Efficacy of Unsupervised YouTube Dance Exercise for Patients With Hypertension: Randomized Controlled Trial
Authors: Sakairi Mizuki , Miyagami Taiju , Tabata Hiroki , Yanagisawa Naotake , Saita Mizue , Suzuki Mai , Fujibayashi Kazutoshi , Fukuda Hiroshi , Naito Toshio 
Published: November 2024

Background
High blood pressure (BP) is linked to unhealthy lifestyles, and its treatment includes medications and exercise therapy. Many previous studies have evaluated the effects of exercise on BP improvement; however, exercise requires securing a location, time, and staff, which can be challenging in clinical settings. The antihypertensive effects of dance exercise for patients with hypertension have already been verified, and it has been found that adherence and dropout rates are better compared to other forms of exercise. If the burden of providing dance instruction is reduced, dance exercise will become a highly useful intervention for hypertension treatment.

Objective
This study aims to investigate the effects of regular exercise therapy using dance videos on the BP of patients with hypertension, with the goal of providing a reference for prescribing exercise therapy that is highly feasible in clinical settings.

Methods
This nonblind, double-arm, randomized controlled trial was conducted at Juntendo University, Tokyo, from April to December 2023. A total of 40 patients with hypertension were randomly assigned to either an intervention group (dance) or a control group (self-selected exercise), with each group comprising 20 participants. The intervention group performed daily dance exercises using street dance videos (10 min per video) uploaded to YouTube. The control group was instructed to choose any exercise other than dance and perform it for 10 minutes each day. The activity levels of the participants were monitored using a triaxial accelerometer. BP and body composition were measured on the day of participation and after 2 months. During the intervention period, we did not provide exercise instruction or supervise participants’ activities.

Results
A total of 34 patients were included in the study (16 in the intervention group and 18 in the control group). The exclusion criteria were the absence of BP data, medication changes, or withdrawal from the study. The mean age was 56 (SD 9.8) years, and 18 (53%) of the patients were female. The mean BMI was 28.0 (SD 6.3) m/kg2, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 139.5 (SD 17.1) mm Hg and 85.8 (SD 9.1) mm Hg, respectively. The basic characteristics did not differ between the two groups. In the multivariate analysis, SBP and DBP improved significantly in the intervention group compared to the control group (mean SBP –12.8, SD 6.1 mm Hg; P=.047; mean DBP –9.7, SD 3.3 mm Hg; P=.006).

Conclusions
This study evaluated the effects of dance exercise on patients with hypertension, as previously verified, under the additional condition of using dance videos without direct staff instruction or supervision. The results showed that dance videos were more effective in lowering BP than conventional exercise prescriptions.

Trial Registration
University Hospital Medical Information Network UMIN 000051251; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000058446