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      Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update

      systematic-review

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          Abstract

          Background: Dance is an embodied activity and, when applied therapeutically, can have several specific and unspecific health benefits. In this meta-analysis, we evaluated the effectiveness of dance movement therapy 1 (DMT) and dance interventions for psychological health outcomes. Research in this area grew considerably from 1.3 detected studies/year in 1996–2012 to 6.8 detected studies/year in 2012–2018.

          Method: We synthesized 41 controlled intervention studies ( N = 2,374; from 01/2012 to 03/2018), 21 from DMT, and 20 from dance, investigating the outcome clusters of quality of life, clinical outcomes (with sub-analyses of depression and anxiety), interpersonal skills, cognitive skills, and (psycho-)motor skills. We included recent randomized controlled trials (RCTs) in areas such as depression, anxiety, schizophrenia, autism, elderly patients, oncology, neurology, chronic heart failure, and cardiovascular disease, including follow-up data in eight studies.

          Results: Analyses yielded a medium overall effect ( d 2 = 0.60), with high heterogeneity of results ( I 2 = 72.62%). Sorted by outcome clusters, the effects were medium to large ( d = 0.53 to d = 0.85). All effects, except the one for (psycho-)motor skills, showed high inconsistency of results. Sensitivity analyses revealed that type of intervention (DMT or dance) was a significant moderator of results. In the DMT cluster, the overall medium effect was small, significant, and homogeneous/consistent ( d = 0.30, p < 0.001, I 2 = 3.47). In the dance intervention cluster, the overall medium effect was large, significant, yet heterogeneous/non-consistent ( d = 0.81, p < 0.001, I 2 = 77.96). Results suggest that DMT decreases depression and anxiety and increases quality of life and interpersonal and cognitive skills, whereas dance interventions increase (psycho-)motor skills. Larger effect sizes resulted from observational measures, possibly indicating bias. Follow-up data showed that on 22 weeks after the intervention, most effects remained stable or slightly increased.

          Discussion: Consistent effects of DMT coincide with findings from former meta-analyses. Most dance intervention studies came from preventive contexts and most DMT studies came from institutional healthcare contexts with more severely impaired clinical patients, where we found smaller effects, yet with higher clinical relevance. Methodological shortcomings of many included studies and heterogeneity of outcome measures limit results. Initial findings on long-term effects are promising.

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          Measuring inconsistency in meta-analyses.

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            The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

            Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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              Trim and Fill: A Simple Funnel-Plot-Based Method of Testing and Adjusting for Publication Bias in Meta-Analysis

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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                20 August 2019
                2019
                : 10
                : 1806
                Affiliations
                [1] 1Department of Creative Arts Therapies and Therapy Sciences, Alanus University , Alfter, Germany
                [2] 2School of Therapy Sciences, SRH University Heidelberg , Heidelberg, Germany
                [3] 3Department of Psychology, Friedrich-Schiller-University , Jena, Germany
                [4] 4Department of Psychology, University of Bochum , Bochum, Germany
                [5] 5Department of Creative Arts Therapies, Drexel University , Philadelphia, PA, United States
                Author notes

                Edited by: Federica Scarpina, Italian Auxological Institute (IRCCS), Italy

                Reviewed by: Corinne Jola, Abertay University, United Kingdom; Kim Frances Dunphy, The University of Melbourne, Australia

                *Correspondence: Sabine C. Koch sabine.koch@ 123456alanus.edu

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2019.01806
                6710484
                31481910
                bf3aff36-61c3-48e8-88d0-1e11f7776cae
                Copyright © 2019 Koch, Riege, Tisborn, Biondo, Martin and Beelmann.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 22 January 2019
                : 22 July 2019
                Page count
                Figures: 4, Tables: 8, Equations: 3, References: 159, Pages: 28, Words: 22882
                Categories
                Psychology
                Systematic Review

                Clinical Psychology & Psychiatry
                dance movement therapy,dance interventions,meta-analysis,randomized controlled trial,clinical controlled trial,creative arts therapies,integrative medicine

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