Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis 

Introduction: Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence.

Methods: Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE.

Results: Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance vs usual care, Mean Difference (MD)=1.36; 95%CI -3.57 to 0.85), Sit-to-Stand (dance vs exercise MD=-0.85; 95%CI -2.64 to 0.93: dance vs education MD=-1.64;95%CI -4.12 to 0.85), Berg Balance Scale (dance vs usual care MD=0.61; 95%CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls.

Conclusions:
There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found.