Is ballet good exercise for older people?

As a specialist in weight issues for women over 50, I am forever searching around for enjoyable exercise options for my clients.  In order to maintain a healthy weight, it is important to consider how to keep our muscles in tone.  Muscle is metabolically active, so as well as giving us strength and endurance, healthy muscles increase the rate at which our body uses nutrients and thus guards against metabolic diseases like diabetes type 2.

Most of my clients enjoy walking, and tend to follow the advice of taking moderate exercise every day for half an hour or so. But for those who have the energy, a slightly more strenuous exercise regimen is recommended.  Walking is aerobic exercise, it is good for health and weight loss, but it is resistance exercise that will stretch muscles a bit more.  Some people will go to a gym for this type of exercise, but gyms are often unwelcoming to older patrons and the 20 something instructors may not be well trained in helping older customers, especially if they have health issues. I believe that the best exercise is social and creative as well as appropriately strenuous.  There are loads of things to do that are much more fun than gyms.

Recently one of my clients suggested that she might like to go to ballet classes and I decided I’d go along as well.  London is spoilt for ballet classes for active older people.  Sadler’s Wells even runs a Company of Elders where international choreographers work with people in their 60s, 70s, 80s and beyond to make and perform new works1.  The Royal Academy of Dance sponsors ‘Silver Swans’ instructors who run classes for men and women all over the country.  Their web has stretched to the rest of Europe and there’s even a Silver Swans group in New Zealand2.

My friend and I chose to join a beginner’s class run by Simona Scotto at the Claremont Centre in Islington. I’m glad I remembered to ask what we should wear.  In fact, most beginners’ classes don’t require very strict dress codes, the same thing you’d wear to any exercise class will do. Though you won’t look out of place if you wear the classical ballet uniform of leotard, tights and ballet shoes.

After the first lesson, which didn’t seem taxing, I must have used several muscle groups I didn’t know I had. The next day I felt quite stiff.  That’s a good thing, and didn’t stop me doing my normal aerobic exercise of walking the dog the next day.  I decided to look at the science of ballet, to find out where it was doing me good.  There have been quite a few studies that investigate the benefits of dance classes for older people.  Some studies have looked at silver swans, some at seated ballet for less active older people, others have looked at the benefits for people with dementia or Parkinson’s – and for all of these the outlook looks positive.  Other studies have looked at different types of dance. But is the exercise that ballet provides better than say Zumba, line dancing or cha-cha-cha? Simply getting out and about, working with a like minded group and being spurred on by music and rhythm seems to be good for all of us.

There are a few reasons why ballet might be just a bit better than other dance exercise. Firstly, ballet exercise work muscles that we don’t always use in everyday life (hence my aches the next day).  And secondly ballet requires us to use the creative and imaginative parts of our minds, not simply to remember and follow the steps.  There is growing evidence that that might be good to guard against dementia.

The nature of ballet practice, most notably Aplomb, Turn Out, Ports de Bras and Battements Tendus all exercise muscle and ligament groups that are important to the prevention of falls, and in cardiopulmonary maintenance.  These moves are ubiquitous in ballet, but not as common in other dance or exercise routines.

We all assume that falls are mainly due to bone loss, not muscle loss.  But clinicians now realise this is very far from the truth.  In the US the risk of hip fractures has been calculated to increase by 100-fold between the ages of 60 and 84, but bones don’t reduce to 1% of their strength.  The missing factor is muscle strength, coordination and changes in the way we walk as we become more timid.

In ballet much of the art is associated with graceful movements and balance.  The dancer is encouraged to engage both arms and legs in any movement across the floor.  They stand, walk, or run on tip-toe. Ballet teaches us to become more aware of the body’s position in space, straightening and lengthening the spine while using the limbs and the head to adjust the balance. This is described as the aplomb, the term being ascribed to the famous Russian teacher Agrippina Vaganova 3.

Some of that confidence and balance may rub-off on our normal walk. The term ‘silver swans’ so beloved of older persons ballet, is itself a description that can evoke a tall stance, an elegant poise and strong rhythmic movement.   Before we can move a muscle, our brain must imagine and plan that movement.  It takes a split second, but muscles never move on their own. It is the engagement of sophisticated brain activity, using imagination, memory, rhythm and creativity that perhaps influences the movement most powerfully and which is so expressively realised in aplomb.

In ballet the turnout is use to describe the angle of the feet. In first position a professional ballet dancer will stand, heels together, feet turned out 180o away from each other.  In leisure ballet the feet in first position are most likely to be placed at 90o.  But in fact, all the turned-out ballet positions are primarily achieved by rotating the thigh bone in the hip socket, with the knee, calf, ankle and foot in dynamic partnership, following – not leading – the pelvic level movement.  Even the most gentle of first positions will stretch all the leg and hip muscles, including the deep lateral rotators [a], six small muscles that arise from different points around the sacrum and strengthen the pelvic girdle.  These muscles all terminate at the greater trochanter (the easily felt bony knob on the outer face of the femur or thigh bone). It may be that by strengthening all these muscles, including the deep rotators, that older people can maintain a more confident and upright gait.

