Literature Review: Needs Assessment for a Dance-Based Program

Dance-based movement is evidenced to have a positive, holistic impact on therapy outcomes (cognitive, physical, social, and emotional) and increased brain plasticity in neurorehabilitation (Aldana-Benítez et al., 2023; Allen et al., 2017; Basso et al., 2021; Bek et al., 2022; Bruyneel et al., 2023; Hackney & Earhart, 2010; Hackney, Burzynska, & Ting, 2024; Joung et al., 2021; Kullberg-Turtiainen et al., 2019; Teixeira-Machado et al., 2019; Trinkler et al., 2019; Wu et al., 2022). Dance interventions are shown to improve motor performance, body coordination, and quality of life across many neurological conditions including stroke, TBI, Huntington’s disease, CP, and Parkinson’s disease (Aldana-Benítez et al., 2023; Bruyneel et al., 2023; Hackney & Earhart, 2010; Joung et al., 2021; Trinkler et al., 2019). Current literature on dance-based intervention approaches also suggest associated structural and functional brain changes: increased gray matter volume, neuromuscular consistency, enhanced motor module recruitment, and improved motor performance through rhythm-based motor facilitation (Allen et al., 2017; Hackney, Burzynska, & Ting, 2024; Teixeira-Machado et al., 2019). Occupational therapy’s person-centered and individualized approach to patient care aligns with the physical, cognitive, social, and emotional benefits of participating in dance movement (Basso et al., 2021; Hackney, Burzynska, & Ting, 2024).  

My capstone project will further investigate if evidence-based movement utilizing dance as a goal-directed intervention can lead to enhanced occupational outcomes for the outpatient neuro population. Dance provides a crucial avenue for individual expressivity in the rehabilitative process (ldana-Benítez et al., 2023; Kullberg-Turtiainen et al., 2019). Fundamental movement patterns provide an approach to restore neuronal connections in the body for more efficient functioning within a context which encourages personal expression and full psychophysical involvement (Basso et al., 2021)

The literature identifies current gaps in knowledge regarding dance therapy as a consistent and sustainable intervention for OT practice (longevity of therapeutic benefits) (Aldana-Benítez et al., 2023; Allen et al., 2017; Basso et al., 2021; Bek et al., 2022; Bruyneel et al., 2023; Hackney & Earhart, 2010; Hackney, Burzynska, & Ting, 2024; Joung et al., 2021; Kullberg-Turtiainen et al., 2019; Teixeira-Machado et al., 2019; Trinkler et al., 2019; Wu et al., 2022). Although dance movement research is expanding within rehabilitation, there is limited evidence specific to Bartenieff Fundamentals, Somatics, and Laban Movement Analysis as structured models of movement for patients (Basso et al., 2021; Teixeira-Machado et al., 2019). Additionally, there is limited objective measures for neuroplasticity and body connectivity, as most research has been completed on small samples of participants or pilot studies - this has led to more subjective outcomes (perceived body awareness and emotional changes) to determine therapeutic progress and potential of dance as an intervention (Kullberg-Turtiainen et al., 2019; Trinkler et al., 2019). In many of the studies, there are evident contextual constraints such as clinician knowledge and experience with dance and dance-based modalities, as well as rigor of dance-based interventions based on insurance limitations and therapist workload. Thorough review of the literature has emphasized the importance of using measurable clinical outcomes (measures such as the TUG, BERG, ABC Scale). There is an additional need to collect patient reported perception scales (surveys) to distinguish the effectiveness of dance-based interventions and to maintain curriculum flexibility during initial program development. 

At my capstone site, Mayo Clinic PHX General Outpatient Rehabilitation, many patients experience persistent deficits in dual-tasking, balance, coordination, and endurance - all areas in which dance-based interventions have proven impactful across neurological conditions including stroke, Parkinson’s disease, CP, TBI, and Huntington’s disease (Aldana-Benítez et al., 2023; Bruyneel et al., 2023; Hackney & Earhart, 2010; Joung et al., 2021; Kullberg-Turtiainen et al., 2019; Trinkler et al., 2019). A structured dance program may address unmet needs of patients who struggle with motivation, social and emotional well-being after diagnosis of neurological conditions - assisting them through an evidence-supported method to enhance neuroplasticity and multisensory engagement which is inherent in dance (Basso et al., 2021; Bek et al., 2022). Patients also need meaningful, functional exercises to include in Home Exercise Programs (HEPs) to establish carry-over in the home and longevity of therapeutic benefits. Mayo Clinic outpatient rehabilitation prioritizes patient centered interventions that are meaningful and high intensity (to promote neuroplasticity). Integrating dance-based interventions could expand OT practice and promote long-term functional gains through digital education materials for the patients’ HEPs. Dance can be utilized in therapy sessions to not only promote coordination and balance of gross-motor function, but can enhance mind-body awareness and bring meaning to movement (Aldana-Benítez et al., 2023; Allen et al., 2017; Basso et al., 2021; Bek et al., 2022; Bruyneel et al., 2023; Hackney & Earhart, 2010; Hackney, Burzynska, & Ting, 2024; Joung et al., 2021; Kullberg-Turtiainen et al., 2019; Teixeira-Machado et al., 2019; Trinkler et al., 2019; Wu et al., 2022).