Elsevier

The Arts in Psychotherapy

Volume 70, September 2020, 101685
The Arts in Psychotherapy

Research Article
Prenatal vestibular stimulation as dance (VES-D) program: A mixed methods feasibility study

https://doi.org/10.1016/j.aip.2020.101685Get rights and content

Highlights

  • Feasibility study of prenatal dance program on low-risk pregnant women.

  • Dance classes informed by Laban theory and movement fundamentals.

  • Mothers reported qualitative benefits and acceptability of dance program.

  • Newborns’ looking time is a suitable outcome measure of attention.

  • Administration of home infant lab determined to safe and efficient.

Abstract

This study used a mixed-methods design to examine the acceptability of a dance program for pregnant women, the feasibility of conducting home-based assessments of newborn infants using a non-invasive attention task, and the suitability of the outcome measure. Prenatal vestibular-stimulation-as-dance (VES-D) was informed by Laban movement theories, modern dance technique, and pregnant hunter-gatherer’s activity patterns. Five pregnant women completed the VES-D program and participated in semi-structured interviews that explored their attitudes, expectations, and cultural beliefs before and during the dance program. Between nine and 11 days post-birth, the adult participants’ five newborn infants completed a home-based visual attention task that measured looking time and eye shifts using direct and averted gaze face stimuli. Adult participants reported the dance program was relaxing, enjoyable, and beneficial for both themselves and for their fetus. All infants showed habituation of the non-face stimulus and reorientation to the face stimulus for a mean time of 36 s, establishing looking time as a suitable outcome measure. Gaze preference based on infants’ pupil shifts was not determined to be a suitable outcome measure of attention. Administration of a home infant lab enhanced the ecological validity of the study design.

Introduction

Prenatal influences on human development have been studied across multiple disciplines including obstetrics, nursing, pediatrics, neurology, and psychology. Research designs examining proximal outcomes abound in the extant literature, where death and disease are plausible alternative outcomes (Conley, Strully, & Bennett, 2006; Jaakkola & Gissler, 2004; Khandaker, Zimbron, Lewis, & Jones, 2013). Distal outcomes are prevalent in studies examining the relationships between prenatal factors (e.g., stress, anxiety, and deprivation) and a child’s behavioral and academic performance (Almond, Mazumder, & Van Ewijk, 2011; Kingston & Tough, 2014; Shen et al., 2016). Noticeably, a gap exists in the inquiry of prenatal contributors to an infant’s nascent attention development, with methodological challenges contributing to this dearth. Recent findings in neurobiology and neurophysiology have implicated the vestibular system as a prominent but formerly overlooked influence on multiple cognitive processes, including memory, attention, and social cognition (Deroualle et al., 2015; Lopez, 2016; Palla & Lenggenhager, 2014). Because fetal vestibular activity is experienced abundantly in prenatal life—both passively by way of the mother’s movements and actively as fetal motoric patterns begin to organize—it is plausible that prenatal vestibular stimulation can yield proximal outcomes in newborn infants’ attentional capacities believed to underlie social cognition development.

Methods of vestibular stimulation used in clinical, therapeutic, and, more recently, neuroscientific contexts include caloric and galvanic stimulation of the vestibular organs in the ears as well as mechanical stimulators, such as rotating chairs and displacing platforms (Palla & Lenggenhager, 2014). Dance as a form of naturalistic vestibular conditioning has been studied as a contributor to improved balance, posture, and stability in groups of dancers compared to non-dancers (Oliveira-Barreto et al., 2017). Moreover, a retrospective study of mothers who had danced during pregnancy examined the sleeping behaviors and musical preferences of their children at infancy and again during middle childhood (Bellieni, Cordelli, Bagnoli, & Buonocore, 2004). To date, no research exists that uses dance as an independent variable from which to examine the relationship between prenatal vestibular stimulation and neonatal attention. The feasibility of designing a study that incorporates innovative methods in two sensitive environments—pregnancy and neonatal life—has not been established, suggesting there is a need to assess the acceptability and feasibility of noninvasive measures and procedures. Mixed-methods research designs are well-suited to explore the complex physical, social, and emotional contexts (Tashakkori & Teddlie, 2010) in which pregnant women find naturalistic dance-based prenatal vestibular stimulation safe, enjoyable, and beneficial to their well-being and that of their unborn children. The present study uses a mixed-methods design to examine the feasibility of undertaking a dance program for pregnant women and the feasibility of conducting out-of-hospital assessments of 9- to 11-day-old neonates using a non-invasive attention task.

