Research

Susan was recently interviewed for TWO podcasts about BB4B. Check out our Media/Press page to go to the links and listen, or bring them up on your favorite podcast source.

• Balance Matters – Episode: “Ballroom Basics for Balance with Susan Frikken”
• Second Act Fit Pros – Episode: “Susan Frikken: Ballroom Basics for Balance”

Erica Demarch‘s “Balance Matters: A neuro physical therapist’s journey to make ‘sense’ of balance.”

Erica is a physical therapist specializing in neurological issues, including balance. She is also the creator of the Balance Matters(R) system, an innovative device using tactile, auditory, and visual feedback intended to improve balance and gait!

Erin Eleurtario‘s “Second Act Fit Pros“.

Erin is a functional aging specialist, experienced in training older adults to improve balance, strength, and functional abilities. Second Act Fit Pros is her podcast and also a community, designed to bring together individuals pursuing a second-act career in health and fitness with those currently working in health and fitness.

Please enjoy hearing about BB4B, and please explore and follow their other podcasts!

In 2021, dancers from one of our BB4B classes were invited to participate in a study with Dr. Kristen Pickett and her lab at the UW-Madison Kinesiology department examining the effectiveness of our class on many measures, including balance and self-reported confidence in various daily activities.

The results are in!  UW-Madison Doctor of Occupational Therapy students presented the findings at the recent American Occupational Therapy Association conference.

Using highly-regarded, valid, commonly-used tools, the researchers found improvement in occupational performance according to the Canadian Occupational Performance Measure, which identifies and measures the issues important to each person in their daily life.

Improvement was also seen in balance confidence using the Activities-specific Balance Confidence (ABC) scale screening tool.

While this is only a pilot study, it reflects what we have seen over our nine years offering these classes:  People regularly report an increase in confidence and enjoyment, and a decrease in fear. That’s HUGE!

Why?

Increasingly research shows that fear and low confidence in one’s abilities are the factors that can MOST predict a fall.

Strength, coordination, healthy vision, and overall good health DO MATTER. AND…if we can help ourselves feel more confident even while we are working to maximize our potential, our risk of falls can decrease!

So let’s keep dancing, playing pickleball or ping pong, doing tai chi, and all the movement that makes us happy! 

Pol F, Khajooei Z, Hosseini SM, Taheri A, Forghany S, Menz HB.

Summary:

Several foot and ankle characteristics are associated with fear of falling and mobility in older people. Targeting these modifiable risk factors may play a role in reducing fear of falling and enhancing mobility performance in this population.

Click here to read the full article.

Patima Silsupadol, PT, PhD, Anne Shumway-Cook, PT, PhD, Vipul Lugade, MS, Paul van Donkelaar, PhD,
Li-Shan Chou, PhD, Ulrich Mayr, PhD, Marjorie H. Woollacott, PhD

Summary:
Dual-task training is effective in improving gait speed under dual-task conditions in elderly participants with balance impairment. Training balance under single-task conditions may not generalize to balance control during dual- task contexts. Explicit instruction regarding attentional focus is an important factor contributing to the rate of learning and the retention of the dual-task training effect.

Year study was published: 2009

Click here to read the full article

Luz A. Varela-Vásquez, Eduard Minobes-Molina, Javier Jerez-Roig

Summary:

Considerable attention has recently focused on the role of dual-task exercises (DT) in the older adult. The aim was to conduct a review to describe the dual-task exercises that have been shown to be effective in improving balance and other physical characteristics such as decreased falling and walking speed in older adults. Review of intervention studies, in the Pubmed, PEDro, CINAHL and Web of Science databases. The search produced 498 references, 11 of which were identified with the description of the dual-task exercises, finding a wide variety of exercises, as well as great variability of outcome measures, discovering that the dual task is predominantly used for balance and walking speed training. All studies presented at least one group performing a double cognitive-motor task, some studies used the fixed priority modality in one group and variable in another, finding greater improvements in variable prioritisation. It can be said that dual-task training in older adults can improve balance and walking speed, which in turn reduces the risk of falling only if the planned dual-task training meets certain characteristics, such as training in specific concepts crucial in motor learning and dual-task training modalities.

