Aging Clinical and Experimental Research

https://doi.org/10.1007/s40520-019-01440-y

REVIEW

Dance intervention effects on physical function in healthy older

adults: a systematic review and meta‑analysis
Xuegang Liu1,2 · Pei‑Lin Shen1 · Yung‑Shen Tsai3 

Received: 24 September 2019 / Accepted: 6 December 2019

© Springer Nature Switzerland AG 2020

Abstract
Background and objective  Dancing is a form of physical exercise associated with health benefits in older adults. Regular
dancing can prolong healthy aging, maintain or even improve physical function, and thus enhance their quality of life. The
aim of this review was to evaluate the effects of dance intervention on physical function performance in healthy older adults
in randomized-controlled trials (RCTs).
Methods  Five electronic databases (Cochrane Library, PsycINFO, PubMed, Scopus, and Web of Science) were searched
systematically until the end of June 2018 by two independent reviewers. These searches were limited to the English language
and persons with average age older than 65. The tool from the Cochrane Collaboration was used to assess the risk of bias.
A standard meta-analysis was performed using Review Manager Software version 5.3.
Results  Thirteen RCTs from a total of 1029 older participants were included in this meta-analysis. The results showed that
dance intervention significantly improved mobility function and endurance performance when compared with control groups
for healthy older adults. However, gait was not significantly improved through dancing. Studies included in this review were
not enough to perform meta-analysis for the effectiveness of dance on balance and general health in healthy older adults.
Conclusion  Overall, dance intervention was effective to improve physical function performance in healthy older adults. The
results from this meta-analysis strengthen the evidence from previous individual studies. Properly organized dance interven-
tion would be a safe and effective exercise to incorporate into daily life.

Keywords  Systematic review · Meta-analysis · Dance intervention · Physical function · Healthy older adults

Introduction health services for the elderly must also receive increasing
attention worldwide. Physical exercise has long been proven
The rapid growth of the world economy, low birth rate and effective in improving the physical function of older adults
extended live expectancy, has made aging an emerging issue. [2]. The forms of physical exercise that is designed for older
The population of people aged above 65 reached 962 mil- adults are numerous, including aerobic exercise, dancing,
lion in 2018. This was 12.8% of the world population. It is jogging, Tai Chi, walking, and yoga [3–7]. Research has
estimated that the number of people over 65 will escalate to shown that physical exercise is effective in reducing the risks
1.5 billion by 2050, which will be 16% of the world popula- for diseases and improving body functions such as balance,
tion [1]. As the societal population ages, the development of agility, endurance, and gait speed [8–11]. Physical exercise
intervention has relieved symptoms in diseases prone to
elders such as Parkinson’s [5, 12], diabetes [13], hyperten-
* Yung‑Shen Tsai
ystsai@utaipei.edu.tw sion [14, 15], and dementia [16]. Physical exercise is an
effective way to improve the quality of life for older adults
1
Department of Sports Sciences, University of Taipei, [2, 3, 9, 17].
Taipei 111, Taiwan Dancing is deemed a popular and effective physical exercise
2
College of Music, Zhejiang Normal University, that has an excellent effect on physical function (e.g., muscular
Jinhua 321004, China strength, endurance, and balance) [18, 19], and reduces the
3
Graduate Institute of Sports Equipment Technology, risk of falling [20]. The effect of dance is not only to improve
University of Taipei, No.101, Sec. 2, Zhongcheng Rd., Shilin physical and cognitive function, but also as an engaging social
Dist., Taipei City 111, Taiwan

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 Aging Clinical and Experimental Research

