Purpose:
Cerebral palsy (CP) is defined as a group of permanent disorders of the development of
movement and posture that are attributed to non-progressive disturbances which occurred
in the developing fetal or infant brain. As children with CP experience development and
growth, motor disorders present along with disorders related to sensation, perception,
cognition, and/or a seizure disorder. The way that CP manifests itself can change over
time as a child grows and their surrounding environment changes, however, the lesion does
not change. Throughout childhood and adolescence, a common obstacle that children with
cerebral palsy face is a lack of participation and inclusion in the same leisure
activities containing physical activity as their peers due to physical, cognitive, and
social limitations. Currently, there is limited research pertaining to the concepts of
adapted dance and its relation to children with CP and in turn, limited information about
the benefits that these programs offer to the target population.
Background and Intervention Children with CP may not participate in the same leisure
activities containing physical activity as their peers due to physical, cognitive, and
social limitations. Children with CP who lack opportunities for physical activity are at
increased risk for fatigue, injury, and pain secondary to maladaptation resulting from
exacerbating physical impairments. To decrease these risks, it is imperative that
children with CP participate in physical activity and develop a habit of healthy
exercise. However, opportunities for physical activity must have accommodations for
physical and cognitive deficits experienced by this population. Thus, an adapted sports
program, such as dance, can be developed to cater to the target population. The program
developed should be a physical activity that is meaningful and engaging. Thus, an adapted
dance or sports program for the target population could be an effective solution to the
obstacle.
Of the current research conducted on adaptive dance programs for children with CP, there
is an overall theme of the active ingredients used in the programs. Each dance class was
60 minutes in length for 2-3x per week depending on the study. Most of the dance programs
recruited volunteers to support participants throughout the dance class as needed. All
programs consisted of a warm-up section and a cool-down portion at the end of class. The
type of dance ranged in each study from hip-hop, ballet, and a variety of all dance
types. The major theme of all adaptive dance programs for children with CP included focus
on repetition of movements and an improvisation portion of the class. Dance movements
were focused on balance, postural control, and directional movements. All programs
consisted of a dance performance for participants' families and friends. The main
outcomes from included significant gait improvement and control of movements. Major
outcomes of an adaptive dance program can include significant improvement in
coordination, balance, and endurance.
The use of the action-observation treatment intervention strategy has yielded a
significant amount of evidence that shows the activation of the mirror neuron system can
help improve specific motor skills. This motor learning technique has been successfully
applied in a variety of adult populations such as stroke patients and Parkinson's disease
patients, as well as more recently, children with cerebral palsy. In the context of
rehabilitation sessions, patients typically work on one action per session, and this
action is separated into 3 to 4 consecutive motor actions. Each action is observed for at
least 3 minutes, with the total action then taking 12 minutes to observe. Actions are
shown from multiple perspectives to further enhance learning. Following the observation,
participants spend at least 2 minutes imitating the observed actions. The total time a
session takes is typically 30 minutes.
In the context of a dance class, the research team will incorporate an action-observation
technique as a method of teaching choreography steps. A section of a dance routine will
be focused on for the duration of one class session, with the dance section broken up
into 3 to 4 smaller movements. The environmental aspect of adding a mirror will add
multiple perspectives for participants to observe the instructor performing dance
actions, which could enhance learning and comprehension of dance moves.
Study Design A quasi-experimental mixed-method study will be conducted with clinical
assessments completed pre-intervention and post-intervention to determine the feasibility
and the impact of the intervention. The intervention will consist of participating in a
1-hour class, two times a week for 10 weeks.