Year study was published: 2020

Click here to read the full article

Betty Chewning, PhD, Dale Wilson, MA, Jane E Mahoney, MD, Kristine M Hallisy, PT, DSc, Nisaratana Sangasubana, PhD, Ronald Gangnon, PhD 

Summary:

Falls among older adults is a pressing public health challenge. Considerable research documents that longer tai chi courses can reduce falls and improve balance. However, longer courses can be challenging to implement. Our goal was to evaluate whether a short 6-week modified tai chi course could be effective at reducing falls risk if older adults designed a personal home practice plan to receive a greater tai chi “dose” during the 6 weeks.

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Click here to check out our easy-to-understand poster!

Gyrd Thrane, Ragnar M Joakimsen and Eline Thornquist

Summary:

A relationship between TUG time and history of falls in men but not in women was determined. However, the clinical relevance of this associated is limited due to the relatively small statistical significance found between the results male fallers and non-fallers as well as the inconsistent results of falls questionnaires. The conclusion of the research was the TUG may not be used as a test of fall risk in an ambulatory elderly population.

Year study was published: 2018

Mean age of participants in study: 74-89 years

Click here to read the full article

Tiffany E. Shubert, Matthew L. Smith, Lavina Goto, Luohua Jiang, Marcia G. Ory

Summary:

Otago Exercise Program (OEP) is a fall prevention program that consists of 5 warm-up exercises and 17 strength and balance exercises, which are progressed over the course of the program. This program can be administered by a PT or other healthcare professional in a home health or outpatient setting (US OEP) or in a community based setting (community OEP). This study reports significant improvements in physical and self-reported measures in both US and community OEP. There were no significant differences in improvements of outcomes measures (TUG, 30-second chair rise test, and four-stage balance test) between community and US OEP; therefore, the less costly community OEP can achieve results similar to those achieved with US OEP – especially with Timed “Up & Go” as concluded by this study.

Year study was published: 2017

Mean age of participants in study: 80 years old

Click here to read the full article

Merrill R. Landers, Sarrie Oscar, Jessica Sasaoka, Kyle Vaughn

Summary:

Physical-based measures (Berg Balance Scale, Sensory Organization Test, Timed “Up & Go”, and Dynamic Gait Index) as well as psychological-based measures (Falls Efficacy Scale, Activity Specific Balance Confidence Scale, and Fear of Falling Avoidance Behavior Questionnaire) were assessed during this study to determine which variable(s) were most predictive of falls in older adults. The results of this study concluded that balance confidence was the best predictor of falling, followed by fear of falling avoidance behavior, and the Time “Up & Go” (TUG). Fall history, presence of pathology, and physical tests did not predict falling. The study also concluded that psychological factors (balance confidence and fear avoidance) were stronger predictors of future falls than physical factors (gait, balance, visual acuity, etc.)

Year study was published: 2018

Mean age of participants in study: 72.2 years

Click here to read the full article

Phoebe Woei-Ni Hwang, MS; Kathryn L. Braun, DrPH

Summary:

Physical inactivity is common in individuals over the age of 60. This systemic review was looking at the benefits of physical health using dance. The compiled results of 18 studies suggest dance, regardless of style (ballroom, jazz, contemporary, cultural, pop) can significantly improve muscular strength and endurance, balance, flexibility, and other aspects of functional fitness in older adults. These results show dance as a promising method for improving older adults’ physical health as it might address the barriers associated with older adults being physically active.

Year study was published: 2015

Mean age of participants in study: 76 years

Click here to read the full article

Urs Granacher, Thomas Muehlbauer, Stephanie A. Bridenbaugh, Madeleine Wolf, Ralf Roth, Yves Gschwind, Irene Wolf, Rui Mata, Reto W. Kressig

Summary:

In this 8 week of progressive salsa dancing, researchers investigated the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in older adults. The researchers concluded this was a safe and feasible exercise program for older adults and there was a significant increase in stride velocity in the salsa group as compared to the control group; however, there were no significant changes in gait variability and muscle power of leg extensors. This was the first study that has investigated the impact of salsa dancing no intrinsic fall-risk factors (stride velocity and leg extensor power) in older adults.

