Increasing Physical Activity in Children: An Intrinsic Creative Movement and Creative Dance Approach
INTRODUCTION
In the animal world, penguins are known to face some of the harshest conditions on earth. Most of the species live in Antarctica and, on average, it is the coldest, driest, and windiest continent with temperatures reaching −40 °C (−40 °F). Penguins have an extensive social support system that enables them to survive these harsh conditions (38). Spinning off these facts, in 2006 Warner Brothers produced a comical, computer-animated film about penguin life (Happy Feet). The star of the film was a young penguin named Mumble (3). Because he was different than other penguins, Mumble was ridiculed and isolated by his elders, and only later in the movie was he able to win over the elders and a significant other. He managed this feat by using his talented tap dancing movements. As Mumble tap danced, viewers could observe his self-expression of movement and creativity that came from the upbeat percussion feedback. Children loved the movie. Two questions may come to mind when reflecting on this animated film. First, do the feelings of rejection and isolation experienced by Mumble align with emotions felt by obese children today? And, although not part of the storyline in Happy Feet, consider if Mumble was one of the nearly 12.5 million children and adolescents suffering from childhood obesity in the United States (1,2). Could creative dancing or other creative movement be a potential method to help counter any feelings of rejection and isolation and also be a potential fun way to increase physical activity levels, especially by children who are obese?
PREVALENCE OF OBESITY AND PHYSICAL INACTIVITY
Childhood obesity continues to be prevalent in the United States (2,13,31). Data shows that obesity rapidly increased among children and adolescents between the 1980s and 1990s, and this increase occurred during a similar time of reductions of daily physical activity (2,26). The National Health and Nutrition Examination Survey (NHANES) estimates that 17% of U.S. children and adolescents aged 2 to 19 yr are obese, and another 15% are overweight (13). The potential for a life of disease and disability is very high in these children. Several well-documented health consequences are associated with obesity that can begin as early as childhood including: dyslipidemia, high blood pressure, heart disease, diabetes, asthma, sleep apnea, and cardiovascular disease (7,12,32). In addition, overweight and obese children and adolescents face various psychosocial comorbidities and are at risk for poor health and premature deaths as adults (7,12,32).
The U.S. Department of Health and Human Services (HHS) has published physical activity guidelines recommending that children engage in daily physical activity (37). These recommendations include aerobic exercise performed a minimum of 3 d·wk−1 (but ideally daily) for a minimum of 60 min and at a moderate to vigorous intensity. And when possible, resistance training exercises should also be incorporated at least 3 d·wk−1 to promote an improved body composition (37). Physical inactivity (PIA) is a term to identify children who do not meet this recommended amount of daily physical activity.
A high prevalence of PIA among children in the United States is well-documented for both sexes and the majority of various races and ethnicities (9,10,17,34). Comparable to obesity, the prevalence of PIA is associated with a number health risks such as diabetes, hypertension, coronary heart disease, colorectal cancer, premature mortality, obesity, and various psychosocial disorders among U.S. children and adolescents (17). As a result, regular exercise is increasingly becoming accepted as an initial treatment of choice for children and adolescents for disease prevention and health promotion in the United States (37).
The purpose of this manuscript is to review several behavioral theories related to encouraging engagement in PA. This evidence will serve as an underlying theoretical framework for practitioners to implement creative movement and creative dance as a viable PA intervention. This paper will conclude with a practical review of implementing a creative movement and/or dance program for children and adolescents.
BEHAVIORAL THEORIES FOR EXERCISE ADOPTION, ADHERENCE, AND MAINTENANCE
While viewing the talented and fancy footwork of Mumble, viewers might wonder how to motivate someone to practice and become as accomplished as this character? Several behavioral theories to promote exercise adoption and adherence are listed in Chapter 11 of the ninth edition of the ACSM Guidelines for Exercise and Testing and Prescription (ACSM-GETP). These theories include the Social Cognitive Theory (SCT), the Transtheoretical Model (TTM), and the Self-Determination Theory (SDT) (5,10,18,19,39). For each of these theories, the underlying behavioral concepts of self-efficacy and enjoyment are extremely important. Self-efficacy is defined as an individual's belief in the ability to initiate and successfully complete an endeavor. Importantly, it is related to the behavioral theories with respect to what might prompt a child to adopt exercise as a permanent lifestyle activity. Exercise programs that allow for choice and a variety of movements (i.e., creativity) offer individuals a feeling of enjoyment and reward (19,39).
