Journal of Cancer Survivorship

, Volume 11, Issue 3, pp 350–359 | Cite as

A dance intervention for cancer survivors and their partners (RHYTHM)

  • Maria PisuEmail author
  • Wendy Demark-Wahnefried
  • Kelly M. Kenzik
  • Robert A. Oster
  • Chee Paul Lin
  • Sharon Manne
  • Ronald Alvarez
  • Michelle Y. Martin



The purpose of this study was to assess the feasibility, acceptability, and impact of a ballroom dance intervention on improving quality of life (QOL) and relationship outcomes in cancer survivors and their partners.


We conducted a pilot randomized controlled trial with two arms (Restoring Health in You (and Your Partner) through Movement, RHYTHM): (1) immediate dance intervention and (2) delayed intervention (wait-list control). The intervention consisted of 10 private weekly dance lessons and 2 practice parties over 12 weeks. Main outcomes were physical activity (Godin Leisure-Time Exercise Questionnaire), functional capacity (6 Minute Walk Test), QOL (SF-36), Couples’ trust (Dyadic Trust Scale), and other dyadic outcomes. Exit interviews were completed by all participating couples.


Thirty-one women survivors (68% breast cancer) and their partners participated. Survivors were 57.9 years old on average and 22.6% African American. Partners had similar characteristics. RHYTHM had significant positive effects on physical activity (p = 0.05), on the mental component of QOL (p = 0.04), on vitality (p = 0.03), and on the dyadic trust scale (p = 0.04). Couples expressed satisfaction with the intervention including appreciating the opportunity to spend time and exercise together. Survivors saw this light-intensity physical activity as easing them into becoming more physically active.


Light intensity ballroom dancing has the potential to improve cancer survivors’ QOL. Larger trials are needed to build strong support for this ubiquitous and acceptable activity.

Implications for cancer survivors

Ballroom dance may be an important tool for cancer survivors to return to a physically active life and improve QOL and other aspects of their intimate life.


Neoplasms Survivors Physical activity Dance Quality of life Couples 



Authors are thankful to Richard Silver of Fred Astaire Dance Studios, the staff of the Recruitment and Retention Shared Facility of the UAB Comprehensive Cancer Center, Aquila Brown-Galvan, Amy Dobelstein, and Subrena Felder, as well as RHYTHM participants.

Authors’ contributions

Conceptualization: MP, MYM, WDW, SM, RAO

Methodology: MP, MYM, WDW, RAO, KMK

Data curation and analysis: RAO, CPL, KMK

Investigation: RAO, CPL, KMK, MP, MYM

Writing—original: MP, MYM

Writing—review/edit: All

Supervision, project administration, and funding acquisition: MP, MYM

Compliance with ethical standards

Funding sources

This study was funded by the National Cancer Institute R21CA158678 and the National Center for Advancing Translational Sciences UL1TR001417.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was reviewed and approved by the Institutional Review Board of the University of Alabama at Birmingham. All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