Year study was published: 2012

Mean age of participants in study: 71.6 years

Click here to read the full article

Madeleine E. Hackney, BFA1 and Gammon M. Earhart, PhD, PT

Summary:

American smooth waltz and foxtrot as well as Argentine tango lead to significant benefits with respect to balance, motor ability, and locomotion in patients with idiopathic Parkinson’s Disease who took part in 20 hours of partnered dance instruction. These improvements were correlated to the use of external cues (music or use of partner) as well as specific movements incorporated in the particular form of dance. This study concluded that although foxtrot and tango both lead to improvements, tango was slightly more beneficial with TUG and gait (helping with freezing of gait). This was attributed to the strategies taught during tango (visual cues such as tapping partners foot or crossing one foot over the other, rhythmic rocking, backwards walking, etc.).

Year article was published: 2009

Mean age of participants in study: 67 years old

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Justin W.L. Keogh, Andrew Kilding, Philippa Pidgeon, Linda Ashley, and Dawn Gillis

Summary:

Results of 18 studies in all concluded that dancing can significantly improve power, lower body muscle endurance, strength and flexibility, balance, agility, and gait in older adults. Although it was concluded with a lower level of evidence, it was also suggested that dancing might improve older adults’ lower body bone-mineral density content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. There were no conclusions for different results based on type of dance or the difference in effectiveness of dance compared to other exercise modes.

Year study was published: 2009

Mean age of participants in study: 65 years old

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Lindy Clemson, BAppSc(OT), MAppSc(OT), PhD, Robert G. Cumming, MBBS, MPH, PhD,zk Hal and Kendig, Kirsty Taylor, MPI, PhD, BA(Psych), Megan Swann, BAppSc(OT),z Robert Heard, BA(Hons), PhD,w

Summary: This 14 month randomized trial concluded Stepping On (a multifaceted community-based program using a small-group learning environment which aims to improve fall self-efficacy, encourage behavioral change, and reduce falls all together) was effective for reducing falls in communityresiding elderly people. This was demonstrated by the Stepping On group experienced a 31% reduction in falls. The Stepping On program was determined to be especially effective for men.

Year study was published: 2004

Mean age of participants in study: 78 years old

Click here to read the full article

Hui-Ya Chen, Pei-Fang Tang

H-Y. Chen, PT, PhD, School of Physical Therapy, Chung Shan Medical University, Taichung, Tai- wan, and Physical Therapy Room

Summary:

When comparing the factors that contribute to performance on the single- and dual-task (serial subtraction or carrying water) TUG tests in 64 participants the following factors were found to be associated with better performance on all TUG tests (single- and dual-task): younger age, hip extensor weakness, walking speed, general mental function, and Stroop scores for word and color. However, factors contributing to solely to dual-task TUG were influenced by age and focused attention, specifically for carrying water and serial subtraction, respectively. These results suggest the importance of the combined use of the 3 TUG tests.

Year study was published: 2015

Mean age of participants in study: 71.6 years old

Click here to read the full article

Eliane Gomes da Silva Borges a,b,c,*, Sama ́ria Ali Cader b,c,d, Rodrigo Gomes de Souza Vale b,c, Thales Henrique Pires Cruz b,c, Mauro Cezar de Gurgel de Alencar Carvalho b,c, Francisco Miguel Pinto b,c, Este ́lio H.M. Dantas b,c

Summary:

In this study based out of Brazil, 39/75 individuals from three long-term institutions participated in a 50 min Ballroom Dance Program that incorporated rumba, swing, samba, and bolero and took place 3 times a week. The control group (36/75 individuals) maintained their normal daily activities. These individuals were evaluated using the Latin American Group for Maturity (GDLAM) protocol to assess functional autonomy and the stabiolometer to assess physical balance. The results of this study concluded the ballroom dance program led to an increase in the level of functional autonomy and in physical balance.

Year study was published: 2012

Mean age of participants in study: 77 years old

Click here to read the full article

Ken Kimura, Noriko Hozumi 

Summary: This study was comparing two types of aerobic dance exercises: a workout that consisted of several patterns of movement vs. a workout consisting of similar patterns of movement, but the patterns were joined to forma long choreographic routine/dance. The results of this study concluded that the executive cognitive network was facilitated in the choreographic routine workout due to the complex motor functions with a dual-task nature used in this workout group. The choreographic routine seems to improve actions that facilitate attentional control and even memory processes.

