Feasibility of a live-stream dance class for people with chronic stroke

Adapted dance is a promising intervention to improve physical and psychosocial well-being post-stroke. At-home participation with a live-streamed dance program could address barriers to in-person attendance (e.g., limited community ambulation, and transportation). However, psychosocial benefits may be diminished because of reduced social interactions. The primary study objective was to assess the feasibility and safety of a live-streamed dance program for chronic stroke. Secondary objectives were to characterize participants who chose live-stream vs in-person options and quantify pre-post-changes in balance, gait and social connection.

People with chronic stroke chose to attend a live-streamed adapted dance program in-person or at home twice a week for 4 weeks. Feasibility criteria were tracked, and participants were characterized with self-report (Center for Epidemiologic Studies-Depression Scale; CES-D) and performance-based measures (e.g., Montreal Cognitive Assessment and Chedoke McMaster Assessment) at baseline. Pre-post-secondary measures included gait speed, Mini-Balance Evaluation Systems Test, Activities of Balance Confidence Scale, and Inclusion of Community in Self scale. Unpaired median/mean differences in baseline clinical presentation were used to compare groups. Paired median/mean differences were used to examine change in secondary outcomes.

Interest and enrollment rates for both groups combined were 87% and 38%, respectively. Of those enrolled, 8/13 chose in-person and 5/13 chose live stream. In-person and live-stream attendance rates were 83% and 89%, and retention rates were 80% and 75%, respectively. There were no major adverse events related to the classes. There were 3 unrelated minor events of fatigue and 1 minor event of muscle soreness as expected with exercise. At baseline, the in-person group had greater depressive symptoms (CES-D score, median [IQR] difference: 11.5 [-21.5, -5]), and faster mean gait speed (-25.8 cm/s [-50.98, 0.006]) than the live-stream group. There were no pre-post-changes in secondary outcome measures.

A live-streamed dance intervention featuring in-class and at-home participation is safe and feasible for people with chronic stroke. These results will inform a future randomized controlled trial of a live-stream dance program with a longer duration while considering how factors such as gait function and mood may relate to the choice between in-person and at-home attendance.