The SCT is a comprehensive concept based on the inter-relational effect of the individual (i.e., emotions or personality), the individual's current behavior (e.g., previous exercise), and the individual's environment (i.e., physical, social, cultural) upon a targeted behavior such as PA. The TTM is the most oft used method for assisting individuals to adopt increase exercise behaviors (1). The TTM theory consists of five stages of change that include: 1) precontemplation, 2) contemplation, 3) preparation, 4) action, and 5) maintenance, and answers can be used to design a method for convincing an individual that regular physical activity would be beneficial. Three key psychological needs form the underlying assumptions of SDT for individuals (1,6). These include: 1) autonomy or self-determination, 2) the need to feel competent and have mastery of a behavior, and 3) a feeling of being connected socially and having meaningful interactions. For the SDT, intrinsic motivation is thought to play a critical role that allows individuals to display behaviors due to natural interest and a sense of enjoyment (6,24).
In summary, previous research suggest that SCT, TTM, and SDT are viable theories and concepts to employ for increasing self-efficacy, enjoyment, and intrinsic motivation to perform PA among children. Adapting these theories to children and adolescents and practicing one or more of them may lead to and improved chance of the adoption, adherence, and maintenance to PA as a permanent lifestyle.
CREATIVE MOVEMENT AND CREATIVE DANCE
A paper entitled “What Can We Do for Childhood Obesity? Let's Go Dancing!” offers support for participating in dance as a regular form of PA for children (33). The author explains that for children to change their attitudes and perceptions of PA, they need to experience activities that positively affect their lives and are enjoyable, such as singing, playing music, and dancing. Furthermore, children who participate in dancing are more likely to adopt and maintain physical activity as a permanent lifestyle (33). Given this information, both creative movement and creative dance have recently grown in popularity among physical educators as a viable method to increase PA, especially among elementary school–age children.
Creative movement is defined as an art form where the body serves as the conduit for various motions (8). Lobo et al. describes creative dance as the synergetic relationship of physical movement which expresses feelings and creative ideas (25). A report by Dow explains that terms describing creative movements are comparable with the terms describing creative dance (8). Creative movement consists of four basic elements of variation: 1) body parts and their range of movement, 2) space, 3) time, and 4) energy. Examples of the activities for these basic elements are listed in Table 1.
The key to unlocking the range of unlimited, imaginative, and creative movement possibilities can be discovered by using these four elements and understanding their conceptual basis. The benefits of creative movement include children learning to move in space with other children while they learn to improve their control of body movement (8). Creative dance can also use these movement elements, but are done rhythmically to music or a beat. The dancing can be completely creative and new, or variations of existing dance types such as tap dancing.
Putting It Into Practice
The power and benefits of creative dance was realized at the University of Pittsburgh, where, as part of a study, I was a creative movement instructor for groups of pre-school-age children. Imagination and imitation provided key learning strategies for this age group to initiate PA in a playful and enjoyable setting. Creative movement and dance also worked very well with both large and small group sizes. The remainder of this section provides an example of how this type of creative movement PA can be initiated.
During warm-up, themes can be used to initiate movements that have a goal of enhancing awareness of specific types of movement. For instance, children can watch someone imitate the movements of various animals, such as a monkey, a snake, or turtle, which involved jumping and swinging arms and skipping and other movements. The children can then be asked to imitate the movements with an unspoken goal of developing an overall awareness of how their bodies move. When performed, the response is almost always overwhelming with enjoyment and full participation by all children. The advantages of using themes allow children to use their imagination and imitation to perform creative movement. These children will increase their likelihood of becoming self-movers with excellent control of their body movements, and improved movement skill levels (28). Further examples of movements and corresponding themes are listed in Table 2.
