Indian aesthetic dance and yoga improves mental health among caregivers of children with neurodevelopmental disorders: a randomized trial

Jayashree R. Hegde, Sridhar K. Melukote, T. M. Srinivasan, Deepeshwar Singh


Background: This study aimed to assess the effects of Indian aesthetic dance (IAD) and yoga on psychological behavioral and mental health-related problems among the caregivers of children with neurodevelopmental disorders (NDDs).

Methods: One hundred one caregiver participants were randomly allocated to either intervention of IAD or a structured yoga program or in a control group. The invention groups received supervised eight-weeks IAD or yoga training for 3 alternative days, 75 min each day. In total, 96 subjects completed the study with after high adherence of 95% to intervention sessions. Caregivers were assessed with self-rated primary measures including the Zarit burden scale (ZBS), depression, anxiety, and stress (DASS-21) scale; and secondary measures were revised caregiver’s appraisal scale (RCAS) and WHO Quality of Life WHOQOL (BREF) scale. The assessments were done at pre (1st day), mid (ENT of 4th week), and post (end of 8th week) of interventions.

Results: Statistical analysis showed there was a significant reduction in scores of ZBS (p<0.001), DASS-21 (p<0.001), and significant improvement was found in the subscales of RCAS and WHOQOL (BREF) (p<0.001).  

Conclusions: The outcome of the study suggests that IAD and Yoga can be feasible interventions for alleviating symptoms of mental health-related issues among caregivers.


Caregivers, Dance, Mental health, Neurodevelopmental disorders, Yoga

Full Text:



Moritz DJ, Fox PJ, Luscombe FA, Kraemer HC. Neurological and psychiatric predictors of mortality in patients with Alzheimer disease in California. Arch Neurol. 1997;54(7):878-85.

Arora NK, Nair MKC, Gulati S. Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India. Persson LA, ed. PLOS Med. 2018;15(7):1002615.

Abbeduto L, Seltzer MM, Shattuck P, Krauss MW, Orsmond G, Murphy MM. Psychological Well-Being and Coping in Mothers of Youths with Autism, Down Syndrome, or Fragile X Syndrome. Am J Ment Retard. 2004;109(3):237.

Peckham A, Spalding K, Watkins J, Barrett BC, Grasic M, Williams AP. Caring for Caregivers of High-Needs Children. Healthc Q. 2014;17(3):30-5.

Pinquart M, Sorensen S. Differences between caregivers and non-caregivers in psychological health and physical health: A meta-analysis. Psychol Aging. 2003;18(2):250-67.

Levallois S. The health and well-being of caregivers of children with cerebral palsy. In: Orthopedic Management of Children with Cerebral Palsy: A Comprehensive Approach. 2015:611-8.

Ambikile JS, Outwater A. Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam-Tanzania. Child Adolesc Psychiatry Ment Health. 2012;6:16.

Gillick MR. The Critical Role of Caregivers in Achieving Patient-Centered Care. JAMA. 2013;310(6):575.

Baruch E, Pistrang N, Barker C. Psychological interventions for caregivers of people with bipolar disorder: A systematic review and meta-analysis. J Affect Disord. 2018;236:187-98.

Aithal S, Karkou V, Kuppusamy G, Mariswamy P. Backing the backbones - A feasibility study on the effectiveness of dance movement psychotherapy on parenting stress in caregivers of children with Autism Spectrum Disorder. Arts Psychother. 2019;64:69-76.

Manmohan Ghosh. Natya Shastra Ascribed to Bharat Muni. Vol II. The Asiatic Society, Culcutta, India; 1961.

Rasa. Abhinavagupta on the Purpose (s) of Art. Natyasastra Anthol New York McFarland. 1994:72-88.

Paranjpe AC. In Defence of an Indian Approach to the Psychology of Emotion. Psychol Stud (Mysore). 2009;54(3):22.

Chakravorty P. Dance, Pleasure and Indian Women as Multisensorial Subjects. Vis Anthropol. 2004;17(1):1-17.

Milbury K, Liao Z, Shannon V. Dyadic yoga program for patients undergoing thoracic radiotherapy and their family caregivers: Results of a pilot randomized controlled trial. Psychooncology. 2019;28(3):615-21.

Milbury K, Mallaiah S, Mahajan A. Yoga Program for High-Grade Glioma Patients Undergoing Radiotherapy and Their Family Caregivers. Integr Cancer Ther. 2018;17(2):332-6.

Khalsa SBS. Treatment of Chronic Insomnia with Yoga: A Preliminary Study with Sleep? Wake Diaries. Appl Psychophysiol Biofeedback. 2004;29(4):269-78.