activity which is very important for relieving aging as well as Data search strategy
a promising alternative to traditional exercise programs [3].
Current systematic research has proven that dance interven- Five electronic databases (Cochrane Library, PsycINFO,
tion is effective in improving the symptoms of diseases such PubMed, Scopus, and Web of Science) were systematically
as cardiovascular disease [21], dementia [16], and Parkinson searched until the end of June 2018. The searches were lim-
disease [22]. ited to the English language and people with average age
Dancing is a multi-faceted performance art that combines 65 or older. The search was based on the following terms:
diverse stimuli such as visual, audio, and sensual. Through [Danc* or Dance or Dancing or Ballroom or Ballet or Bolero
dance, one can experience the music flow and movement, acti- or Foxtrot or Jazz or Hip-pop or Latin or Polka or Rumba or
vate one’s memory, and express his or her emotions. Research Samba or Salsa or Tango or Tap or Waltz] and [Older adults
has shown the effectiveness of dance intervention on delaying or Elderly] and [Random*or Randomized or Controlled trial
aging and maintaining mental health in older adults. The wide or clinical trials]. A manual search was also conducted with
variety of dance styles makes it a very original and popular reference lists of key articles published in English.
form of activity in many cultures such as ballet, ballroom, folk,
traditional, and jazz [18, 23]. Each type of dance has its dis-
tinct characteristics and requirements in techniques and move- Study selection
ment styles. For example, the tango focuses on partnership
and the changes in position between the two dancers [24]. The Two authors (X.G.L. and P.L.S.) independently searched the
tango is effective in promoting elders’ motor cognition, stride, literature. Studies were included if they were a full origi-
and shifts in center of gravity [25, 26]. On the other hand, bal- nal study comparing dance interventions to other exercise
let is a graceful, lite, and slow movement dance. It focuses on interventions or no intervention. The inclusion criteria were:
the training of agility and coordination in the whole body [27]. randomized-controlled trial, at least 6 weeks dance interven-
Massive research has demonstrated that dance intervention is tions, participants aged 65 years or older adults without any
effective in relieving the decline in physical function, cognitive known cognitive impairment or disabling disease, and pub-
function, and quality of life linked with aging [3, 18, 28, 29]. lished English language. Any uncertain study design or data
Physical function including balance, endurance performance, were excluded. Studies were excluded if they were system-
flexibility, muscular strength and mobility, and the declining atic reviews, case or pilot studies, dance therapy, movement
in these abilities is regarded as the sign of aging. Evidence has therapy, or creative dance movement, and dance intervention
shown that the effectiveness of dance for physical functioning was combined with other exercise.
reduces the risk of falling and general improves health in older
adults [30, 31]. However, recent reviews lack randomized-con-
trolled trials (RCTs) evaluating physical function related to Data extraction
dance interventions in healthy older adults by meta-analysis.
Previous systematic reviews have looked at the effects of dance The following information from the included studies was
on cognitive function [29], functional and metabolic perspec- extracted: Study ID (authors), study population (number of
tives [23], patients with cardiovascular disease [21], demen- participants, gender, mean age), dance intervention and con-
tia [16], Parkinson disease [32], and falling prevention in the trol groups (type, duration, frequency, length), and outcome
elderly [33]. However, there has not been a comprehensive measures. The measurements were as follows: balance, flexi-
evaluation of dance intervention on physical function (e.g., bility (sit-and-reach), gait speed, short form 36 questionnaire
endurance, balance, mobility, and gait) in healthy older adults. (SF-36), sit-to-stand (STS), 6-min walking test (6MWT),
The aim of this meta-analysis is to conduct a systematic and timed up-and-go (TUG). All outcomes were assessed
analysis of random controlled research on the effectiveness between the baseline and end of intervention.
of dance intervention in the physical function of healthy older
adults. This work provides reliable, suitable suggestions and
guidelines for the health management of healthy older adults. Quality assessment

Risk of bias was evaluated independently by two review-

Methods ers using seven criteria (rating: low risk, unclear, and high
risk) recommended by the Cochrane Collaboration’s tool
This review study followed the Preferred Reporting Items for [35]. The quality assessment criteria included: random
Systematic Reviews and Meta-Analysis (PRISMA) guideline sequence generation, allocation concealment (selection
[34]. This review was registered in the PROSPERO with bias), blinding of participants and personnel (performance
CRD number 42018097106. bias), blinding of outcome assessment (detection bias),