  1. 1.
    Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):82–91.CrossRefPubMedGoogle Scholar
  2. 2.
    Pekmezi DW, Demark-Wahnefried W. Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011;50(2):167–78.CrossRefPubMedGoogle Scholar
  3. 3.
    Demark-Wahnefried W, Rogers LQ, Alfano CM, Thomson CA, Courneya KS, Meyerhardt JA, et al. Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin. 2015;65(3):167–89.CrossRefPubMedGoogle Scholar
  4. 4.
    Irwin ML, McTiernan A, Manson JE, Thomson CA, Sternfeld B, Stefanick ML, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the women's health initiative. Cancer Prev Res (Phila). 2011;4(4):522–9.CrossRefGoogle Scholar
  5. 5.
    Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2014;25(7):1293–311.CrossRefGoogle Scholar
  6. 6.
    Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Journal of cancer survivorship : research and practice. 2010;4(2):87–100.CrossRefGoogle Scholar
  7. 7.
    Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. The Cochrane database of systematic reviews. 2008(2):CD006145.Google Scholar
  8. 8.
    Duijts SF, Faber MM, Oldenburg HS, van Beurden M, Aaronson NK. Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psycho-Oncology. 2011;20(2):115–26.CrossRefPubMedGoogle Scholar
  9. 9.
    Peddle CJ, Au HJ, Courneya KS. Associations between exercise, quality of life, and fatigue in colorectal cancer survivors. Dis Colon rectum. 2008;51(8):1242–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Spence RR, Heesch KC, Brown WJ. Exercise and cancer rehabilitation: a systematic review. Cancer Treat Rev. 2010;36(2):185–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Thorsen L, Courneya KS, Stevinson C, Fossa SD. A systematic review of physical activity in prostate cancer survivors: outcomes, prevalence, and determinants. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2008;16(9):987–97.CrossRefGoogle Scholar
  12. 12.
    Ferrer RA, Huedo-Medina TB, Johnson BT, Ryan S, Pescatello LS. Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Ann Behav Med. 2011;41(1):32–47.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Blair CK, Morey MC, Desmond RA, Cohen HJ, Sloane R, Snyder DC, et al. Light-intensity activity attenuates functional decline in older cancer survivors. Med Sci Sports Exerc. 2014;46(7):1375–83.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Lin YY, Rau KM, Lin CC. Longitudinal study on the impact of physical activity on the symptoms of lung cancer survivors. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2015.Google Scholar
  15. 15.
    Thraen-Borowski KM, Trentham-Dietz A, Edwards DF, Koltyn KF, Colbert LH. Dose-response relationships between physical activity, social participation, and health-related quality of life in colorectal cancer survivors. Journal of cancer survivorship : research and practice. 2013;7(3):369–78.CrossRefGoogle Scholar
  16. 16.
    Loprinzi PD, Lee H, Cardinal BJ. Objectively measured physical activity among US cancer survivors: considerations by weight status. Journal of cancer survivorship : research and practice. 2013;7(3):493–9.CrossRefGoogle Scholar
  17. 17.
    Lewis FM. Strengthening family supports. Cancer and the family Cancer. 1990;65(3 Suppl):752–9.PubMedGoogle Scholar
  18. 18.
    Lewis FM. The effects of cancer survivorship on families and caregivers. More research is needed on long-term survivors. Am J Nurs. 2006;106(3 Suppl):20–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Williford HN, Scharff-Olson M, Blessing DL. The physiological effects of aerobic dance. A review Sports medicine. 1989;8(6):335–45.CrossRefPubMedGoogle Scholar
  20. 20.
    Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, et al. 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.CrossRefPubMedGoogle Scholar
  21. 21.
    Keogh JW, Kilding A, Pidgeon P, Ashley L, Gillis D. Physical benefits of dancing for healthy older adults: a review. J Aging Phys Act. 2009;17(4):479–500.CrossRefPubMedGoogle Scholar
  22. 22.
    Hackney ME, Earhart GM. Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism Relat Disord. 2009;15(9):644–8.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Murrock CJ, Gary FA. A culturally-specific dance intervention to increase functional capacity in African American women. J Cult Divers. 2008;15(4):168–73.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Alpert PT, Miller SK, Wallmann H, Havey R, Cross C, Chevalia T, et al. The effect of modified jazz dance on balance, cognition, and mood in older adults. J Am Acad Nurse Pract. 2009;21(2):108–15.CrossRefPubMedGoogle Scholar
  25. 25.
    Holmerova I, Machacova K, Vankova H, Veleta P, Juraskova B, Hrnciarikova D, et al. Effect of the Exercise Dance for Seniors (EXDASE) program on lower-body functioning among institutionalized older adults. Journal of aging and health. 2010;22(1):106–19.CrossRefPubMedGoogle Scholar
  26. 26.
    Belardinelli R, Lacalaprice F, Ventrella C, Volpe L, Faccenda E. Waltz dancing in patients with chronic heart failure: new form of exercise training. Circ Heart Fail. 2008;1(2):107–14.CrossRefPubMedGoogle Scholar
  27. 27.
    Paterson C, Robertson A, Smith A, Nabi G. Identifying the unmet supportive care needs of men living with and beyond prostate cancer: a systematic review. European journal of oncology nursing : the official journal of European Oncology Nursing Society. 2015.Google Scholar
  28. 28.
    Manne S, Badr H, Kashy DA. A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers. J Behav Med. 2012;35(3):334–46.CrossRefPubMedGoogle Scholar
  29. 29.
    Song L, Northouse LL, Braun TM, Zhang L, Cimprich B, Ronis DL, et al. Assessing longitudinal quality of life in prostate cancer patients and their spouses: a multilevel modeling approach. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 2011;20(3):371–81.CrossRefGoogle Scholar