Lima CD, Brown LE, Wong MA. Acute Effects of Static vs. Ballistic Stretching on Strength and Muscular Fatigue Between Ballet Dancers and Resistance-Trained Women. J Strength Cond Res. 2016;30(11):3220-7.

Subrahmanyam P. Karanas. 1st ed. Nrithyodaya, Chennai, India; 2003.

Limpawattana P, Theeranut A, Chindaprasirt J, Sawanyawisuth K, Pimporm J. Caregivers Burden of Older Adults with Chronic Illnesses in the Community: A Cross-Sectional Study. J Community Health. 2013;38(1):40-5.

Cox BJ, Antony MM, Enns MW, Swinson RP, Bieling PJ. Psychometric properties of the 42-item and 21 items versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 2005;10(2):176-81.

Farhadi A, Foroughan M, Mohammadi F. Validity and reliability of the Persian version of the revised caregiving appraisal scale in Iranian family caregivers of older adults with dementia. Iran Red Crescent Med J. 2017;19(1):1-9.

Lingjiang L, Derson Y, Shuiyuan X, Xiao Z, Liang Z. Psychometric properties of the WHO Quality of Life questionnaire (WHOQOL-100) in patients with chronic diseases and their caregivers in China. Bull World Health Organ. 2004;82(7):493-502.

FAH Facilitation Techniques in Therapeutic Exercise; 1978:110-178.

Puymbroeck VM, Payne LL, Hsieh PC. A phase I feasibility study of yoga on the physical health and coping of informal caregivers. Evid Based Complement Alternat Med. 2007;4(4):519-29.

Sanchez FH, Hernandez CBE, Sidani S, Osorio CH, Contreras EC, Mendoza JS. Dance Intervention for Mexican Family Caregivers of Children with Developmental Disability: A Pilot Study. J Transcult Nurs. 2020;31(1):38-44.

Collins C. Yoga: Intuition Preventive Medicine Treatment. J Obstet Gynecol Neonatal Nurs. 1998;27(5):563-8.

Bernardi MLD, Amorim MHC, Salaroli LB, Zandonade E. Effects of Hatha Yoga on caregivers of children and adolescents with cancer: a randomized controlled trial. Esc Anna Nery. 2020;24(1).

Li AW, Goldsmith CAW. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.

Sibia A, Misra G. Understanding Emotion. In: Handbook of Psychology in India; 2011:286-298.

Rehfeld K, Luders A, Hokelmann A. Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One. 2018;13(7).

Lopez G, Chaoul A, James PC. Group Yoga Effects on Cancer Patient and Caregiver Symptom Distress: Assessment of Self-reported Symptoms at a Comprehensive Cancer Center. Integr Cancer Ther. 2018;17(4):1087-94.

Horwitz EB, Theorell T, Anderberg UM. Fibromyalgia patients’ own experiences of video self-interpretation: A phenomenological-hermeneutic study. Scand J Caring Sci. 2003;17(3):257-64.

Evans S, Cousins L, Tsao JCI, Sternlieb B, Zeltzer LK. Protocol for a randomized controlled study of Iyengar yoga for youth with irritable bowel syndrome. Trials. 2011;12(1):15.

Meeusen R, Roeykens J, Magnus L, Keizer H, Meirleir DK. Endurance Performance in Humans: The Effect of a Dopamine Precursor or a Specific Serotonin (5-HT 2A/2C) Antagonist. Int J Sports Med. 1997;18(08):571-7.

Jeong YJ, Hong SC, Myeong SL, Park MC, Kim YK, Suh CM. Dance movement therapy improves emotional responses and modulates neurohormones in adolescents with mild depression. Int J Neurosci. 2005;115(12):1711-20.

Manincor DM, Bensoussan A, Smith CA. Individualized Yoga for Reducing Depression and Anxiety, and Improving Well-Being: A Randomized Controlled Trial. Depress Anxiety. 2016;33(9):816-28.

Lewis C, Annett LE, Davenport S, Hall AA, Lovatt P. Mood changes following social dance sessions in people with Parkinson’s disease. J Health Psychol. 2014;21(4):483-92.

Hackney ME, Earhart GM. Effects of dance on movement control in Parkinson’s disease: A comparison of Argentine tango and American ballroom. J Rehabil Med. 2009;41(6):475-81.

Valla JM, Alappatt JA, Mathur A, Singh NC. Music and Emotion: A Case for North Indian Classical Music. 2017;8:1-9.

Deng W, Aimone JB, Gage FH. New neurons and new memories: How do adult hippocampal neurogenesis affect learning and memory. Nat Rev Neurosci. 2010;11(5):339-50.

Gage FH. Mammalian Neural Stem Cells. Science. 2000;287(5457):1433-8.