Background and Objectives: Older adult social inclusion involves meaningful participation that is increasingly mediated by information communication technology and in rural areas requires an understanding of older adults’ experiences in the context of the digital divide. This article examines how the multimodal streaming (live, prerecorded, blended in-person) of the Sharing Dance Older Adults program developed by Canada’s National Ballet School and Baycrest influenced social inclusion processes and outcomes in rural settings. Research Design and Methods: Data were collected from on-site observations of dance sessions, research team reflections, focus groups, and interviews with older adult participants and their carers in pilot studies in the Peterborough region of Ontario and the Westman region of Manitoba, Canada (2017–2019). There were 289 participants including older adults, people living with dementia, family carers, long-term care staff, community facilitators, and volunteers. Analytic themes were framed in the context of rural older adult social exclusion. Results: Remote delivery addressed barriers of physical distance by providing access to the arts-based program and enhancing opportunities for participation. Constraints were introduced by the use of technology in rural areas and mitigated by in-person facilitators and different streaming options. Meaningful engagement in dynamic interactions in the dance was achieved by involving local staff and volunteers in facilitation of and feedback on the program and its delivery. Different streaming technologies influenced social inclusion in different ways: live-stream enhanced connectedness, but constrained technical challenges; prerecorded was reliable, but less social; blended delivery provided options, but personalization was unsustainable. Discussion and Implications: Understanding different participants’ experiences of different technologies will contribute to more effective remote delivery of arts-based programs with options to use technology in various contexts depending on individual and organizational capacities.

Background: Dance has emerged as a complementary treatment that may promote adaptive neural plasticity while improving symptoms of Parkinson disease (PD), such as balance, gait, posture, and walking. Understanding brain changes that arise from participation in dance interventions is important as these neural plastic changes play an important role in protecting and healing the brain. Although dance has been shown to improve PD motor and nonmotor symptoms, the neural mechanisms underlying these changes, specifically depression and mood, remain elusive. Further, many side effects of PD drug treatments can be exacerbated or even induced by dopaminergic drugs, particularly depression and anxiety, making these nonmotor symptoms more noticeable throughout the progression of the disease. Objective: In this study, we focused on the impact of dance interventions on PD nonmotor symptoms by conducting an 8-month observational study, tracking the relationship between depression scores and functional neuroimaging measures for people with PD. Methods: A total of 34 dancers—23 (68%) people with PD and 11 (32%) healthy controls—completed the Geriatric Depression Scale (GDS) before and after attending weekly community-based dance classes, referred to as Dance for PD classes. Specifically, we examined changes within the functional magnetic resonance imaging signal from the subcallosal cingulate gyrus (SCG), an important node within the depression network and a controversial target for deep brain stimulation in the treatment of major depressive disorder. Results: Depression scores on the GDS decreased in each preintervention to postintervention comparison (all P<.025). In addition, GDS scores also improved over the 8-month dance period (all P<.01). Blood oxygen level–dependent signals from frontal cortex brain region implicated for emotional regulation within the SCG decreased at each testing time point (all P<.05). Also, a significant decrease in depression scores (GDS) was correlated with reduced blood oxygen level–dependent signals from the SCG (P=.02). Conclusions: This study contributes to an improved understanding of the neural mechanisms that are involved in depression, as well as the beneficial contribution that longitudinal dance interventions have in reducing nonmotor symptoms associated with PD, particularly in depression symptoms.

Aim: To outline the successful development and implementation of a nurse practitioner role within a professional ballet school. Background: Nurse practitioners are well integrated into primary and acute care in Ontario, yet the role within schools and private athletic institutions is not well documented. Canada’s National Ballet School is a professional ballet school with a combination of day students and those living in residences. Students complete both dance training and academics at the School. The physical and mental health of students was identified as a key priority by the school, leading to the development of an integrated health and wellness program. To facilitate more timely access to healthcare and provide an opportunity for collaboration and consultation within the school, a plan to implement a nurse practitioner role into the school was developed. Methods: In order to develop and implement the role of the nurse practitioner within the institution, the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (PEPPA) framework was used. The first seven steps of the PEPPA framework were applied in this project. Findings: The PEPPA framework allowed for us to identify key barriers and facilitators for the role implementation and successfully implement the nurse practitioner role. While the initial plan was for a slower implementation, the COVID-19 pandemic highlighted the need for a nurse practitioner in the institution more urgently. Conclusion: The PEPPA framework provided us with an organized process for developing and implementing the nurse practitioner role at Canada’s National Ballet School.