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Aging Clinical and Experimental Research

incomplete outcome data (attrition bias), selective report- Results

ing (reporting bias), and other bias. When disagreements
arise, they were resolved by discussing or by consulting a Literature search and study characteristics
third author (Y.S.T.).
A total of 671 records were identified through databases
and other sources searching. After duplicates removed,
Data synthesis and analysis 443 records were included during title and abstract screen-
ing. One hundred and one full-text articles were assessed
The main analysis was a comparison of dance intervention for eligibility. After careful screening, 21 records were
groups versus control groups. The outcome measure of this included in the systematic review, and 8 articles reported
meta-analysis was presented as means, standard deviations on different outcome variables were later excluded. Thir-
(SD). The mean differences (MD) with 95% confidence teen records were included in qualitative synthesis (meta-
interval (CI) were calculated in a random-effects inverse analysis). The process diagram of search and identification
variance model for the same outcome measure [32]. Het- is shown in Fig. 1.
erogeneity between groups was assessed using the I2 sta- The characteristics of the 13 included studies are sum-
tistic. Level of significance was set at P < 0.05. Review marized in Table 1. The total sample size of all included
Manager Software, version 5.3 was used for data analysis studies was 1029 participants (126 males, 875 females,
in this study.

Fig. 1  PRISMA diagram for

study selection and identifica- Records identified through Additional records identified
Identification

tion database searching through other sources

(n=656) (n=15)

Records after duplicates removed

˄n=443˅

342 records excluded by abstract:

Records screened Case studies (n=4)
Screening

(n=443) Conference abstract/full report

(n=20)
Intervention without dance (n=262)
Pilot studies (n=11)
Systematic reviews (n=45)

80 records excluded by full-text˖

Full-text articles
Dance + exercise (n=12)
Eligibility

assessed for eligibility

Dance therapy (n=39)
(n=101)
Not relevant outcomes (n=21)
Not original publication (n=1)
< 6 weeks duration (n=1)
Other (n=6)
Studies included in
qualitative synthesis 8 studies excluded˖
Different testing
Included

(n=21)
methods/outcomes (n=8)

Studies included in
qualitative synthesis
(Meta-analysis)
(n=13)

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 Aging Clinical and Experimental Research

28 unknown) with the sample size range from 23 to 510 (MD: − 2.48, CI − 4.35 to − 0.62, P < 0.01; heterogeneity:
participants, including 543 in dance intervention groups I2 = 89%, ­Chi2 = 27.09, P < 0.001) (Fig. 2c).
and 486 in control groups. The mean participant age was
65 years or older. Dance intervention types included ball-
room [36–38], line [39, 40], folk/traditional [30, 41–43], Endurance performance
tango [26], ballet [44], jazz [40], and salsa [31]. Interven-
tion session duration from 40 to 120-min, frequency 1–3 Four studies used 6MWT to evaluate the endurance perfor-
times per week, and duration ranged from 6 to 12 months. mance of 310 participants [30, 36, 41, 45]. In the 6MWT,
The control groups were required to keep regular daily the distance was significantly increased in dance groups
activities. (MD: 59.71, CI 39.81 to 79.62, P < 0.001; heterogeneity:
In these 13 included studies, functional performance was I2 = 30%, ­Chi2 = 4.27, P = 0.23) (Fig. 3). From these studies,
examined in all the studies, balance ability was measured dance intervention groups had more effectiveness in improv-
in 4 of them [30, 31, 39, 43], and 2 studies used SF-36 [30, ing endurance than control groups.
45]. In addition, the Berg Balance Scale (BBS) [30, 39],
center of pressure (CoP) shifts [31, 43], flexibility [37, 38,
Gait
41, 45], 6MWT [30, 36, 41, 45], STS [26, 30, 37, 38, 41,
42], TUG [36, 37, 44, 45], and gait speed [26, 31, 39, 40,
Gait speed was reported in five studies [26, 31, 39, 40, 42];
42] were also covered in the functional outcomes. We per-
therefore, MD was used for data analysis. Although the out-
formed meta-analysis for the outcome measures included in
comes were favorable to dance, they did not show significant
at least four studies. If an outcome measure was included in
differences in gait speed change between dance groups and
less than four studies, we only report their findings without
control groups (MD: 0.07, CI − 0.02 to 0.17, P = 0.14; het-
conducting further analysis.
erogeneity: I2 = 67%, ­Chi2 = 12.00, P = 0.02) (Fig. 4).