Following a large group warm-up, the children can be divided into smaller groups to participate in a circuit of consecutive movement activities. A circuit can consist of basic movement patterns such as throwing, kicking, climbing, bouncing, and rolling. Rhythmic music can be played while the children rotate between activities such as rolling a ball (bowling imitation), kicking a ball (soccer goal score imitation), short ladder climb, bouncing balance (Swiss) ball, and bean bag toss (e.g., corn hole game) stations (27,35). Importantly, the children should be continually moving and having fun.
After completing the circuit from one to several times, depending upon desired duration of PA, an active game of tag can be played among the children to promote group interaction. As an example for cool-down, a game of parachute hide-and-seek can be performed that allows the children to use a large and colorful circular parachute. For this activity, the group is instructed to stand and grasp the parachute and create waves by moving their arms in a wave-like motion, up and down. During an upward wave, the children would alternate hiding underneath the parachute and return to group after being discovered (27,35). This type of PA program using creative movement can take up to 1 hr to complete and would meet the daily requirement of PA as promoted by the HHS.
Interactive Video Dance Games
Increasing PA among school-age children continues to challenge physical educators. Dance-related video games also provide a potential avenue for enhancement of PA and can also be incorporated into home- or fitness center-based programs for children and adolescents. These games are used either on a home game system or at an arcade and provide music and movements to imitate. Scoring is based on how accurately the user follows in imitation. Some games provide a freestyle (i.e., creative) type of dance, while others allow more traditional dance movements.
Gao et al. examined the effects of interactive video dance games on enjoyment of PA (14). In their study, 200 third through sixth grade children participated in a 30 min physical education class that varied between an interactive dance game or a game of tag. The results revealed that children reported significantly higher levels of enjoyment for interactive dance versus the tag games. In addition, girls exhibited higher enjoyment for interactive dance as compared with the boys (14). This difference is important because girls tend to be less active than boys.
Quinn examined the effects of Just Dance and Dance Dance Revolution (DDR) video gaming systems on change in PA in middle school children (28). Eighty-two 6th grade students (ages 10 to 12 yr) participated. The games were used in physical education class where students played a game and then rotated to allow others to play. Each child participated for 17 to 21 min, 3 d·wk−1 for 6 wk. The results demonstrated that students were significantly more active in PE class after, as compared to before, the intervention. In addition, home recreation use of Just Dance and DDR more than doubled following the intervention. Importantly, the dance interventions were effective to help students meet state and national PE participation standards (28). A similar finding was shown for DDR in a group of Latino children (15).
Dance Dance Revolution was used by Unnithan et al. to determine differences in the submaximal energy cost and cardiorespiratory measures between overweight (OW) and non-overweight (NO) children (36). The participants consisted of 22 children and adolescents (10 OW vs. 12 NO). Cardiorespiratory measurements were taken during a maximal treadmill walking test and a 12 min DDR session. The results indicated that the average e absolute V˙O2 was significantly higher for the OW group when compared to the NO group (917 ± 257 vs. 591 ± 148 mL·min−1). Most importantly, DDR resulted in a percent heart rate intensity for both groups for developing and maintaining cardiorespiratory fitness that met the ACSM guidelines (OW: 65% ± 7 vs. NO: 65% ± 8 of estimated peak heart rate) (36).
Culturally Based Dance Themes
A movement program that is restrictive to only ideas about how the body moves is a concern expressed by some physical educators and critics of creative movement. A report by Ritson (29) suggests using events from social experiences and images to expand the teaching repertoire for creative movement to children. He further explains that it is important to consider matching a child's cultural and social background with these movement strategies when attempting to engage the child. They also state that cultural themes need to be clearly defined and assessed for the creative movement to meet the unique needs of each child and gain their interest and response.
To align with the cultural, social, and historical significance of dance in African-American communities, the effects of an after school dance program was examined by Robinson et al. among African-American girls (30). Sixty-one 8- to 10-year-old girls participated in the study and were randomly assigned to either the intervention or control group. The intervention consisted of an after-school dance class at three different community centers and five dance lessons delivered to the participant's homes over a 12 wk period. The dance sessions lasted 45 to 60 min and were comprised of hip-hop, step, and traditional African dance as instructed by female African-American college students. The results demonstrated a lower body mass index (BMI) and waist circumference measure, increased after-school PA levels, and reduced television and other video viewing time for the intervention versus the control group after the intervention. Given the popularity of hip-hop in the African-American community, this study suggests organized dancing as a potential method to combat the very high levels of childhood obesity and PIA observed in this group (30).
