Impact of Theater Experience on Older Adults Living in Retirement Communities

Study Overview
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Brief Summary
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Theater is a complex, multi-component performing art. On stage, actors not only need to memorize the script, but also be able to portray emotion and feeling through movement and move in whichever manner is deemed appropriate by the script. Acting therefore requires as much movement as it does vocalization. As training exercises in theater naturally involve boosting physical, cognitive and affective function, and social relationships, theater experience can be used to promote health and wellness. Over the last two decades, there has been an increase in the use of theater to promote health and wellness among older adults. Thus, the overall aim of this project is to evaluate the therapeutic benefits of a 10-week theory-based theater program on physical functioning and emotional stress among older adults. Hypothesis #1: Older adults residing in subsidized housing who participate in a theory-based theater program will demonstrate better physical functioning, and reduction in emotional stress than wait-list controls at the conclusion of a 10-week theater program. Hypothesis #2: The positive impact of the theater program on the residents' improved physical functioning and stress level will be maintained at 3-month follow-up.

Official Title
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Impact of Theater Experience on Older Adults Living in Retirement Communities

Conditions
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Aging

Intervention / Treatment
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* Behavioral: theater program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 62 or older living in HUD-subsidized housing Residence in a subsidized apartment for at least one year. Able to carry on a daily conversation with or without hearing aids Intact cognition as indicated by a score of greater than 5 on the Short Portable Mental Status Questionnaire (SPMSQ) Ambulatory with or without aids, as the outcome measures require participants to perform static and dynamic balance, and walking activities. Exclusion Criteria: Visual impairment that cannot be corrected with assistive devices Diagnosis of progressive neurodegenerative disorders (self-report)

Ages Eligible for Study
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Minimum Age: 62 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Theater program<br>The design of the 10-week theater program is based on the principles of acting as written and practiced by Constantin Stanislavski in his revolutionary text on acting: An Actor Prepares [Stanislavsky C, 1989]. The exercises target concentration, voice, physical skills, emotion memory, observation, and dramatic analysis and include 3 components: 1. Preparation for the Actor (which involves relaxation , collaboration, movement, posture, and vocality; 2. Learning the Components of the Repeatable Acting Process (which involves physicality, attention, and concentration); and 3. Synthesizing Components into Characterization (which involves creativity and emotional expression). Each of these components will be addressed during each of 20 sessions through the use of group warm ups, group ensemble exercises, and group recitations. Participants will perform physical, mental, and emotional exercises similar to those given to beginning acting students in traditional theater schools. | Behavioral: theater program<br>* 10-week theory-based theater program designed to improve their physical functioning and reduce emotional stress.<br>|
| No Intervention: Wait-list control<br>During the study period, the control group will not receive any type of intervention. However, they will be offered the same theater program experience after the primary data collection period ends. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed Up-and-Go | The timed Up-and-Go (TUG) is a composite measure of functional mobility, including lower extremity power, balance, gait, and fall risk. Measured in absolute time (seconds), where lower time is a better score. | baseline | 
| Timed Up-and-Go | The timed Up-and-Go (TUG) is a composite measure of functional mobility, including lower extremity power, balance, gait, and fall risk. Measured in absolute time (seconds), where lower time is a better score. | immediately post-intervention | 
| Timed Up-and-Go | The timed Up-and-Go (TUG) is a composite measure of functional mobility, including lower extremity power, balance, gait, and fall risk. Measured in absolute time (seconds), where lower time is a better score. | 3-month follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medical Outcomes Study Short Form | The Medical Outcomes Study Short Form, version 2 (SF-36v2) is a 36 item patient reported outcome measure of health-related quality of life in 8 different domains. Scores range from 0 to 100, with high scores indicating more positive health. | baseline | 
| Medical Outcomes Study Short Form | The Medical Outcomes Study Short Form, version 2 (SF-36v2) is a 36 item patient reported outcome measure of health-related quality of life in 8 different domains. Scores range from 0 to 100, with high scores indicating more positive health. | immediately post-intervention | 
| Medical Outcomes Study Short Form | The Medical Outcomes Study Short Form, version 2 (SF-36v2) is a 36 item patient reported outcome measure of health-related quality of life in 8 different domains. Scores range from 0 to 100, with high scores indicating more positive health. | 3-month follow up | 
| 2-minute step test | The 2-minute step test (TMST) is a field test of exercise tolerance where the participant steps in place for 2 min. The higher the number repetition indicates better performance. | baseline | 
| 2-minute step test | The 2-minute step test (TMST) is a field test of exercise tolerance where the participant steps in place for 2 min. The higher the number repetition indicates better performance. | immediately post-intervention | 
| 2-minute step test | The 2-minute step test (TMST) is a field test of exercise tolerance where the participant steps in place for 2 min. The higher the number repetition indicates better performance. | 3-month follow up | 
| 30-sec chair stand test | The 30-sec chair stand test (30CST) is a measure of lower extremity power and functional mobility. The participant stands up from a chair and sits back down as many times as possible in 30 sec. The higher the number repetition indicates better performance. | baseline | 
| 30-sec chair stand test | The 30-sec chair stand test (30CST) is a measure of lower extremity power and functional mobility. The participant stands up from a chair and sits back down as many times as possible in 30 sec. The higher the number repetition indicates better performance. | immediately post-intervention | 
| 30-sec chair stand test | The 30-sec chair stand test (30CST) is a measure of lower extremity power and functional mobility. The participant stands up from a chair and sits back down as many times as possible in 30 sec. The higher the number repetition indicates better performance. | 3-month follow up | 
| Berg Balance Scale | The Berg Balance Scale (BBS) is a 14-iten test that measures function mobility and balance. Scores range from 0 to 56, with higher scores indicating better balance. | baseline | 
| Berg Balance Scale | The Berg Balance Scale (BBS) is a 14-iten test that measures function mobility and balance. Scores range from 0 to 56, with higher scores indicating better balance. | immediately post-intervention | 
| Berg Balance Scale | The Berg Balance Scale (BBS) is a 14-iten test that measures function mobility and balance. Scores range from 0 to 56, with higher scores indicating better balance. | 3-month follow up | 
| Grip strength | Hand-grip strength is a quantitative measure of upper extremity strength. Higher values indicated more strength. | baseline | 
| Grip strength | Hand-grip strength is a quantitative measure of upper extremity strength. Higher values indicated more strength. | immediately post-intervention | 
| Grip strength | Hand-grip strength is a quantitative measure of upper extremity strength. Higher values indicated more strength. | 3-month follow up | 
| Emotional stress | Emotional stress will be assessed via cortisol levels obtained from hair samples analyzed via immunoassay. Typical values range from 2 to 200 pg/mg, with higher levels indicating higher chronic stress. | baseline | 
| Emotional stress | Emotional stress will be assessed via cortisol levels obtained from hair samples analyzed via immunoassay. Typical values range from 2 to 200 pg/mg, with higher levels indicating higher chronic stress. | immediately post-intervention | 
| Emotional stress | Emotional stress will be assessed via cortisol levels obtained from hair samples analyzed via immunoassay. Typical values range from 2 to 200 pg/mg, with higher levels indicating higher chronic stress. | 3-month follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Older adults, Theater, Physical functioning, Emotional stress