Physical function outcomes

General health
Balance function
Two studies used SF-36 to investigate the effects of dance
Data were reported in association with balance function intervention on general health, pain, and role of emotion [30,
in 4 studies [30, 31, 39, 43]. There was no significant dif- 45]. They both reported that general health was significantly
ference about the CoP shifts through one-leg stance in the improved after exercise. However, there were no significant
anterior–posterior and mediolateral direction in two studies differences in role of emotion between the intervention and
[31, 43]. BBS outcome measures, on the other hand, were control groups after exercise. The findings on the effects of
reported to be improved in the dance intervention groups pain relieve were inconsistent between these two studies.
compared to the control groups in the other two studies [30,
39]. Limited numbers of studies using CoP shifts and BBS
Risk of bias with included studies
as outcome measures resulted in difficulty of performing
meta-analysis for balance function.
Included studies did not always provide enough information
to determine the risk of bias. Their methodological qualities
Mobility function are shown in Fig. 5. There was an unclear risk of bias for
random sequence generation and allocation concealment. It
Four studies provided data on flexibility in dance versus con- is difficult to both blind participants and instructors; there-
trol analysis with 239 participants [37, 38, 41, 45]. There fore, all included studies show a high risk for blinding of
was significant difference between the dance and control participants and personnel (performance bias). Among the
groups (MD: 4.09, CI 1.18 to 7.00, P < 0.01; heterogene- 13 studies, one study presented high risk in the blinding
ity: I2 = 66%, ­Chi2 = 8.93, P = 0.03) (Fig.  2a). Six stud- of outcome assessment [39], two studies presented unclear
ies [26, 30, 37, 38, 41, 42] contributed 626 participants, risk in the blinding of outcome assessment [31, 43], and the
there was an improvement in STS scores in favor of dance majority of the studies had a low risk for detection bias. Only
(MD: − 2.90, CI − 5.23 to − 0.58, P = 0.01; heterogene- one study had a high risk for incomplete outcome data [37],
ity: I2 = 89%, ­Chi2 = 45.20, P < 0.001) (Fig. 2b). TUG was some participants did not complete the posttest in this study,
reported in four studies [36, 37, 44, 45] with showing better and 12 studies had a low risk of “attrition bias”. Selective
results. The results indicated significant improvements in reporting had an unclear risk of bias. All 13 studies had low
the dance group, which showed a reduction in TUG time risk of “other bias”.

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 Table 1  Characteristics of included studies
Author Participants (female) Mean age ± SD Intervention Control descrip- Intervention Inter- Intervention length Outcomes assessed
description tion session dura- vention
Intervention Control Intervention Control tion frequency

Bennett and Hack- 12 (10) 11 (10) ≧ 65 ≧ 65 Line dance Daily activities 1 h 2×/week 8 weeks BBS, gait speed
Aging Clinical and Experimental Research

