Enhanced Lower Limb Strength and Dynamic Balance Among Older Canadian Women Following 12-Weeks of Online Ballet-Modern Dance Classes Combined with Blood Flow Restriction

Introduction: Falls are a leading cause of hospitalization among older women. While dance classes have gained popularity to reduce the risk of falls, in-person classes may be inaccessible. Online classes provide feasible solutions, but are limited by the lower intensity required by the virtual environment. Blood flow restriction (BFR) provides a safe way to mimic a higher intensity and promote greater strength. This study investigates whether the addition of BFR to 12-weeks of online ballet-modern (Graham and Limón) dance classes can effectively increase strength and dynamic balance among older women. Methods: 18 females were randomized into BFR and control groups. The BFR group wore 2-inch elasticized cuffs on their proximal thighs throughout the 75-minute Zoom dance classes. Strength and dynamic balance were assessed pre, mid and post using the 30-second Sit to Stand (30STS), Calf-Raise Senior (CRS) and the modified Star Excursion Balance Test (mSEBT). Time effects were assessed for each group using the Friedman’s test with Wilcoxon Signed-Rank post hoc ( P = 0.05). Results: Those using BFR significantly improved their strength at mid and post (30STS: pre-mid P = 0.012, pre-post P = 0.020; CRS: mid-post P = 0.018; pre-post P = 0.050), whereas control group participants only showed improvements on the CRS (mid-post P = 0.012, pre-post P = 0.008). During the mSEBT, the control group reached further in lateral directions ( P = 0.008-0.038), while BFR participants showed improvements when reaching in medial directions ( P = 0.008-0.038). Conclusion: The addition of BFR to online dance classes is a safe way to effectively increase physiological stress and improve strength and balance. This fun and novel program provides an accessible way for older women to reduce their risk of falls, maintaining their independence and quality of life.