Performing arts as a health resource? An umbrella review of the health impacts of music and dance participation

Abstract

An increasing body of evidence notes the health benefits of arts engagement and participation. However, specific health effects and optimal modes and ‘doses’ of arts participation remain unclear, limiting evidence-based recommendations and prescriptions. The performing arts are the most popular form of arts participation, presenting substantial scope for established interest to be leveraged into positive health outcomes. Results of a three-component umbrella review (PROSPERO ID #: CRD42020191991) of relevant systematic reviews (33), epidemiologic studies (9) and descriptive studies (87) demonstrate that performing arts participation is broadly health promoting activity. Beneficial effects of performing arts participation were reported in healthy (non-clinical) children, adolescents, adults, and older adults across 17 health domains (9 supported by moderate-high quality evidence (GRADE criteria)). Positive health effects were associated with as little as 30 (acute effects) to 60 minutes (sustained weekly participation) of performing arts participation, with drumming and both expressive (ballroom, social) and exercise-based (aerobic dance, Zumba) modes of dance linked to the broadest health benefits. Links between specific health effects and performing arts modes/doses remain unclear and specific conclusions are limited by a still young and disparate evidence base. Further research is necessary, with this umbrella review providing a critical knowledge foundation.

Mechanisms of Music Impact: Autonomic Tone and the Physical Activity Roadmap to Advancing Understanding and Evidence-Based Policy

“…In addressing these questions, present evidence remains limited. For instance, the recent review cited above found that as little as 30 min of music-making was associated with positive health effects in healthy populations, but could not support any further conclusions regarding the optimum music-making type, duration, frequency and health applications (McCrary et al, 2021). Such a detailed understanding is needed to inform evidence-based policy, prescriptions and care (Bickerdike et al, 2017;Clift et al, 2021), but is presently limited by common features of a young and developing evidence base: a substantial heterogeneity of interventions and outcome measures (Fancourt and Finn, 2020;McCrary et al, 2021) elucidating a glut of potential mechanisms (Fancourt et al, 2021) and leading to disparate and often contradictory outcomes (Clift, 2020;Fancourt and Finn, 2020;McCrary et al, 2021).…”

“…FITT criteria have enabled broad research insights to be efficiently organized toward the establishment of a dose-response relationship between increased weekly aerobic physical activity (Intensity * Timing * Frequency) and improved health and reduced disease risk (Barisic et al, 2011;Arem et al, 2015;Rhodes et al, 2017 Similar links between acute music-induced autonomic changes and sustained modulations of autonomic tone are likely (Figure 1). However, studies of the effects of repeated music engagement on autonomic tone have only considered and prescribed FTT (Frequency, Timing, and Type) criteria (Takahashi and Matsushita, 2006;Le Roux et al, 2007;Okada et al, 2009;Chuang et al, 2011;Chlan et al, 2013;Hu et al, 2015;Helsing et al, 2016;Kunikullaya et al, 2016;Finn and Fancourt, 2018;Ribeiro et al, 2018;Fancourt and Finn, 2020;Mojtabavi et al, 2020;McCrary et al, 2021). Similarly, observational and intervention studies of the effects of repeated music engagement on health conditions linked to autonomic tone have not assessed and/or controlled the acute autonomic responses to music-making or listening (Fancourt and Finn, 2020;McCrary et al, 2021).…”

“…The broad health benefits of music listening and music-making are increasingly well acknowledged (Fancourt and Finn, 2020;McCrary et al, 2021), with a recent review noting that music has been associated with positive health effects across 13 domains (most prominently auditory, cognitive, immune, self-reported health/wellbeing, and social functioning domains) (McCrary et al, 2021). Accordingly, the most salient questions are quickly becoming less if and more how music can be used to promote health, both in preventive and clinical/rehabilitative applications.…”

“…Both music-making and music listening have demonstrated an ability to modulate autonomic nervous system activity (Ellis and Thayer, 2010;McCrary et al, 2021). The bulk of research has investigated acute autonomic changes during or immediately following a single session of music-making or listening, with these short-term effects linked most strongly to acute reductions in stress and anxiety, particularly in pre-operative settings (Allen and Blascovich, 1994;Bradt et al, 2013;Fu et al, 2019).…”

“…Further, an ability to modulate autonomic tone is a key mechanism underpinning the impact of established behavioral health interventions (e.g., physical activity; smoking cessation) shown to broadly promote health and prevent disease and 1.6-7.2 million annual deaths (Stein et al, 1996;Iwane et al, 2000;Curtis and O'Keefe, 2002;Fu and Levine, 2013;Harte and Meston, 2014;Forouzanfar et al, 2016). Accordingly, we propose that music's suggested ability to modulate autonomic tone may be a key central mechanism influencing the broad range of music's noted physical, mental and social health benefits (Fancourt and Finn, 2020;McCrary et al, 2021). The following sections explore how investigations of music's impact on autonomic tone can efficiently build understanding and broadly facilitate evidence-based prescriptions and policies.…”