ney [39]
Cepeda et al. [36] 19 (19) 15 (15) 69.1 ± 6.5 71.5 ± 7.4 Ballroom dance Daily activities 1 h 3×/week 8 weeks 6MWT, TUG​
Eyigor et al. [30] 19 (19) 18 (18) 73.5 ± 7.6 71.2 ± 5.5 Turkish folklore Daily activities 1 h 3×/week 8 weeks BBS, 6MWT, STS,
dance SF-36
Granacher et al. 14 (Unknown) 14 (Unknown) 71.6 ± 5.3 68.9 ± 4.7 Salsa dance Daily activities 1 h 2×/week 8 weeks CoP shifts, gait
[31] speed
Hamacher et al. 19 (11) 16 (10) 67.2 ± 3.4 68.5 ± 3.1 Line dance, Jazz Daily activities 90 min 2×/week 6 months Gait speed
[40] dance, Square
dance
Holmerova et al. 27 (25) 25 (21) 81.0 ± 9.6 82.8 ± 7.5 Ballroom dance Daily activities 75 min 1×/week 3 months Flexibility test, STS,
[37] TUG​
Hui et al. [45] 52 (50) 45 (44) 68.0 ± 4.5 69.1 ± 4.2 The choreographed Daily activities 50 min 2×/week 3 months 6MWT, flexibility
dance test, TUG, SF-36
Janyacharoen et al. 20 (20) 18 (18) 64.9 ± 4.0 66.8 ± 6.0 Thai dance Daily activities 40 min 3×/week 6 weeks 6MWT, flexibility
[41] test, STS
Machacova et al. 27 (25) 25 (21) 81.0 ± 9.6 82.8 ± 7.5 Ballroom dance Daily activities 1 h 1×/week 3 months Flexibility test, STS
[38]
McKinley et al. 14 (11) 11 (8) 78.1 ± 7.6 74.6 ± 8.4 Argentine tango Daily activities 2 h 2×/week 10 weeks Balance, gait speed,
[26] dance STS
Merom et al. [42] 279 (231) 251 (217) ≧ 65 ≧ 65 Folk dance Daily activities 1 h 2×/week 12 months Gait speed, postural
away, STS
Serrano-Guzman 27 (27) 25 (25) 69.1 ± 4.4 69.5 ± 3.2 Flamenco dance, Daily activities 50 min 3×/week 8 weeks TUG​
et al. [44] Sevillanas, Ballet
steps.
Sofianidis et al. 14 (13) 12 (7) 69.2 ± 4.4 72.6 ± 5.2 Greek traditional Daily activities 1 h 2×/week 10 weeks CoP shifts, dynamic
[43] dance balance

BBS Berg balance scale, CoP center of pressure, SF-36 short form 36 questionnaire, STS sit-to-stand, 6MWT 6-min walking test, TUG​timed up-and-go

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 Aging Clinical and Experimental Research

Fig. 2  Mean difference in dance intervention effect versus no intervention on mobility function (Flexibility, STS, and TUG)

Fig. 3  Mean difference in dance intervention effect versus no intervention on endurance performance (6MWT)

Discussion better results than the control groups. Dance can signifi-
cantly improve mobility (measured by flexibility, STS, and
From this meta-analysis, we found that a large number TUG) and endurance performance (measured by 6MWT)
of outcomes from the dance intervention groups showed for healthy older adults. The gait and other results did not

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Aging Clinical and Experimental Research

Fig. 4  Mean difference in dance intervention effect versus no intervention on gait (gait speed)

Fig. 5  Risk of bias graph:

review authors’ judgements
about each risk of bias item
presented as percentages across
all included studies

show significant improvement for the dance intervention Mobility function

groups compared with the control groups.
STS, TUG, and flexibility are important tools for test-
ing mobility function. Mobility function is significantly
Balance function improved after dance intervention according to STS, TUG,
and flexibility measurements. Previous research indicated
Previous studies reported that dance benefited physical that after 8  weeks of dance intervention positively the
function and reduced the risk of falls for healthy older physical function of older adults. The time to complete the
adults [9, 18, 25, 46, 47]. We were unable to perform TUG test had improved from 10.1 to 7.7 s. It was a sig-
meta-analysis for the effects of dance on balance. Only nificant improvement [20]. Following two times a week and
two studies indicated that BBS scores were improved after 10 weeks dance intervention, the performance of STS sig-
dance intervention [30, 39]. BBS is a 14-item objective nificantly improved from 17.12 ± 7.05 to 12.36 ± 4.46 s [26].
measure designed to assess static balance and the risk for Comparing to a study using resistance training, healthy older
fall in older adult populations. The overall balance func- adults were improved in TUG and STS after 6 months of
tion of older adults on the BBS score had a significant training, but there was no significant improvement in long-
improvement in the over 8-week dance intervention group term care older adults [17]. Flexibility is the range of motion
which could delay the decline of body balance and reduce in a joint or in a group of joints. The current study indicates
the risk for falls. However, the results from two other stud- that flexibility can improve the range of motion and increase
ies showed that there was no significant difference between the muscle length [2]. Dancing is a multi-faceted exercise
the dance intervention groups and the control groups in that produces various stimuli such as coordinating the limbs
CoP shift [31, 43]. Single leg standing balance was tested better through movement following the music. The ability
in these two studies. Whether this test is too difficult for to maintain good mobility function ensures body position
older adults to perform that led to similar findings for the stability, which is clinically important, because it reduces
groups with and without dance intervention require further the high fall risk in healthy older adults to either no risk or
study to confirm. lowered fall risk.