In addition, by exercising the gluteus maximum (muscles flanking the back of the pelvic bone) and the quadriceps (thigh muscles) [b] we are building the ‘padding’ that will help to protect our hip and pelvic bones if we fall, as well as exercising other muscles and tendons that stabilise the leg and knee.

Ports de bras literally means ‘carriage of the arms’ and refers not only to the classical arm positions, but also to the flowing moves that create the graceful and expressive gestures of the upper body.   Even people, who may have difficulty walking or standing, can derive exercise benefit and pleasure from some of the classical arm routines.

While these movements are generally gentle and thus easy to perform, they confer beneficial exercise on the heart.  Arm exercises, simply because the arms are lifted above the heart, provide a good cardiovascular workout at lower levels of exertion, or where it simply isn’t possible to stand for any length of time4.

Above: The difference between confident and less confident walking stances. Source Cummings and Nevitt, 1989.

During a fall there is a very short critical period of time in which to take protective action; to extend an arm to minimise impact, to grab onto something, or to perform rapid movements of the feet in order to re-stabilise the body or decrease the downward velocity, as shown in Fig3/4 above 5.  The battements tendu are quickly performed leg stretches and heel/toe bends that manoeuvre one foot in front, to the side or to the rear.  In ballet, a certain caché is derived from increasing the speed and accuracy of these moves, which in themselves are by no means strenuous.  But in a fall, having recourse to such a speedy series of protective manoeuvres can be very useful in order to regain stability.

As we age our memory does decline, and for some of us that decline will slip into dementia.  But even though dementia and Alzheimer’s is now the most common cause of death in England for both men and women over 80, this decline may not be inevitable. For example, some research shows that our ability to remember, both short or long term, may not be the most important aspect of brain power.  Neurologists are beginning to suggest that fluid intelligence might be more important than working memory.  Fluid intelligence is the ability to adapt our knowledge to a new situation or challenge.  It has been shown to be a skill that improves with mental exercises. Ballet lessons, where learning the choreography requires a complex overlay of spatial, social and memory skills, can provide a really good cognitive workout. In addition, imagination must be used in motivating the various moves and in improvisation.

There is evidence that activities such as ballet, that combine complex motor functions with a dual-task nature can improve executive cognitive performance, maintaining executive and attentional abilities.

In a study of choreographed dance moves in Japan, acute effects were observed on executive cognitive function that were significantly more impressive when the class had to learn each move and then put them together by improvising, rather than simply copying the teacher.

Mastering a slightly tricky ballet move provides the senior student with an important feeling of being in charge.  The Queensland Ballet group found that respondents reported improvements in self-confidence, self-esteem and coping strategies 6.  In Melbourne older women dancers have been shown to have stronger social ties, and feel less marginalised by continuing their ballet practice 7.

The type of exercise that ballet offers, and the moves and muscle groups that are stimulated in an ordinary class may be vital to reduce the danger of falls.  More research would certainly be welcomed to find out how ballet might be moulded to help older active people to remain resilient.  And the complex layering of memory, repetition and imagination that it can contribute to cognitive agility would seem to mark it out as potentially special.

Today we know that ballet is enjoyed by many active older adults, it certainly provides a level of physical and cognitive exercise and social stimulation as good as any other form of dance class. Ballet teachers should be aware of ballet’s potential to reduce the danger of falls by incorporating choreography associated with confident walking and stability.  There is some evidence that the use of imagination is important in movement – and that that self-expression can be a useful tool in maintaining agency, so part of the class could be set aside for improvisation.

I’ve found the ballet so enjoyable that I’ve recently joined another Silver Swans class in Hampstead run by Bluebirds Ballet School, led by Emma McMahon, a registered silver Swans teacher.

[a] Deep lateral rotators include piriformis, superior gemellus, obturator internus, inferior gemellus, obturator externus and quadratus femoris.

[b] Quadriceps include vastus intermedius, rectus femoris, vastus lateralis and vastus medialis

FURTHER INFORMATION

  1. Sadler’s Wells Theatre – Company of Elders. Available at: https://www.sadlerswells.com/learning/learning-performing/company-of-elders/. (Accessed: 29th September 2019)
  2. Simona Scotto Dance Artist and Educator for the Over 50s.
  3. Royal Academy of Dance. Dance Classes for Seniors | Silver Swans | Royal Academy of Dance. Available at: https://www.royalacademyofdance.org/silverswans/. (Accessed: 27th September 2019)
  4. Vaganova, A. Basic Principles of Classical Ballet. (1948).
  5. Pendergast, D. Cardiovascular, respiratory, and metabolic responses to upper body exercise. Med. Sci. Sports Exerc. (1989).
  6. Cummings, S. R. & Nevitt, M. C. A HYPOTHESIS: The Causes of Hip Fractures. Journal of Gerontology: MEDICAL SCIENCES 44, (1989).
  7. Ali-Haapala, A., Moyle, G. & Kerr, G. Ballet Moves for Adult Creative Health Stage One-Research Report  Ballet Moves for Adult Creative Health Research Report. (2018).
  8. Southcott, J. & Joseph, D. “If you can breathe, you can dance”: Fine lines contemporary dance for mature bodies in Melbourne, Australia. J. Women Aging, 1–20 (2019).

 

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