Music, dance, evidence, education. Getting students and older adults moving in the "Key of G"
Purpose
Physical activity in the older adult population has well documented wellness benefits 1. However engaging the older adult in activity can be challenging with poor health, lack of company and interest 2 along with fear of falling 3 being the most cited reasons for non-participation. It has been shown that music can significantly increase participation and engagement in exercise4 as well as eurhythmics 5 and Tango 6. Social cognitive theory emphasizes peer modelling and social norms while resilience theory emphasizes positive interactions and having fun. Movement and music workshops designed on these theories to address specific areas of balance through themed activities, peer modelling and fun have been introduced at various senior living locations, using students in a service learning capacity.
APTA Choosing Wisely #2, emphasizes the need to adequately prescribe exercise for the older adult. Students who have participated in movement and music workshops have reflected on the activity ability of the older adult, along with the older adult’s resilience to participate thereby reinforcing the concept of adequate activity prescription. Service learning has been reported to address academic curriculum concurrently with community needs, and encourages student positive attitudes toward the older adult 7.
Methods and/or Description of Project
Movement and music workshops have been presented at various levels of senior living, including assisted living, memory care and low income senior housing locations. Students participate in a service learning capacity for their HSC Gerontology class, which falls at the end of their first year of full time study. Students are taught concepts of balance and exercise in a classroom situation, during which they complete a pre and post survey. Some of the students (chosen via a lottery system) participate in the movement and music workshops for their service learning. Students subsequently write a reflection paper on the experience that demonstrates how participation has influenced them.
Results/Outcomes
Classical conctent analysis of qualitative data from the surveys demonstrated that those students who participated in the workshops showed increased awareness of advanced concepts for addressing balance and activity in the older adult population. Comments in the reflection papers include emphasis that students have experienced the ability of the older adult to participate in exercise, the fact that music and dance encourages increased participation particulalry in the memory units, and the intensity at which older adults can be exercised. Concepts that cannot be taught in a classroom environment.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
Student ability to approach the older adult population with innovative and intensity appropriate activity was greatly enhanced through service learning participation in movement and music workshops. The use of dance style activity and themed choreography demonstrates a novel approach that cannot be appropriately experienced in a classroom setting. The experience helps reinforce the APTA choosing wisely concept of not under prescribing exercise for the older adult.
References
1.Goodman C, Davies S, Dinan S, Tai S, Iliffe S. Activity promotion for community-dwelling older people: a survey of the contribution of primary care nurses. British Journal Of Community Nursing [serial online]. January 2011;16(1):12-17 6p. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed January 28, 2016.
2.Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T. Barriers to physical activity in older adults in Germany: a cross-sectional study. The International Journal Of Behavioral Nutrition And Physical Activity [serial online]. November 2, 2011;8:121. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed January 28, 2016.
3.Bertera E, Bertera R. Fear of falling and activity avoidance in a national sample of older adults in the United States. Health & Social Work [serial online]. February 2008;33(1):54-62. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed February 23, 2016.
4.Shimizu N, Umemura T, Hirai T, Tamura T, Sato K, Kusaka Y. Effects of movement music therapy with the naruko clapper on psychological, physical and physiological indices among elderly females: A randomized controlled trial. Gerontology. 2013;59(4):355-67.
5.Trombetti, A, Hars, M, Herrmann, F, Kressig, R, Ferrari, S, Rizzoli, R et al. "Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial. Archives of internal medicine 2011;171.6: 525-533.
6.Hackney ME, B.F.A., Kantorovich S, B.S., Levin R, D.P.T., Earhart, Gammon M,P.T., PhD. Effects of tango on functional mobility in parkinson's disease: A preliminary study. Journal of Neurologic Physical Therapy. 2007;31(4):173-9.
7.Beling, J. Impact of service learning on physical therapist students' knowledge of and attitudes toward older adults and on their critical thinking ability. Journal of Physical Therapy Education 2004.
Course Objectives
Analyze the benefits of service learning for students in a DPT program.
Analyze the compliance issues for encouraging the older adult population to participate with activity.
Discuss the implications of using social cognitive and resilience theories in designing activity promotion programs for the older adult.
Analyze the research and implications of using music, rhythm and dance for activity promotion and balance in the older adult
Participate in themed choreography designed to address balance strategies and activity promotion
Discuss locations and populations, across the older adult spectrum of care that have successfully utilized the program being described.
Apply student comments and feedback to service learning and integrated clinical education program development
Take home concepts that can immediately be incorporated into a variety of clinical and academic settings.
Instructional Methods
Lecture, covering the theory and research behind the development of the workshop.
Active participation of themed choreography to experience the types of activities
Discussion regarding the influence of the workshops on student learning.
Tentative Outline/Schedule
5 min: Introduction and objectives
15 min: Analyze the research regarding service learning and influence on students’ understanding and attitudes to the elderly and discuss the influence of this program through student reflections. To include 1 choreographed movement break
15 min: Analysis of the literature discussing the health benefits of activity in the older population and lack of compliance of the older adult. Include discussion on the frail older adult, the AL community and their need to increase activity. To include 1 choreographed movement break
10 min: Present the different theories including social cognitive theory and resilience theory along with current theories of aging with relation to designing activity programs for the older adult. To include 1 choreographed movement break
10 min: Present the research and programs currently available that utilize movement or music to include dance for PD, Tango for PD, Eurhythmics, and clapper. To include 1 choreographed movement break
15 min: Discuss balance strategies commonly impaired in the older adult, and discuss and demonstrate themed concepts that can be incorporated into a program for the current silent generation. To include 1 – 3 choreographed movement breaks.
10 min: Discuss the different locations that have so far been included in this workshop, to include memory care, AL, low income senior housing, home health and analyze the strengths and pitfalls for each location. To include 1 choreographed movement break
Question and answer session