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 Aging Clinical and Experimental Research

Endurance performance safe exercise that can improve gait freezing for healthy older
adults [39]. However, this meta-analysis review showed no
The results from six of the meta-analysis studies on 6MWT significant results associated with gait. The contradictive
showed that the dance intervention groups had significant results among these studies might be, because there were
endurance performance improvement over the control not enough studies included in this review, and also differ-
groups. The 6MWT can be used to measure the endur- ent types of dance intervention might have different effects
ance performance of older adults [7, 15]. Aerobic capac- on elderly’s gait performance. One study showed no sig-
ity declines 30–40% in elderly over aged 65 compared with nificant result with 422 participants. This study displayed a
young adults [48]. Dance implies leg movements, steps, and high weight, which may influence the outcome assessment
interaction which contributed to aerobic endurance perfor- of this meta-analysis. Focusing on the intervention of a sin-
mance. This meta-analysis showed 6MWT significantly gle dance is suggested for in-depth systematic research in the
improved 40 m in walking distance compared with baseline future. Two studies showed that gait performance in older
following 6 weeks dance training [30, 36, 41, 45]. Dance adults is linked to cognitive changes, which is as an impor-
exercise can improve endurance function, because it changes tant external feature of cognitive function [51, 52]. Future
cardiovascular fitness and increases maximal oxygen con- studies should include follow-up work designed to evaluate
sumption ­(VO2max). Two other studies confirmed that dance whether dance exercise in the long term can improve cogni-
intervention helped to increase muscular strength and lower tive function. Some evidence provided cognitive training
limb endurance in older adults, as well as their cardiovas- program that improved gait speed [53] and a composite gait
cular endurance [22]. Dancing involves contracting and task (timed up-and-go) [11] in older adults.
exercising the large leg muscles. Improvements in endur-
ance performance involve dynamic movements of the lower
limbs, such as 6MWT and the 2-min step test [49]. The lower General health
limb endurance may enhance cardiovascular endurance to
eliminate cardiovascular risk factors. It was suggested that SF-36 includes eight indicators: physical functioning, physi-
greater and significant improvement in ­VO2max should be cal role, pain, general health, vitality, social functioning, role
associated with longer training length, about 16–20 weeks of emotion, and mental health [54]. Common SF-36 indica-
(aged 65 years and older) [4]. Six studies were included in tors included in the two studies of this review were general
this meta-analysis with length less than 16 weeks. Future health, pain, and role of emotion [30, 45]. These two studies
dance intervention length should be longer than 16 weeks reported that dance could improve the general health and
which can promote V ­ O2max for healthy older adults. In sum- the quality of life for older adults. Dance intervention did
mary, endurance performance has been improved associated not effectively improve pain and emotional roles in SF-36.
with muscle force production capacity and inability to per- The pain and role of emotion improvement may need the
form daily living activities in older adults [2]. These results assistance of drugs and medical procedures [45]. These
showed a significant increase in endurance outcomes which results were in contrast to the reports of improved mood,
makes it easy to walk, go up and down stairs, and creating social contacts, and total satisfaction after dance intervention
smoother body movements during daily life for healthy older from previous studies [42, 44]. More studies are required for
adults. meta-analysis.
For study quality assessment using seven criteria recom-
Gait mended by the Cochrane Collaboration’s tool, there was a
low-to-moderate risk of bias in all 13 studies. However, a
Gait speed performance following dance intervention did few bias (performance and selection bias) showed a high
not produce significant results compared with the control risk of bias, all studies presented high risk in the perfor-
in this study. However, in other studies, using salsa dance mance bias due to that they did not use blinding, and eight
and dance video game training, significant improvement studies presented unclear risk in the selection bias [30, 31,
occurred in gait in the older adults [31, 50]. Out of five 36–39, 41, 43]. It was difficult to make a judgment for selec-
studies included in this meta-analysis, different types of tive reporting (reporting bias), as there were not enough
dance were involved [26, 31, 39, 40, 42]. We found that details in included studies, these results may influence the
line dancing can improve stride length, stride time, and gait outcome assessment of the intervention group when com-
speed [39, 40]. Line dancing is a simple aerobic dance that pared. In addition, most of included studies only contain
involves continuous integrated leg and trunk movements, small sample size calculations in their methodology [26, 30,
weight transfer, and postural control. Line dancing includes 31, 36, 39–41, 43]. The trials need to be adequately covered
walking in different directions, with abrupt turns and stops, to reduce the risk of random error and consequently false-
knee flexion, stepping, and stomping. Line dancing can be a positive results [55].

