted. Guidance to the methodology of this research proposal was drawn from adherence to the reporting items considered in systematic reviews. Additionally, meta-analyses statements that find use in reporting systematic reviews were also in handy. The intensity of the dance will be determined through accelerometers twice in the entire period at the intervals of 10, 30, and 40 hours during the dance lessons. All participants in the control group will have opportunity to continue with the scheduled activities, and should not join the dance. Although, inherent participants will rely on a designed waiting list for practicing the dances, effective control is imperative. It is important for all the participants in the dance sessions to receive monthly newsletters for updates. The newsletter will have a “check the team” section and a “self-care” section. In “check the team” section, all updates regarding the program will remain availed in a similar manner to those under the “self-care” section information regarding health. For example, information relating to effective use of vitamins, how to stop smoking, falls statistics and including ways of sleeping habits in the “self-care” section. Recruitment of Participants Those individuals that prefer self-care from the participating villages will be called to attend a recruitment session. Posters, notice boards, and community newsletters will be availed to notify the residents about the event. During the session, individuals who want to take part in ballroom dancing will be required to give their details in the consent forms and sheets provided to them. Individuals not willing to participate will remain directed to filling simple questionnaires with details about age, gender, and reasons for deciding not to participate (Medina, Barquera, and Janssen, 2013, p. 21). Those with the desire to attend inherent sessions but did not attend the lessons will have the researchers’ details for more information and training. Eligibility (Inclusion criteria) Villages that have at least 70 self-care individuals, and have good and accessible common area for dance would have the prime chance for participation. Those who do not currently provide the ballroom dance lessons will also be eligible to participate in this exercise. All older adults willing to participate in ballroom dance should be between the ages of 65 and above, this is because more adults will prefer to retire age 65. Age 65 formerly regarded as the retirement age in the UK, thus more people may still prefer to adhere to it allowing them more time to participate in ballroom dance (https://www.gov.uk/retirement-age). Qualitative and quantitative data collection methods Through the contacts provided by the interested participants, the researchers will conduct short interviews through phone calls and set a date for baseline measurement. The mean mental state examination (MMSE) will be administrable to ensure eligibility of the participants after which the eligible ones fill questionnaires. Further, they will pass through a series of psychological and physiological tests to ascertain that they are free from any health condition. The tests that will remain carried out include physical activity, demographics, and other forms of leisure (Reichert, Barros, Domingues, and Hallal, 2007). These involve; Fall history, medical history, and falls efficacy. The assessment quality Symptoms of depression Social networks The dancing history and self-efficacy of the dance Physiological test Physiological performance Assessment(PPA) Short Physical Performance Battery (SPPB) Choice Stepping Reaction Time (CSRT) With and without cognitive load tests Psychological measurement Trail Making Tests (TMT) Rey Auditory Verbal Learning Test (RAVLT) How to carry out physiological tests 1) The PPA test involves a series of other sub-tests using a risk score for physiological fall where tests such as the ones mentioned below will be carried out. Sensitivity in edge contrast (vision), Proprioception in peripheral sensation, Strength in lower extremity (that is knee extension), A simple reaction based on time with figure press to act as the response, and Measuring balance through body sway while standing on a rubber mat with medium density foam These tests will help the participant with actual gain in balance and a consequent reduction in falls incidences. 2) CSRT having cognitive and cognitive load test. This particular test will involve two sub-tests, that is, test 1 and test 2 that will need the participants to take quick and correctly targeted steps by use of a dance mat measured in terms of milliseconds as outlined below. Test 1 will involve a graphical presentation of 4 arrows on the screen of a computer indicated by front right, front left, side right, and side left. The participants quickly step on the chosen corresponding arrow on the mat and get back to the stance panels. In this context, there will be four practice trails, that is, front right, front left, side right, and side left with a total of 32 trial tests having a stimuli randomly appearing amid 1 and 2 seconds immediately the participants goes back to the centre. Test 2 (also known as Stroop stepping test) will be used to determine selective attention and response inhibition. Here, there will be 8 panels on the mat with 2 on the centre, 2 on the front, 1 on the left, 1 on the right, and 2 on the stance. The computer screen will indicate an arrow at the centre pointing to any of the directions of the four sides matching the 4 possible directions. Within the arrow, there is a word indicating an opposite direction to that of the arrow and the participants are required to take action following the word while ignoring the direction of the arrow and immediately stand back in the panels at the centre. After practicing 4 times with arrow indicating in the possible 4 directions, 20 trials commence randomly where the word and direction of shape are not matching. Consequently, a player places the left foot on the panel on the left, right foot on the right panel and then either of the foot to the back or front panels. In case a participants place a foot on the wrong panel, they repeat until the steps are correct. For each case, the reaction time, which is lifting off the foot and movement time, which is step down, and all the stepping errors will be gauged. The tests are vital to give the participant a sense of coordination of the limbs during taking the steps. The situation will reduce falls incidences while improving balance among the adult individuals. Data Analysis Within this scope, the study will adopt the intention-to-treat analysis methodology. The data will remain analyzed through negative binomial regression having a random effect with many standard errors to account for clustering procedures. The analysis will provide information on the number of falls and determine the magnitude of the intervention for implementation (Bradley, 2011). To approximate impact of the intervention on psychological measures, generalized linear model having random standard errors will find use. Additionally, the research will also use product-of-coefficient test to estimate intervention effects on falls. Report will also remain established on adjusted and unadjusted methods of analysis. The analysis methods will experience a blind eye towards group identification. In cases of any missing data, the issue will handled by the sensitivity analysis. Expected results This will be the first exercise to cover the effectiveness of ballroom dance on improving balance while minimizing falls incidences. Physical activities for example, balance training have been used widely to improve balance and extremely reduce falls incidences. There exits thoughts that the balance exercise will equally challenge abilities to gain balance. However, falls via balance ballroom dance might be better than that tailored to specific balance training, ballroom dance possess a potential to correct a broader range of falls incidences because it can induce synergy, rhythm, and cognitive capabilities. Ballroom dance is therefore the best practice to implement among the old adults to affect balance and reduce falls incidences. Milestones With a continuous ballroom training and follow-up, there will exist a great reduction in the number of falls incidences that occur among old adults. Additionally, the time used to complete a TMT will remain reduced since the participants’ cognitive abilities increase. On the contrary, the PPA score, functioning of the lower limb, quality of life, and CSRT with and without load will go up because of increased memory and other cognitive abilities. Further, the cost per fall prevented and the cost of the quality of life adjusted per year will substantially reduce. Conclusion The program is set to determine the effectiveness of ballroom dance towards balance promotion and reduction of fall incidents. Ballroom dance offers a novel approach to balance for the older adults through studying a piece of physical activity preferable to the participants in a holistic manner. It is therefore paramount to provide a wider range of physical activities to the older individuals. The situation will enhance social engagement and provide a leeway for multicultural groups to advance their dance styles through ballroom dancing programs. 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