Dance, Ageing and Collaborative Arts-Based Research contributes a critical and comprehensive perspective on the role of the arts –specifically dance – in enhancing the lives of older people. The book focuses on the development of an innovative arts-based program for older adults and the collaborative process of exploring and understanding its impact in relation to ageing, social inclusion, and care. It offers a wide audience of readers a richer understanding of the role of the arts in ageing and life enrichment, critical contributions to theories of ageing and care, specific approaches to arts-based collaborative research, and an exploration of the impact of Sharing Dance from the perspective of older adults, artists, researchers, and community leaders. Given the interdisciplinary and collaborative nature of this book, it will be of interest across health, social science, and humanities disciplines, including gerontology, sociology, psychology, geography, nursing, social work, and performing arts. Licence line: Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.

Community-based dance training has proven beneficial for people with Parkinson’s (PwPD) and their caregivers. It promotes structural and functional changes in brain regions associated with visual motor processes while improving quality of life, along with motor and non-motor symptoms. The specific neurobiological network effects of long-term dancing in a community setting are yet to be determined. This study seeks to elucidate specific contributions of visual motor learning on brain activation signal changes in areas associated with this network. This longitudinal neuroimaging investigation reports on neural changes for 10 PwPD who regularly participated in weekly Dance for Parkinson’s classes at Canada's National Ballet School for 8 months. Visual motor training included watching, following, and repeating complex motor sequences accompanied by live music provided in the studio. Participants progressed through upper and lower body sequences before engaging in whole-body movements through space in a learned choreographic sequence supported by in-class volunteers. Participants were instructed to imagine/visualise performing this choreography from a first-person perspective as if they were in the studio. Four scanning sessions were completed at different stages of learning in the months of September, December, January, and April while fMRI was performed while the participant listened to music and imagined the dance movements from the training classes for 1-minute blocks interspersed with 30s fixation blocks. Significant activations were observed in SMA, pre-SMA, auditory, insula, premotor, parietal, caudate, putamen, thalamus, cerebellum (P<0.0001, Bonferroni correction). The observed pattern of activation across timepoints demonstrates learning as an effect of long-term training in SMA, pre-SMA and cerebellum (P<0.05). These results indicate that long-term community dance training promotes BOLD cortical changes in regions involved in visual motor learning with imagery and performance. It is hypothesised that these functional changes are also associated with structural improvements that support adaptive plasticity.

Background: Parkinson's disease (PD) is the most common neurodegenerative disorder after Alzheimer's disease, and is characterized by motor and non-motor symptoms, including gait dysfunction and cognitive decline. Dance has emerged as a promising intervention for improving motor and non-motor symptoms in persons with PD (PwPD), yet long-term effects remain underexplored. Objective: To assess changes in cognitive function and gait performance over six years among PwPD who participated in a weekly dance program, compared to a Reference group who remained physically inactive. Methods: This six-year longitudinal observational study included 43 PwPD who attended weekly dance classes and were evaluated using the Mini-Mental State Examination (MMSE) and Movement Disorder Society–Unified Parkinson's Disease Rating Scale (MDS-UPDRS). A Reference group of 28 PwPD, matched on age, gender, and Hoehn & Yahr scores, were selected from the Parkinson's Progression Marker Initiative, and assessed using the MDS-UPDRS and Montreal Cognitive Assessment (MoCA). Cognitive scores were standardized. Generalized estimating equations were used to compare cognitive and gait outcomes across time. Results: The Dance group was significantly different from the Reference group ( p < 0.001), with improved cognitive scores in 2016, 2017, and 2018. The Dance group had worse gait at baseline, however, the Reference group showed significantly poorer gait performance by 2018. In a subset of our data (n=10), no significant association was found between gait and cognitive scores. Conclusions: After two years of weekly dance, the Dance group showed improvements in cognition and maintained stability in gait performance. The findings highlight the potential neuroprotective benefits of continued dance engagement over six years.