Celebrity Inspiration
People are often inspired by the pop culture of their time (for instance, Shirley Temple, who starred in a 1935 motion picture The Little Colonel, where she worked with African-American tap dancer Bill Robinson). This pair performed a memorable scene of tap dancing on a stair case. When watching one can certainly note the athleticism and physical fitness required to perform the routine. Shirley Temple's films of the 1930s inspired many young girls to take tap dance lessons (11).
Although movie musicals with dancing are a thing of the past, today there are other dancing inspirations. The television show Dancing With the Stars is currently very popular and viewers would surmise that if creative dancing icons such as Ginger Rogers and Fred Astaire were alive today, they certainly would be making guest appearances on the show. This famous dancing duo, known for their nine musical films in the 1930s, set a new standard for virtuosity, creativity, elegance, and grace in the world of dance (20). And again, when watching their films, viewers can see the fitness and agility levels required for their performances. Most inspiring, their performances were full of extremely creative movements.
Choreographer Kenny Ortega stated about legendary dancer Gene Kelly (in Anatomy of a Dancer) that he was “the most exciting, the most masculine, the most commercial dancer of his time” (23). Kelly was a dance innovator who developed a style that was native to his upbringing and environment. His unique brand of dance and self-expression that incorporated tap, Spanish dancing, modern, and ballet idioms invoked highly creative movements. Interestingly, Kelly was an accomplished athlete in high school and college and encouraged athletes to use dance as preparation for their individual sports strength and conditioning. In the 1970s, there were reports of NFL football players using ballet as a method to enhance their fitness, flexibility, and agility in hopes that it would translate to the playing field. A recent quote from 145 kg (320 lb) Pittsburgh Steelers nose tackle Steve McLendon was “It's [ballet] harder than anything else I do” (22).
And even today there are dancing icons. Both Savion Glover and Jason Samuels Smith are star tap dance performers. Glover was notably the choreographer for Mumble's dancing (3). The importance of adults to teach and pass down the various art forms to kids cannot be overstated. Glover's talents represent the ideal example of an art form being passed down to the next generation of kids. He was a beneficiary of the teachings from the late Gregory Hines, who in turn was inspired and motivated by the late Sammy Davis Jr. (16). These three stars of tap can be seen performing and showcasing their talents in the motion picture film Tap (11). Emerging star Smith is a choreographer/dancer and has appeared on So You Think You Can Dance and Dancing With The Stars, and starred in the Tony Award–winning Broadway show Bring in 'da Noise, Bring in 'da Funk. He continues to travel the country with his tap dance company (21). Exposing children and adolescents to these contemporary dancing stars, to popular television shows with a dancing theme, and to athletic stars who use dance for training may be a method to encourage their participation.
CLINICAL EXERCISE PHYSIOLOGY IMPLICATIONS
Creative movement and creative dance may offer a viable strategy for motivating children to adopt, adhere, and maintain physical activity as permanent lifestyle with a goal of reducing childhood obesity and enhancing their quality of life. With so many sedentary distractions offered to today's children and adolescents, it is with little wonder why PIA and obesity are at record levels. But dancing and creative movement might be a way to combat these issues. Can it be possible for kids to dance like Mumble? Or to dance like today's—or yesterday's—stars? Sure it is. Clinical exercise physiologists working with obese children should consider creative dance and creative movement for their clients and can use today's many dancing inspirations as motivation. In addition to increasing levels of PA and calorie expenditure, dancing can also help to enhance self-efficacy and the enjoyment of creative movement that crosses all ages, both sexes, and many ethnicities.
Contributor Notes
1Health Science Programs, La Roche College, 9000 Babcock Boulevard, Pittsburgh, PA
The author denies any conflicts of interest.