COLUMBIA — Jean Krampe wanted to help stop older people from falling, so she taught them a new way to dance.
Krampe knew that mobility and balance are two of the main reasons seniors fall, and she wanted to find a way to change these factors. Through her doctoral studies at MU's Sinclair School of Nursing, she found that dancing was becoming a popular therapy method.
She landed on Healthy-Steps, a dance-based therapy and movement program.
Although the program had been used to treat people with chronic illnesses, Krampe was the first to apply Healthy-Steps to people 65 and older and conduct studies on its effects. Her studies had positive results, showing that seniors would come to the activity and move during the sessions. Results also showed trends toward improving gait and balance.
Krampe, now an assistant professor at St. Louis University School of Nursing, introduced Healthy-Steps to the residents of TigerPlace, an independent living facility in Columbia, as part of her dissertation project.
“It’s going to take a multitude of interventions to help reduce falls,” Krampe said, “and this is one that may have some evidence going forward.”
Seniors reported they tremendously enjoyed the program, Krampe said. The results were so positive that the sessions are going to become a regular part of the activities at TigerPlace.
Growing the program
Helen Steinmann, lifestyle coordinator at TigerPlace, will run the program when classes begin in early January 2011. She was certified to be a Healthy-Steps instructor in October during a three-day certification training at Ellis Fischel Cancer Center.
“Watching the residents here at TigerPlace participate in the class Jean offered made me aware that it is something they would enjoy and benefit from,” Steinmann said.
The facility will hold at least two classes per week. Steinmann hopes to have between six and eight people in each class, but there is room for as many as 10 participants per session. Healthy-Steps will be open to all TigerPlace residents. The facility is owned and operated by Americare Systems Inc., in conjunction with the Sinclair School of Nursing, which provides all nursing services.
“I think it’s going to be a great program,” Steinmann said. “It is just plain fun.”
Ellis Fischel Cancer Center will also start holding Healthy-Steps in 2011.
Victoria Day, an active dance-based therapy instructor, will hold classes at the Unity Center of Columbia beginning on Jan. 22. The six-week sessions will be open to anyone 18 and older. She will hold a presentation and a free class on Jan. 16 at the center.
Recognizing the benefits
Krampe participated in a gerontology nursing conference this month at the Peachtree Catering and Banquet Center in Columbia. This included a Healthy-Steps exhibit and a demonstration of the dance therapy.
Shirley J. Farrah, assistant dean in the nursing outreach department of the Sinclair School of Nursing, was in charge of the Dec. 2-3 conference. She said she was impressed with Krampe’s way of doing things gently.
“Regardless of what your physical state is, you can participate in this,” she said. “This is exactly what our nursing home residents need. If you can move your head side to side, you can participate.”
Farrah said Krampe used music seniors could relate to and wore a top hat and feather boa to draw people in.
“She made it seem so comfortable and natural,” Farrah said.
Socialization is an important for residents of nursing homes. They can get bored and lonely, Farrah said, and anything people can do to spice up their lives helps.
Testing the method
Before introducing the program to Columbia, Krampe did a pilot study in 2008 with the Alexian Brothers Program of All-inclusive Care for the Elderly, or PACE, in St. Louis. The study was small, with 11 people, but went well. She received an Alexian Brothers Ministry Grant to fund her training so she could lead future programs.
“I wanted to learn the theory behind it so I could know a lot more than just what I was told about it,” Krampe said.
Krampe used and enhanced the information from the pilot study for her dissertation intervention. In January and February 2010, seniors at TigerPlace participated in the dance classes.
The participants were asked to attend classes three times a week for six weeks, and each session lasted 45 minutes.
“(The seniors) were asked to take 18 doses of the ‘medicine,’” Krampe said.
Each class began with the song "Tiny Bubbles." During the song, the group blew bubbles so they could start breathing deeply before starting the movement part of the class.
After the warm up, the class did dances that were specially choreographed to be done sitting or standing. Participants cooled down with sharing time and a sing-a-long to “I Hope You Dance.”
“I landed on this particular type of dance because it works so well with older people,” Krampe said. “I knew I’d use a method that would be safe and not harmful to them.”
Building from the past
Sherry Lebed Davis, president of Healthy-Steps, who is based in Lynnwood, Wash., said Krampe’s research is vital to the senior community.
“If you can take a program that will significantly change seniors’ quality of life and extend their time to live, why wouldn’t you?” she said.
Davis and her two brothers founded the program. In 1980, their mother was diagnosed with breast cancer, and after going through surgery, she had severe loss of range of motion and went into a depression.
Davis started as a professional dancer and became a dance movement therapist. Her two brothers were, and still are, OB-GYN physicians and surgeons. With these backgrounds, they developed the Lebed Method, now called Healthy-Steps.
“It was put together to help people get better emotionally and to relieve depression, stress and anxiety,” Davis said. “It was put together to help people improve their balance, range of motion, strength, flexibility and their transition of steps.”
The first program started at the Albert Einstein Medical Center in Philadelphia where Davis’ mother had surgery. The surgeon wanted every breast cancer patient in his hospital to go through the program, Davis said.
After People magazine published a story about the method in 2000, Healthy-Steps went international and was applied to other diagnoses. More than 900 hospitals in 14 countries use the program, along with other facilities around the world, like wellness centers, assisted living centers and cancer centers.
The method has been used to improve the well being of people with chronic illnesses and other conditions. For people with lymphedema, a swelling anywhere in the body, Healthy-Steps helps reduce fluid build-up through the movements.
For seniors, Healthy-Steps helps prevent falls by focusing on certain movements that increase gait and balance. According to the Centers for Disease Control and Prevention, one-third of adults age 65 and older will fall each year, and two million will be treated in emergency departments for fall injuries that can be detrimental to their health.
Krampe continues to research Healthy-Steps and is meeting with facilities in St. Louis to help set up more dance therapy programs.
“What we need to do now is build the evidence,” Krampe said. “Ultimately we need large studies to demonstrate that this really does make a difference in balance and mobility.”