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Aging Clinical and Experimental Research

Dance intervention was reported to enhance the personal widely among the various trials, as did the study methods
psychological function of healthy older adults [56]. Dance and outcomes. In addition, there were not enough evidences
has been proven to be a safe and feasible activity [39]. Dance to check some physical function outcomes due to limited
intervention is considered more effective than other types of number of studies that could be included for meta-analysis.
activity to improve health [57]. Furthermore, dance expe- Finally, the female elderly largely outnumbered the male
rience with specific activities such as rhythm tasks, body elderly in the studies included, which makes it impossible
coordination training, tracking visual, and auditory cues to explore the gender differences in physical function in the
can improve neurocognitive performance [58–60]. Dance present meta-analysis.
is, therefore, a better method to prevent dementia and Par-
kinson’s disease for older adults [32].
Among the 13 studies included in this review, the dance
types most adopted for intervention were ballroom dance Conclusion
[36–38], traditional dance [31, 41, 43], and folk dance [30,
42]. These three dance types significantly improved physi- Only randomized-controlled trials were included in this
cal function of healthy older adults. The common features meta-analysis to investigate the effectiveness of dance inter-
of these three dance types are: mild and soothing rhythm, ventions on physical function in healthy older adults. The
utilizing breathing, diverse variation in steps, and more in results from this meta-analysis reveal that dance can improve
line with the physical strength and intensity of the elderly. mobility and endurance for healthy older adults, but gait was
This provides a future reference for the dance prescription not significantly improved through dancing. Dance exercises
for healthy older adults. A large number of studies have are also attractive for its entertainment effect and high par-
shown that dance therapy has a significant effect on disease ticipation rate, so they may be more preferred and utilized as
prevention and physical function improvement in the elderly an optimal approach to relieve aging. Meanwhile, the sub-
[12, 24, 46, 61]. stantial evidence from this meta-analysis also supports the
suggestion from the American College of Sports Medicine
that dance is an exercise can help to decrease fitness risks
Strengths and limitations and outcomes about sedentary and inactive behavior [63].
These findings will help to confirm the effectiveness and
The dance intervention results were effective on mobility efficacy of dance interventions on physical health indices
and endurance performance in healthy older adults when when compared to daily activities, and properly systematic
compared to no intervention (daily activities). Further- dance program would be a safe and effective exercise to
more, a meta-analysis showed that dance interventions sig- incorporate into daily life for healthy older adults who wish
nificantly improved body composition, blood biomarkers, to improve their physical function.
and musculoskeletal function compared to other forms of
physical activity [57]. Therefore, dance can be a safe and
Funding  This study did not receive any specific grant from funding
popular physical exercise for older adults. These results sup- agencies in the public. This research was funded by the authors.
port new evidence for elderly management. Results from
this meta-analysis and other related review studies suggest Compliance with ethical standards 
that a good dance exercise program for older adults should
conduct two or three times per week, 30–60 min each time, Conflict of interest  The authors declare that they have no conflict of
at least 6 weeks [2, 18, 21, 57]. In addition, it was suggested interest.
that a long-term (e.g., 6 months) dance intervention can pro-
Ethical approval  This is a meta-analysis study. It dose not contain stud-
vide more healthy improvements in older adults [62]. Future ies with human participants and animals performed by the authors of
studies need to ensure that the dance types, frequency, and this study.
intervention duration are tracked to identify which dance
intervention program is the most effective on the physical Informed consent  For this type of study, consent is not required.
health of older adults.
There are limitations that should be highlighted in the
included studies. First, there was wide variability in the
interventions. Different types of dance have different move- References
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