Year study was published: 2012

Mean age of participants in study: 70.7 years old

Click here to read the full article

Esther Lopez Fernandez-Arguelles, Juan Rodriguez-Mansilla, Luis Espejo Antunez,  Elisa Maria Garrido-Ardila, Rafael Perez Munoz

Summary:

This article compiled data from 7 articles to determine the therapeutic effects of dancing as a physical exercise modality on balance, flexibility, gait, muscle strength, and physical performance in older adults. These studies did show positive effects on reducing the risk of falls in relation to improved balance, gait and dynamic mobility, strength and flexibility; however, they were unable to confirm that dance has significant benefits on the aforementioned factors based on scientific evidence due to problems with study designs.

Year study was published: 2015

Mean age of participants in study: 72 years old

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Kathrin Rehfeld1, Patrick Müller1, Norman Aye, Marlen Schmicker,
Milos Dordevic1, Jörn Kaufmann, Anita Hökelmann and Notger G. Müller

Summary:

Dancing combines aerobic fitness, sensorimotor skills, and cognitive demands while maintaining a low risk of injury. In this study, an 18-month dancing intervention was compared to traditional health fitness training. Researchers were looking for both volume increases in the hippocampus, a region of the brain crucial for memory consolidation, learning and navigation in space, as well as improvements in balance. While both the dancing group and traditional fitness group both showed volume increases in the hippocampus, the dancing group showed increases in more areas of the hippocampus as well as significant increase in the balance score. From these results the researchers concluded dancing seems to be a promising intervention for both improving balance and hippocampal structure in the elderly.

Year study was published: 2017

Mean age of participants in study: 68 years old

Click here to read the full article

by Tiffany E. Shubert, MPT, PhD

Summary:

The current best practices for physical therapists to effectively improve balance and manage fall risk in patients are those that incorporate a structured, progressing, individually tailored exercise program that meets the optimal exercise dose. These interventions need to continue even after discharge from physical therapy and therefore a continuum of care approach is needed in order to maintain progress, continue to improve upon their abilities, sustain meaningful and permanent changes in risk factors, and ultimately reduce falls risk.

Year study was published: 2011

Mean age of participants in study: N/A

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by Catherine Sherrington, Anne Tiedemann, Nicola Fairhall, Jacqueline C.T. Close and Stephen R. Lord

Summary:

This updated systematic review compiled data from 99 comparisons from 88 randomized controlled trials, totaling 19,478 participants, looking at exercise as a single intervention to prevent falls. They concluded that exercise for falls prevention at least three (3) hours per week showed the greatest effects and should be targeted at both the general community as well as those at high risk of falls and may occur in both a group or home-based setting. The exercise programs should include: moderate to high challenges to balance as well as strength training, a sufficient dose of exercise, exercise needs to be ongoing, and should include a brisk walking training, unless they are a high risk falls individual.

Year study was published: 2017

Mean age of participants in study: 65+ years old

Click here to read the full article

by Merrill R. Landers, Sarrie Oscar, Jessica Sasoka & Kyle Vaughn

Summary:

Physical-based measures (Berg Balance Scale, Sensory Organization Test, Timed “Up & Go”, and Dynamic Gait Index) as well as psychological-based measures (Falls Efficacy Scale, Activity Specific Balance Confidence Scale, and Fear of Falling Avoidance Behavior Questionnaire) were assessed during this study to determine which variable(s) were most predictive of falls in older adults. The results of this study concluded that balance confidence was the best predictor of falling, followed by fear of falling avoidance behavior, and the Time “Up & Go” (TUG). Fall history, presence of pathology, and physical tests did not predict falling. The study also concluded that psychological factors (balance confidence and fear avoidance) were stronger predictors of future falls than physical factors (gait, balance, visual acuity, etc.)

Year study was published: 2018

Mean age of participants in study: 72.2 years

Click here to read the full article

by Regena G. Stevens-Ratchford

Summary:

This qualitative research design explored stories of ballroom dance participants to gain an understanding of the participants’ experiences and the relation between ballroom dance and successful aging using the Successful Aging Profile (SAP). The mean years of dancing experience was 38 years including engagement in waltz, fox trot, swing, tango, rumba, samba, salsa, and cha-cha. Researchers found that the sample they interviewed all reported positive successful aging including high function and positive well-being. The main aspect of ballroom dance that fosters successful aging is the inclusion of physical activity that these individuals are interested in.

Year study was published: 2016

Mean age of participants in study: 68 years old

Click here to read the full article