A feasibility study of a home-based ballet-inspired workout program to improve post-stroke physical and cognitive outcomes

Background: Balancing problems and memory loss are common in people after stroke. Growing evidence shows that dance-based interventions may improve the outcomes of gait, stability and cognitive functions among stroke survivors. Objectives: To establish the feasibility and preliminary effects of a home-based ballet-inspired workout program for stroke survivors. Methods: Thirty-two adults with a first-ever ischemic or hemorrhagic stroke were randomly assigned to the control or the intervention group, in which they completed an 8-week program grounded on Bandura’s principles of self-efficacy and outcome expectation. The program was delivered by a lay volunteer and a peer volunteer, and supported by a registered nurse. Participants practiced eight ballet-inspired workouts, mental rehearsal, and signature dance through a mutually agreed goal and action plan. Feasibility (recruitment rate, attendance, and safety), and survivors’ balance, balance confidence, gait, walking endurance, and memory were assessed at baseline and post-intervention. Individual semi-structured interviews were conducted to understand participants’ and volunteers’ experiences. Interview data were thematically analyzed. Bias-corrected Hedges’ effect sizes were calculated. Results: Four participants were recruited per month on average over eight months. The participants had a mean age of 62.7 years (standard deviation (SD)=12.9)). The attendance rate was 100%. No adverse events were reported. Two themes were identified: mutual multi-faceted benefits, importance of ongoing support strategies and program tailoring. Though showing small effect sizes and non-significant between-group differences, participants in the intervention group improved in all outcomes. Conclusions: The ballet-inspired workout program was safe and feasible, and may improve stroke survivors’ mobility, confidence, and cognitive outcomes.