Section snippets

Prenatal exercise and child outcomes

A small body of literature has addressed the possible impact of prenatal non-dance exercise on fetal and child neurocognitive development (Álvarez‐Bueno et al., 2017; Domingues et al., 2014; Labonte-Lemoyne, Curnier, & Ellemberg, 2017; Niño Cruz, Ramirez Varela, da Silva, Hallal, & Santos, 2018) as measured by IQ tests, language skills measures, developmental inventories, and fetal EEGs. In a literature review of empirical studies documenting the effects of exercise during pregnancy on various

Sample and setting

A purposive sample of five mothers and their five infants (N = 10) was recruited from a birthing center and a local university in the U.S. Southwest. The birthing center is staffed by certified nurse midwives who provide onsite prenatal healthcare and non-surgical birthing care. The researcher was allowed to approach birthing center patients with an information flyer and place recruitment flyers at the reception desk. Additionally, a recruitment email was sent out to the all graduate,

Demographics and pregnancy history

Table 1 summarizes the demographic characteristics and pregnancy history of the adult subsample (n1 = 5). All but one participant was over the age of 30 years at the start of the study (mean age = 31.2 years), indicating the sample was substantially older than the average age (26.3 years) of women who gave birth in the United States in 2014 (Matthews & Hamilton, 2016). All participants were in heterosexual marriages, and four participants were already parenting one biological child. The small

Discussion

The present paper describes the acceptability of a prenatal vestibular-stimulation-as-dance (VES-D) program on five pregnant women and the suitability and feasibility of a perceptual-based eye gaze task administered on five newborn infants in a home-based lab. The experience of participating in the dance-based sessions was reported as positive for the five adult participants and supported by high attendance rates and qualitative descriptions of perceived benefits to their own health as well as

Funding

This work was supported by the Mathes Family Scholarship Fund and the Delta Pilots Charitable Fund.

Declaration of Competing Interest

None.

Acknowledgements

Thank you to the mothers and infants who participated in this study. The author wishes to acknowledge the following individuals for their support with the research design and proof reading the manuscript: Dr. Jakob Vingren, Dr. Rebecca Glover, Dr. Cynthia Frosch, and Jon Greuel.

References (55)

  • C. Álvarez‐Bueno et al.

    Pregnancy leisure physical activity and children′ s neurodevelopment: A narrative review

    BJOG: An International Journal of Obstetrics & Gynaecology

    (2017)
  • American College of Obstetricians and Gynecologists

    Exercise during pregnancy and the postpartum period

    Clinical Obstetrics and Gynecology

    (2003)
  • M. Arain et al.

    What is a pilot or feasibility study? A review of current practice and editorial policy

    BMC Medical Research Methodology

    (2010)
  • H. Ballieux et al.

    Feasibility of undertaking off-site infant eye-tracking assessments of neuro‐cognitive functioning in early-intervention centres

    Infant and Child Development

    (2016)
  • C.V. Bellieni et al.

    11-to 15-year-old children of women who danced during their pregnancy

    Neonatology

    (2004)
  • G. Borg

    Borg’s perceived exertion and pain scales

    (1998)
  • D.T. Campbell et al.

    Experimental and quasi-experimental designs for research

    Handbook of research on teaching

    (1963)
  • S.G. da Silva et al.

    Maternal exercise during pregnancy increases BDNF levels and cell numbers in the hippocampal formation but not in the cerebral cortex of adult rat offspring

    PloS One

    (2016)
  • M.D. de Hevia et al.

    Representations of space, time, and number of neonates

    Proceedings of the National Academy of Sciences of the United States of America

    (2013)
  • C. Dell

    A primer for movement description using effort-shape and supplementary concepts

    (1970)
  • M.R. Domingues et al.

    Physical activity during pregnancy and offspring neurodevelopment and IQ in the first 4 years of life

    PloS One

    (2014)
  • K.R. Evenson et al.

    Leisure time physical activity among pregnant women in the US

    Paediatric and Perinatal Epidemiology

    (2004)
  • T. Farroni et al.

    Eye contact detection in humans from birth

    Proceedings of the National Academy of Sciences of the United States of America

    (2002)
  • T. Farroni et al.

    Newborns’ preference for face-relevant stimuli: Effects of contrast polarity

    Proceedings of the National Academy of Sciences of the United States of America

    (2005)
  • O.M. Hellenes et al.

    Regular moderate exercise during pregnancy does not have an adverse effect on the neurodevelopment of the child

    Acta Paediatrica

    (2015)
  • J.J. Jaakkola et al.

    Maternal smoking in pregnancy, fetal development, and childhood asthma

    American Journal of Public Health

    (2004)
  • G.M. Khandaker et al.

    Prenatal maternal infection, neurodevelopment and adult schizophrenia: A systematic review of population-based studies

    Psychological Medicine

    (2013)
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