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

Importance: An increasing body of evidence notes robust health benefits of physical activity, yet participation rates have stagnated. Challenges related to exercise self-efficacy are at least partly responsible. Exercise self-efficacy is a consistent moderator of physical activity participation and highly resistant to change, but also activity-specific. Health-promoting nonexercise activities may thus substantially improve health outcomes by engaging inactive individuals. Performing arts are globally popular (up to 40% annual adult participation) and intrinsically physically exertive, presenting an intriguing alternative. This umbrella review aims to evaluate the public health utility of active performing arts participation by systematically reviewing and appraising evidence regarding its health effects in healthy adults, adolescents and children. PROSPERO ID #: CRD42020191991

Observations: Results of 33 systematic reviews (286 primary studies), 9 observational studies of performing arts participation and non-communicable disease risk, and 87 studies reporting mean heart rate during performing arts participation were synthesized and appraised according to the GRADE framework following a 3-component umbrella review. Positive health effects of performing arts participation were found in 17 of 18 investigated domains, including 9 domains supported by moderate-high quality evidence: auditory; body composition; cognitive; immune function/inflammation; mental health; physical fitness; physical function; self-reported health/wellbeing; social functioning. 9 of 13 domains associated with the health benefits of physical activity. Heart rate data indicate that both music and dance participation intrinsically elicit, while maintaining expressive rather than exertive aims, mean heart rate values corresponding to a range of intensities, including moderate and vigorous (≥64% maximum).

Conclusions and Relevance: Performing arts participation is health promoting activity and likely a valuable public health resource and exercise alternative/adjunct. The specific frequency, timing, types and mechanisms of performing arts participation underpinning observed benefits are presently varied, justifying research aiming to facilitate specific performing arts prescriptions and public health recommendations.