  30. 30.
    Chelune G, Robison J, Kommor M. A cognitive interactional model of intimate relationships. In: Derlega V, editor. Communication, intimacy, and close relationships. Orlando, FL: Academis Press, Inc; 1984. p. 11–40.Google Scholar
  31. 31.
    Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141–6.PubMedGoogle Scholar
  32. 32.
    Cahalin LP, Arena R, Labate V, Bandera F, Lavie CJ, Guazzi M. Heart rate recovery after the 6 min walk test rather than distance ambulated is a powerful prognostic indicator in heart failure with reduced and preserved ejection fraction: a comparison with cardiopulmonary exercise testing. Eur J Heart Fail. 2013;15(5):519–27.CrossRefPubMedGoogle Scholar
  33. 33.
    Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Gibbons WJ, Fruchter N, Sloan S, Levy RD. Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardpulm Rehabil. 2001;21(2):87–93.CrossRefGoogle Scholar
  35. 35.
    Schmidt K, Vogt L, Thiel C, Jager E, Banzer W. Validity of the six-minute walk test in cancer patients. Int J Sports Med. 2013;34(7):631–6.CrossRefPubMedGoogle Scholar
  36. 36.
    Ware J. SF-36 health survey update. In: Maruish M, editor. The use of psychological testing for treatment planning and outcomes assessment. 3rd ed. Mahwah (NJ): Lawrence Erlbaum Associates; 2004.Google Scholar
  37. 37.
    Contopoulos-Ioannidis DG, Karvouni A, Kouri I, Ioannidis JP. Reporting and interpretation of SF-36 outcomes in randomised trials: systematic review. BMJ. 2009;338:a3006.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Larzelere R, Huston T. Dyadic trust scale: toward understanding interpersonal trust in close relationships. Journal of Marriage and the Family. 1980;43(3):595–604.CrossRefGoogle Scholar
  39. 39.
    Spanier G, Filsinger E. Marriage and family assessment: a sourcebook for family therapy. In: Filsinger E, editor. The dyadic adjustment scale. Beverly Hills: Sage; 1983. p. 155–68.Google Scholar
  40. 40.
    Manne S, Ostroff J, Rini C, Fox K, Goldstein L, Grana G. The interpersonal process model of intimacy: the role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their partners. J Fam Psychol. 2004;18(4):589–99.CrossRefPubMedGoogle Scholar
  41. 41.
    Sturm I, Baak J, Storek B, Traore A, Thuss-Patience P. Effect of dance on cancer-related fatigue and quality of life. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2014;22(8):2241–9.CrossRefGoogle Scholar
  42. 42.
    Archer S, Buxton S, Sheffield D. The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials. Psycho-Oncology. 2015;24(1):1–10.CrossRefPubMedGoogle Scholar
  43. 43.
    Coteur G, Feagan B, Keininger DL, Kosinski M. Evaluation of the meaningfulness of health-related quality of life improvements as assessed by the SF-36 and the EQ-5D VAS in patients with active Crohn's disease. Aliment Pharmacol Ther. 2009;29(9):1032–41.CrossRefPubMedGoogle Scholar
  44. 44.
    Swigris JJ, Brown KK, Behr J, du Bois RM, King TE, Raghu G, et al. The SF-36 and SGRQ: validity and first look at minimum important differences in IPF. Respir Med. 2010;104(2):296–304.CrossRefPubMedGoogle Scholar
  45. 45.
    Frendl DM, Ware Jr JE. Patient-reported functional health and well-being outcomes with drug therapy: a systematic review of randomized trials using the SF-36 health survey. Med Care. 2014;52(5):439–45.CrossRefPubMedGoogle Scholar
  46. 46.
    Wang XS, Zhao F, Fisch MJ, O'Mara AM, Cella D, Mendoza TR, et al. Prevalence and characteristics of moderate to severe fatigue: a multicenter study in cancer patients and survivors. Cancer. 2014;120(3):425–32.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Bjorner JB, Lyng Wolden M, Gundgaard J, Miller KA. Benchmarks for interpretation of score differences on the SF-36 health survey for patients with diabetes. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2013;16(6):993–1000.CrossRefGoogle Scholar
  48. 48.
    Dagan M, Hagedoorn M. Response rates in studies of couples coping with cancer: a systematic review. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2014;33(8):845–52.CrossRefGoogle Scholar
  49. 49.
    Terp H, Rottmann N, Larsen PV, Hagedoorn M, Flyger H, Kroman N, et al. Participation in questionnaire studies among couples affected by breast cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2015;23(7):1907–16.CrossRefGoogle Scholar
  50. 50.
    Sadler GR, Ko CM, Malcarne VL, Banthia R, Gutierrez I, Varni JW. Costs of recruiting couples to a clinical trial. Contemporary clinical trials. 2007;28(4):423–32.CrossRefPubMedGoogle Scholar
  51. 51.
    Fredman SJ, Baucom DH, Gremore TM, Castellani AM, Kallman TA, Porter LS, et al. Quantifying the recruitment challenges with couple-based interventions for cancer: applications to early-stage breast cancer. Psycho-Oncology. 2009;18(6):667–73.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Adams RN, Mosher CE, Blair CK, Snyder DC, Sloane R, Demark-Wahnefried W. Cancer survivors’ uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer. 2015;121(1):77–83.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Division of Preventive MedicineUniversity of Alabama at Birmingham (UAB)BirminghamUSA
  2. 2.Comprehensive Cancer CenterUABBirminghamUSA
  3. 3.Department of Nutrition SciencesUABBirminghamUSA
  4. 4.Institute for Cancer Outcomes and SurvivorshipUABBirminghamUSA
  5. 5.Center for Clinical and Translational ScienceUniversity of Alabama at BirminghamBirminghamUSA
  6. 6.Rutgers UniversityNew BrunswickUSA
  7. 7.Department of Obstetrics and GynecologyVanderbilt University Medical CenterNashvilleUSA
  8. 8.Department of Preventive MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  9. 9.Center for Innovation in Health Equity Research (CIHER)MemphisUSA

Personalised recommendations